Important issues in the care and evaluation of bilingual/multilingual children

The number of children in the United States who are bilingual or multilingual is both significant and increasing. Pediatricians, physician assistants, and nurse practitioners need to understand the processes of language development in bilingual children in order to support the families of bilingual children, provide accurate educational information, and prevent potential of misdiagnoses in these children as having such conditions as mental retardation, learning disabilities, or speech-language disorders. Evaluation of a child's development begins with a careful review of home, social, educational environments, and medical history. Gathering an accurate history may require the use of resources such as an interpreter, social worker, education consultant, psychologist, or speech-language pathologist. Pediatricians, physician assistants, and nurse practitioners can have a positive impact on the educational and heath care environment of these children by using this information, assessing the development of these children, and by sharing their knowledge with others who play a role in the lives of these children. Bilingualism/multilingualism does not lead to ongoing language delays. Bilingualism/multilingualism can play a positive role in a child's emotional development. In families that place a high value on tradition, speaking the language of parents and grandparents offers a way for the child to better understand the family's heritage even though it is not the dominant language of the child's environment outside the home. Speaking the language of a surrounding culture also provides insights into that culture. Bilingualism is an important resource; it has the potential to increase employment and offer other opportunities in the child's future especially in this rapidly globalizing world.