In the preschool years, all children develop language skills. Over the last 70 years, many studies have indicated this is the area where twins and higher multiples are most likely to be different from single-born children. Thus, language is the main focus of this section. Delays in language have complex and wide-ranging implications for children’s development. Multiples may be behind singletons in their articulation and in their ability to express themselves. Their sentences may be shorter and baby talk may persist longer. They are usually much less delayed in their receptive skills. That is in their knowledge of vocabulary and their ability to comprehend what is said to them. Therefore if multiples have very poor speech, don’t dismiss this potential problem because their vocabulary is good and they understand what you are saying.
We emphasize that problems in speech and language do not necessarily imply any intellectual delay in twins. In areas of ability that does not depend upon language, multiples and single-born children do equally as well. Thus there may be difficulties in school achievement and a slightly greater chance of Reading Disability.
However, consider just how many abilities do relate to language in twins. Words are symbols for objects and multiples may be delayed in other areas involving symbols. By two years children should be starting symbolic play where for example a cardboard box may symbolize a house or a car. The delays of multiples can extend to how their play develops and sometimes this is complicated by delays in fine-motor coordination. Preschool teachers report multiples may be delayed also in social maturity both in their behavior towards the teacher and towards the other children.
This pattern of delays in language, in play, in social maturity, and in fine-motor skills is much more consistent in twins than in single-borns. Unlike twins, single-borns may have a delay in one of these areas but not the others. This difference needs to be borne in mind when planning an intervention. For example, one of our studies in Australia considered whether twins would benefit from being with other children in a playgroup for three-year-olds. The twins who benefited from this were those already fairly advanced in their language. Because of their delays in other areas as well as language, the less mature twins remained isolated from the other children.
The conventional explanation of delays in twins focuses on their unique social situation. However recent studies have shown that some of the birth complications so common in multiples may best indicate which twins will have these language problems. One particular problem is Intrauterine Growth Retardation (“Small for gestational age” where multiples may not be very premature but have ceased to grow so well in the last few weeks before birth). It may be useful for the preschool teacher to know about this, especially if the multiples are still being seen regularly by a hospital or pediatrician as often happens if they were premature.
(i) It is still worth considering in detail the ways in which the social circumstances of preschool multiples are different. There are three main ways in which acquiring language is different for twins and higher multiples:
(ii) Parents are busier with two or more children the same age to care for and have less time to help them develop language skills. This means they may answer the children’s questions more briefly, engage in less dialogue with just one child, brush over mispronunciations and generally have less time to be a good model for adult language. It does mean the children are better at understanding when something is said quickly!
(iii) The multiples are so familiar with each other’s wants and body language that they may not need proper language to communicate. Sometimes they develop their own form of communication, the so-called “secret language” or cryptophasia which only they can understand. This idea of a unique language sounds very mysterious and romantic but is much less common in a fully developed form than the literature on twins would suggest. Any children who can come up with their own grammar and vocabulary must have very advanced language skills! More often it is not a secret language but a set of idiosyncratic manipulations of English, such as changing the first letter of every word to “b”. The problem with such a form of communication is that it is fine at home where people are used to it, but is not adaptive in the wider world.
(iv) Multiples may compete with each other for adult attention. They often speak loudly and simply to get the attention of an adult and often interrupt each other’s conversation. Again, the way they speak may be highly adaptive for this situation but not for life outside the home.
A classic neurological study is of the two-year-old twins who suddenly kept on falling down. What happened was that one worked out that if he fell down, he would get rapid attention and a cuddle. The other one identified this strategy and within two days they were falling like flies…So what does the parent do-and it did not need the neurologist?
There are two phrases about multiples that are so often heard in preschool and school. Even though these are well-intentioned to alleviate parents’ concerns, they are totally wrong. These are:
“Don’t worry-all twins are like that”
This is often applied to the delays in language and reading that are unfortunately more common in twins. However, the fact that more twins have speech problems does not mean that all twins have such problems. Problems are less likely in girls than boys, but even among boys, there are many who do well and experience no difficulties with any aspect of their speech and language. In any case, even if problems are more common in twins, that is no reason for failing to do something about them.
“Don’t worry they will grow out of it”
The error of this statement lies in the potential long-term effects of early language delays. While language undoubtedly improves, delays may continue in more subtle forms in such language-based activities as reading, spelling, and writing. Indeed, the connection between early delays in language and later delays in reading is much stronger in twins than in single-born children. Thus, dismissing the problem as being only temporary is not helpful for twins in the long-term.
It can be difficult to decide where professional help is needed. Take the example “cat.”
The young (2-3-year-old) developing normally may simplify this to “tat”
The four-year-old with a speech disorder may simplify their speech to “tat”
It is, however, unusual to say “at” in this context. This error pattern is not characteristic of younger children.
Early assessment, and intervention if appropriate is essential in order to support the learning and progress of multiples.
(i) Make a special effort to listen to their early speech and reading on a one-to-one basis or find some other adult such as a grandparent who can help with this. Try sometimes to organize activities like feeding or bathing with just one child, where you can enjoy the language interactions with one and not with them all. Of course, the multiples may not want this, but learning to take turns is fundamental to a civilized conversation! Think carefully before getting an older brother or sister to help in this, both because their own language may not be fully mature and they have probably already had enough impact on their life, without creating what may be seen as yet another chore.
(ii) Multiples are “cute” and can achieve popularity despite poor language skills. Find ways of ensuring they understand that better speech will help them to have even better interactions with others. Sometimes articulation problems such as lisping can get them even more attention, and this is obviously to be discouraged in the listeners as well as in the children!
(iii) Don’t let one twin speak for both. If one twin asks for a drink, don’t automatically get one for the other child as well until they ask. Try to address the twins individually-you know you are not doing too well if one twin is asked his name and says, “Michaelandjohn”… This becomes even more of an issue in higher multiples, as the chances are greater that there will be significant differences in speech and language.
One mother only realized there was a problem when a grandparent pointed out to her that she was asking the one girl in a set of three-year-old triplets, “What are your brothers trying to say?”. The sister was so tuned into her brothers and their language idiosyncracies that she could “translate” for her mother.
(iv) Don’t encourage interrupting or other language or behavior designed to get attention away from the other twin. While few parents would do this consciously, every time, you respond to this approach you are encouraging its recurrence in both twins. Multiple children need to learn two things more than other children, namely to wait and to take turns.
(v) Do not forget other children in the family. If twins are delayed because they have had such an impact on the family situation, then one would expect that brothers and sisters close in age to the twins also may suffer.
Fortunately, most multiples have no difficulty, and this question should not arise. There are two circumstances when the proper assessment of speech and language should be sought:
(i) If the child is embarrassed and disturbed by his/her speech at any age.
(ii) If you as the parent or teacher are concerned. It is always better to be safe than sorry, and you have a right to have any fears taken seriously.
The accompanying checklist is a basic guide to children’s speech development that will help you decide if a professional assessment is needed. It is not an absolute test. If multiples are only a little way behind the expected level, do not worry. If they are significantly behind, it is worth contacting a speech therapist for a formal assessment and an evaluation of whether they do need therapy. It is worth finding out if the therapist has worked before with twins and discussing the special issues that may arise. For example, if only one child is getting therapy, he/she may be upset at being singled out-or the other multiples may be upset at missing out on something new! All the work by the therapist and the parents may be in vain because of the interactions between the multiples continuing their old and incorrect speech.
Click here to download: Speech and Language Checklist (Word Document)
Click here to download: Speech and Language Checklist (PDF Document)