Language development in twins and multiples

Author: Amber Hort, Speech Pathologist, Nest Therapy Services

While there is lots of variation in language development for all children, research shows that language development in twins and multiples tends to take longer than their singleton peers and siblings to develop. Male multiples tend to be most at risk for language delays, often being around 6 months behind female multiples, and communication delays are more common in identical twins (suggesting there is a genetic link!). However, there are supports available!

What is a language delay?

A language delay may look different in each individual. It may be:

• Meeting language milestones later than their peers
• Using shorter utterances (phrases/sentences)
• Generally communicating less than peers
• Understanding less/requiring more support to follow instructions

There are several other factors which may be involved. Some multiples may develop their own ‘twin language’ – which is generally thought to be immature speech patterns which they understand (and we don’t!). They often become so effective at communicating with their siblings that their overall communication development can be delayed. There is also often a ‘dominant’ multiple who will speak on behalf of their siblings (or older siblings who will speak on behalf of younger siblings!).

While most multiples will eventually ‘catch up’, language difficulties have been linked with delays in overall development and future academic outcomes, so the old ‘wait and see’ approach is generally not recommended by speech pathologists (though many doctors and nurses will still suggest this). Early Intervention is best! Unfortunately, therapists are unable to tell which children may catch up without support, and which children will fall further behind, so getting support early is key.

Language development in twins and multiples. Why are multiples more at risk?

There are many reasons multiples are at a greater risk of delayed language (and overall development), including prematurity and low birth weight. In addition, multiples generally have a different social and language experience to their peers – they have to share the attention of their caregivers, resulting in less one on one time and overall less language stimulation. In addition, conversations are generally more a three (or four or five) way conversation, rather than one on one.

What supports are available, and how do you access them?

The first step is identifying the delay! If you have concerns about your child’s communication, a Speech Pathologist is your best point of contact. You don’t require a referral to see a speech pathologist, however you may be eligible for a Medicare rebate with a referral from a GP. Depending on your Private Health Insurance cover, you may be eligible for some rebates.

It is always great to discuss your concerns with your GP or Child Health Nurse, however please remember that you know your child best – if you have concerns, even if a GP/CHN/family and friends dismiss them, you can still access an assessment – the worst that can happen is being told that there are no concerns! Early intervention is best, and generally reduces the amount of ongoing supports required.

Services available to assist with language development in twins and multiples

(Please note, I am based in QLD, so the terminology may be different across the country!)

Private Therapists

Private speech pathology services are available to all families, however there is a cost involved (and often a waiting list). If you wish to access private services, it is recommended to go on a waiting list sooner rather than later (you can always decline an appointment when it becomes available if you no longer have concerns). As above, there may be rebates available through Medicare or private health. Some services may offer group based programs (often run for parents to support you to support your child) – this is often a cheaper option. To find a speech pathologist, search for ‘speech pathologist + (your location) or use the Speech Pathology Australia ‘find a speech pathologist’ page

Early Childhood Early Intervention (ECEI) through the National Disability Insurance Scheme (NDIS)

The NDIS funds early childhood supports through their ECEI program. The ECEI partners are organisations in each area who are funded to provided supports in early childhood. You do not need a referral to access these services, however they are only able to provide limited supports, generally to children who require supports across multiple domains (e.g. communication, play, movement).

Contact your local ECEI partner HERE for more information.

Child Development Program

There are limited community health supports available since the introduction of the NDIS. The Child Development Program is a program that a GP or paediatrician can refer your child to if they believe there are delays. Please note, they are only able to provide short term assessment and supports, not ongoing therapy, and you may be waiting up to a year for an assessment.

Discuss with your GP for more information.

Language development in twins: Supporting early communication development

While multiples are more likely to have a language delay, there are things you can do at home to support their communication:

• Spend some individual time talking with each child (while daily is recommended, as a POM I usually recommend whatever is possible – that may be 10 minutes a day, or a larger chunk of time a couple of times a week!)
• Reduce the amount of background noise (e.g. tv/radio) encourages children to make their own noise, and encourages concentration and engagement
• Sing nursery rhymes and reading books (if you’re able to read books 1:1 this is encouraged, however is never possible in my house – they always want the book the other twin has). This blog on reading to twins and triplets may help.
• Talk at a level just above their communication stage – if they are using gestures to show you what they want, label it (e.g. if they point to a book, say ‘book’; if they are using single words, expand it to a short phrase (e.g. if they say ‘more’ or ‘banana’, you say ‘more banana’)

Amber Hort

Twin Mum & Speech Pathologist

Nest Therapy Services