The language development of internationally adopted children follows a unique path compared to other children. It's important to note that children adopted from countries where English is not the primary language should not be categorized as "English as a Second Language" (ESL) learners or bilingual. In most cases, these children no longer have exposure to their first language, and English becomes their primary language. This transition, where they no longer hear their first language, is known as subtractive language or second first language acquisition.

Internationally adopted children are at higher risk for speech and language disorders for a number of reasons, for instance if they are adopted after age 3 or did not experience a language-rich environment as an infant. Additionally, they may not have received proper treatment for childhood illnesses, like frequent ear infections. Children who had been living in institutional situations may have had limited attention and interaction from caregivers, which could have impacted their overall development.

Adoptions before age 2

Most children will have communication skills that appear to be slightly behind same-age peers when they first come home. Usually, after one year, children can understand language as well as other children of the same age. It is common for children to be slightly behind in using spoken language to communicate until around the age of four. Additionally, children are anticipated to produce English sounds appropriate for their age within 1-2 years of coming home. 

Consider a speech language evaluation if your child doesn’t:

• Consistently look for you when you call their name
• Appear to understand phrases related to daily routines within the first three months of coming home; for example, “bath time” or “time for snack”
• Use gestures, such as waving “hi” and “bye,” pointing to request an item, reaching to be picked up, or letting you know they need a diaper change
• Make or imitate sounds while playing with immediate family and when alone
• Try to say English words within the first weeks and months of coming home (if at least 13 months old)
• Engage in play activities, such as playing with dolls or pretending to pour into a cup
• Make eye contact or look at your face while you are talking  

Adoptions after age 2

Children who are internationally adopted may struggle with understanding and using the language required for school success, even if they initially learned language quickly after coming home. Older adopted children may face more challenges in school because they have less time to learn English before starting.

If you're concerned about your child's ability to follow directions, understand written or spoken material, or grasp the higher-level language used in school, it's recommended to have a speech and language evaluation.

If your child is having specific difficulties in school, such as with writing or reading, or if there are concerns about attention, hyperactivity, or anxiety, additional testing like a neuropsychological or psychoeducational evaluation may be needed.

Consider a speech language evaluation if:

• You are concerned about your child’s skills upon coming home
• Your child has a known medical or genetic condition that will affect speech, language, or cognitive development, such as cleft lip and palate, cerebral palsy, or autism spectrum disorder
• You have any questions about speech or language development
• All children who are internationally adopted should have a hearing test. To schedule an appointment at a CHOP location, contact the Center for Childhood Communication

To schedule an evaluation with a speech-language pathologist call the Center for Childhood Communication at 1-800-551-5480. Please specify whether your child has been evaluated by the International Adoption Health Program.

Reviewed on August 1, 2023, by Kimberly Bradley, MS, CCC-SLP