A five-year-old boy named Arman sits across from a speech pathologist in a tiny therapy room outside of Chicago. He speaks three languages: English in preschool, Urdu at home, and a little Punjabi with his grandmother. He mimics noises. He pauses in the middle of his sentence. He clearly looks for the correct word and switches to another language when he can’t find it in the first. His mom is concerned. The clinician notes “stuttering.” For years, the label remains in place.
Arman’s story is not uncommon. In cities where bilingual households are now commonplace rather than uncommon, they are the typical background noise of speech therapy. Roughly one in seven Americans speak a language other than English at home, according to recent U.S. Census data. That equates to about 31.8 million people, and at least 500,000 of them are bilingual stutterers. The numbers have a clear sound. Clinical reality is quite different.
It was widely believed for a long time that being bilingual was a risk factor for stuttering. It wasn’t a novel concept; for decades, it influenced the counsel that medical professionals provided to immigrant families, appeared in textbooks, and was reiterated in parent handouts. Sometimes, parents were quietly advised to stop speaking a language. For the time being only. Until the child is older, that is. That suggestion carries a certain kind of heartache, and it’s difficult to ignore how frequently it fell on families who already felt alienated.
It turns out that the confidence behind the research was stronger than the research itself. An unsettling finding from a more recent analysis of the Early Childhood Longitudinal Study, a database that tracks almost 18,000 American children, is that a large portion of what was reported as stuttering may not have actually been stuttering at all. When asked if their child had “a problem with stuttering,” parents and educators were not given a definition, clinical framework, or explanation of what the term even meant. After all, “stutter” is still regarded by the dictionary as a loose synonym for halting speech. That’s what was frequently reported.
This is significant because bilingual kids create what speech scientists refer to as “mazes,” which are brief pauses in which a child reaches for a word, repeats it, stops, and then starts again. The boy lost his frog. He failed to locate him. These mazes can sound exactly like the early signs of a fluency disorder to an untrained ear, especially a weary teacher’s ear after a long day. They’re not. They are frequently the audible result of a developing brain juggling two grammars simultaneously.
Reading the research gives the impression that the field has been subtly correcting itself without explicitly stating so. According to recent studies, stuttering is not caused by speaking two languages at home from birth. Additionally, unless the child’s first language is already weak, teaching a second language between the ages of three and six does not consistently cause it. More commonplace things like code mixing, longer sentences, and the discrepancy between a child’s vocabulary and what they want to say can cause a brief increase in disfluency. These are not diseases, but rather growing pains.
Though gradually, the recommendations for treatment have changed in line with this. In order to compare disfluencies between the two languages and treat in the stronger language first, clinicians are now advised to take a language sample before making a diagnosis. It seems like common sense. That wasn’t how it was always done.
It’s amazing to see how much of the early assurance regarding stuttering and bilingualism was based on data that wasn’t really developed for the question. The wrong questions were asked in surveys. There were no definitions. Background noise was used to describe cultural context. Additionally, the cost was borne by bilingual kids, who are the least likely to be heard correctly in the first place.
Over the years, it’s still unclear how many children were overdiagnosed or underdiagnosed because their true stutter was obscured by presumptions about “just being bilingual.” Both mistakes were made. Both continue to occur. The field is catching up. The majority of families have been waiting.
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