Families raising bilingual preterm toddlers often hear mixed messages: keep both languages, switch to English, simplify input, or wait and see. Recent research gives a more careful answer. Bilingual exposure by itself was not shown to delay language development in one 2026 study of preterm toddlers, but assessment age, number of home languages, testing language, and family context can affect scores and interpretation.
That distinction matters because preterm children are already more likely to receive developmental follow-up, and bilingual families may face extra pressure to justify normal family language use. The evidence does not support blaming two-language exposure alone for every low score. It does support asking better questions about how a child is being assessed, which languages are being counted, and what kind of support fits the family’s daily routines.
What Research Says About Bilingual Preterm Toddlers
What The 2026 Study Found
A study published on September 9, 2026, in the Journal of Developmental and Behavioral Pediatrics examined language outcomes in toddlers born preterm between 24 and 30 months. The sample included 37 toddlers: 16 English monolingual children, 16 Spanish-English bilingual children, and 5 Spanish monolingual children. Data collection took place from August 2023 through March 2025. In this sample, Spanish-English bilingual children showed language skills comparable to English monolingual preterm toddlers at 24, 27, and 30 months, using vocabulary and experimenter-administered assessments according to the study abstract.
This finding is reassuring, but it should not be stretched beyond the study design. The sample was small, and only five children were classified as Spanish monolingual. The result does not prove that every bilingual toddler born preterm will follow the same path. It does suggest that clinicians and caregivers should avoid assuming that Spanish-English exposure is harmful simply because a child was born preterm.
What Bilingual Preterm Toddlers Were Asked To Do
The 2026 study used measures across the 24- to 30-month period, rather than relying on a single snapshot. That is useful because toddler language can shift quickly, especially across the second and third years of life. A child may use one language more with grandparents, another more in child care, and a mix of both during play with siblings.
For bilingual preterm toddlers, a single-language test can miss part of the child’s communication system. A Spanish-English toddler may know a word in Spanish but not yet use the English equivalent, or the reverse. If only one language is counted, the score may look lower than the child’s total language knowledge. The 2026 study’s finding is best read as evidence against a simple “two languages cause delay” explanation, not as evidence that assessment no longer needs care.
Why Assessment Context Matters
Multiple Languages And Bayley-III Scores
A large Canadian cohort study looked at children born before 29 weeks’ gestation and assessed them at corrected age 18 to 21 months. In that cohort of 6,146 children, 44% were exposed to two or more languages at home. The study reported that exposure to multiple languages, especially more than two languages, was associated with lower Bayley-III Language Composite scores after adjustment for gestational age, developmental delays, and sociodemographic factors. For exposure to more than two languages, the adjusted odds ratio was 1.62, with a 95% confidence interval of 1.18 to 2.23 in the Canadian cohort report.
That result deserves a careful reading. It does not mean that families should stop using their languages. It means that scores at 18 to 21 months corrected age may be affected by the language environment and by how the assessment captures language knowledge. The study also controlled for several factors, but no observational study can remove every source of difference between families.
Corrected Age, Testing Language, And Interpretation
Corrected age matters in preterm follow-up because children born early are often assessed relative to the date they were expected to be born, especially in infancy and toddlerhood. The research described here focused on toddlers in early developmental windows: 18 to 21 months corrected age in the Canadian cohort and 24 to 30 months in the 2026 study. Those age ranges are not interchangeable.
A lower score at 18 to 21 months does not necessarily predict the same pattern at 30 months. A comparable score at 24 to 30 months does not erase earlier assessment concerns. Families can use these findings to ask more precise questions: Which language was tested? Was the child’s corrected age used? Were vocabulary words across both languages considered? Was the child tired, hungry, shy, or unfamiliar with the examiner?
Practical Language Support For Families
Use The Languages Your Family Can Sustain
For many families, the most sustainable language plan is the one adults can use warmly, frequently, and naturally. A parent who is most expressive in Spanish should not feel pressured to switch to less fluent English only because a child was born preterm. The studies above do not show that Spanish-English bilingual exposure itself causes worse outcomes in all preterm toddlers.
Families can also keep track of language exposure without turning home life into a test. For example, note which adults use which language, which routines happen in each language, and where the child seems most communicative. If a child says “agua” with a grandparent and “water” at preschool, both forms matter. For a related discussion of how daily exposure can shape vocabulary, see this article on bilingual vocabulary through daily language use.
Share A Clear Language Picture With Providers
Developmental visits can move quickly. A short language profile can help clinicians interpret results more fairly. Families might prepare notes on:
- which languages the child hears each day;
- which language or languages the child uses to request, protest, greet, and label;
- whether the child combines gestures, sounds, signs, or words;
- who understands the child best in each language;
- whether the assessment counted words from one language or both.
These notes do not replace a professional evaluation. They can make the evaluation more accurate. If a provider recommends speech-language support, families can ask whether the plan will respect the child’s home languages and whether progress will be monitored across real communication settings, not only in one testing session.
Families who enjoy language heritage may also appreciate reading related articles from Old Norse News, a site in the same network that delves into language and cultural history.
What The Evidence Cannot Tell Us Yet
Small Samples And Different Measures
The current evidence is helpful but incomplete. The 2026 study was small, while the Canadian cohort was large but used a different age window and assessment approach. These differences matter. A study of 37 toddlers can observe detail across repeated time points, but it cannot represent every bilingual family. A cohort of more than 6,000 children can identify broad patterns, but it may not capture every child’s total vocabulary across languages.
For bilingual preterm toddlers, the best interpretation is neither alarm nor dismissal. If a toddler has limited communication across both languages, reduced interaction, loss of previously used words, or difficulty understanding familiar routines, families should take those concerns seriously. If a toddler distributes words across two languages, that pattern alone should not be treated as proof of delay.
Correlation Is Not The Same As Cause
The Canadian study reported an association between multiple-language exposure and lower Bayley-III language scores at 18 to 21 months corrected age. An association does not prove that hearing more languages caused lower ability. Language exposure can overlap with many other factors, including immigration history, access to services, assessment language, family resources, and cultural differences in adult-child interaction during testing.
Transparency helps families make better decisions. Research can guide questions, but it cannot see every home routine. A child’s language plan should be built from developmental information, family communication needs, and careful assessment rather than fear that bilingualism is automatically too much for a preterm toddler.
Supporting Bilingual Preterm Toddlers At Home
The practical message for bilingual preterm toddlers is balanced: keep watching development, but do not blame bilingual exposure without evidence. Use the languages that connect the child to caregivers. Count communication across both languages. Ask providers how corrected age and language background were handled. Treat low scores as a reason for closer evaluation and support, not as a reason to remove a family language by default.
Parents do not need a perfect language schedule. They need responsive routines that can last: songs during diaper changes, book sharing in the caregiver’s strongest language, simple choices at meals, naming actions during play, and enough waiting time for the child to respond with a look, gesture, sound, sign, or word. These steps are not a substitute for intervention when intervention is needed. They are practical ways to keep communication active while families and professionals monitor growth.
The best reading of the research is cautious and supportive. Bilingual exposure alone was not shown to delay language outcomes in the small 2026 preterm toddler study, while broader cohort work showed that multilingual exposure and assessment context can relate to lower scores at younger corrected ages. Families deserve guidance that respects both findings: protect the child’s development and protect the child’s access to the languages of home.
