Introduction
Raising a child with Periventricular Leukomalacia (PVL) presents unique challenges on its own, but when you add bilingualism to the mix, the journey takes on additional layers. Surprisingly, despite the growing body of research on bilingualism and its cognitive, social, and developmental benefits, little to no research is available on children with PVL who are raised in two languages. As a mother of a child with PVL and mild cerebral palsy and who is committed to nurturing his language abilities among other developmental skills, I have navigated this journey largely on my own. By sharing our journey, I hope to provide insights not just for other parents in similar situations, but also for therapists and researchers exploring the potential of bilingualism for children with neurological differences.
What is PVL?
Periventricular Leukomalacia, or PVL is a type of brain injury that typically affects infants, especially those born prematurely. It causes damage to the white matter around the brain’s ventricles (fluid-filled spaces), which can disrupt the brain’s ability to communicate between different areas. This damage often affects motor functions, and in some cases, it may also impact cognitive skills, memory, and language.
PVL is commonly associated with cerebral palsy, a condition that affects muscle tone, coordination, and motor skills. However, the severity of PVL can vary widely. Some children experience only mild motor delays and no significant cognitive difficulties, while others may face more severe challenges with both movement and cognitive development. The impact of PVL depends on the extent and location of the brain injury.
The Impact of PVL on My Child’s Development
My child, who is 5 years old at this time of writing, has PVL, which has led to mild cerebral palsy, affecting various aspects of his development. Here are key areas impacted:
- Gross Motor Skills: Gross motor tasks, such as running, jumping, or descending stairs without assistance, remain challenging due to low muscle tone and impaired coordination. His low muscle tone and coordination issues also impact his balance and stability. For instance, he struggles to maintain a stable body position when sliding down a slide and lacks the core strength to go high on a swing or ride a bike.
- Fine Motor Skills: His fine motor skills are similarly affected, requiring additional time and support. Activities like using a spoon, cutting with scissors, buttoning a button, or playing simple piano keys pose a challenge for him.
- Visual Impairments: His visual processing and misaligned eyes present additional challenges, slowing his ability to track moving objects, assemble puzzles, or engage in visual search tasks. These difficulties require step-by-step guidance during certain activities.
- Speech and Tongue Control: His tongue control is also affected by PVL, leading to slower and less clear speech. Verbal communication, though achieved, requires ongoing intervention to improve his articulation and speed.
- Response Speed to Stimuli: PVL affects the efficiency of his brain’s motor and sensory pathways, leading to a slower response to stimuli. This means there is often a noticeable delay between when he perceives a stimulus and when he reacts to it. This slowness is compounded by challenges in motor planning, visual processing, and physical coordination, which make his responses appear delayed compared to his peers.
Despite these challenges posed by his PVL condition, he continues to show gradual improvement in all areas at his own pace through a variety of learning opportunities and early intervention programs.
Bilingualism and PVL
Scientific research has highlighted many advantages of bilingualism, such as enhanced executive function, better problem-solving skills, increased empathy through exposure to multiple cultures, etc. However, most of the research in this area has centered on neurotypical children and the studies conducted on premature children, who are more prone to developing PVL, have shown mixed results.
Children with PVL often face challenges like attention difficulties, slower processing speeds, and working memory limitations. These neurological differences can make managing two languages more demanding, as bilingualism requires cognitive flexibility—switching between languages and using the appropriate one in different contexts. For children with PVL, these processes may be more cognitively taxing due to the inefficiency in processing, organizing, and retrieving language information.
Bilingualism in My 5-Year-Old with PVL
Since the beginning of our bilingual journey, bilingualism has manifested uniquely for my child due to the interplay of motor, cognitive, and neurological challenges associated with PVL.
When he was first exposed to English as a second language around the age of two and a half, he had already experienced a significant speech delay among other areas of his development. However, his comprehension of Japanese indicated age-appropriate development. This was apparent based on his ability for nonverbal communication, his understanding of age-appropriate Japanese materials, and social interaction. His Japanese comprehension was largely supported by regular exposure to Japanese books, weekly early childhood education lessons, and constant verbal interaction at home.
Six months after we began our bilingual journey, he was diagnosed with PVL at the age of three. This diagnosis brought clarity to the underlying challenges he faced, but it also reinforced my commitment to providing him with bilingual education. My decision stemmed from his Japanese comprehension skills and my belief that early exposure to a second language could leverage his language strengths and cognitive adaptability.
Despite these challenges, his comprehension of English advanced rapidly through our at-home bilingual education, matching his Japanese within only a few months.
Navigating His Speech Delays and Code-Switching
The very beginning of our bilingual journey was characterized by his speech delays and his efforts to navigate two distinct languages. During that period, he relied heavily on gestures and a limited vocabulary drawn from both languages to communicate his needs. His lexical choices depended on ease of articulation. For instance, he might say, “ぼく become a ろぼっと (I become a robot)” or “これは another kitchen (This is another kitchen),” selecting words based on their ease of articulation to communicate effectively.
Code-switching, which is common in bilingual children and can occur as they navigate two linguistic systems, became a practical strategy to bridge gaps in his articulation abilities. Code-switching reflects his adaptive approach to language acquisition, leveraging strengths in both languages while compensating for speech production difficulties. Over time, this behavior evolved as his speech progressed.
Another challenge was the cognitive effort to navigate between two distinct languages. Often, he would pause and look upward, as if searching for the right words to express his thoughts. These moments revealed the mental effort needed to sort through his expanding vocabulary and select the appropriate word. This process was further complicated by delayed responses and other cognitive challenges, slowing his ability to verbalize his thoughts.
However, with consistent exposure to both languages, these pauses gradually shortened, and his ability to articulate ideas in either language significantly improved. His progress illustrates the incredible cognitive flexibility bilingualism fosters, even in the face of significant challenges.
How Bilingualism Interacted with PVL: My Son’s Case
Bilingualism has uniquely interacted with my child’s PVL, influencing his linguistic, cognitive, and emotional development in multifaceted ways.
- Auditory Processing: Despite motor challenges caused by PVL, my son’s auditory processing stands out as a remarkable strength. This advantage may have emerged because his brain, affected in other areas, channeled resources to his hearing abilities. He absorbed and retained English with surprising speed, likely building on a solid foundation of Japanese developed through years of exposure to rich, language-focused activities like reading.
- Dual Language Comprehension: Learning two languages—so distinct in structure and syntax—posed a cognitive challenge, but also an opportunity. Japanese and English require navigating vastly different grammatical rules and vocabulary systems, offering a constant cognitive exercise to his brain. My child’s ability to switch between them reflects a growing mastery of both languages.
- Cognitive Flexibility and Load: Bilingualism demanded significant cognitive effort from my son. Processing and organizing two languages required moments of pause, especially at the beginning of our bilingual journey, where he searched for the right word. Yet, over time, these pauses shortened, showcasing his growing ability to manage this dual-linguistic load. His cognitive flexibility, fostered by bilingualism, has been an asset in his overall learning and problem-solving abilities.
- Neuroplasticity: My child’s progress demonstrates the brain’s capacity to adapt, even in the context of a perinatal injury. The interplay between bilingualism and PVL has shaped his unique developmental path, highlighting both the hurdles he has faced and the strengths he has cultivated. His journey illustrates how tailored education approaches can unlock potential, even in the face of significant neurological challenges.
This interaction between PVL and bilingualism underscores the complexity of his journey, blending challenges with opportunities for growth.
Key Considerations
Several factors contributed to my son’s bilingual development despite the challenges of PVL. His birth weight of 2,362 grams and a gestational age of 34 weeks likely played a role in mitigating some of the more severe impacts often associated with very low birth weight. Additionally, the damage caused by PVL was localized primarily to the periventricular white matter, which impacts motor pathways but spared key areas responsible for auditory processing and language comprehension.
One pivotal factor was the absence of a significant language delay. While he initially experienced speech challenges, his ability to comprehend his first language emerged within a typical timeframe. This foundational strength likely provided a solid base for bilingual learning.
Another critical element was the rich linguistic environment I consistently worked hard to create. From an early age, I read countless books to him in Japanese, building his vocabulary and comprehension skills in his first language. Additionally, he attended weekly early childhood lessons, where he engaged with structured language activities, and we frequently listened to the accompanying materials at home. This consistent exposure fostered strong auditory processing skills, which I believe played a crucial role in his rapid acquisition of English later on.
His resilience and neuroplasticity also deserve recognition. The human brain, especially in young children, has an incredible capacity to adapt and reorganize itself. While PVL can introduce cognitive and motor challenges, his brain appeared to capitalize on auditory processing as a relative strength, allowing him to quickly grasp the sounds and structures of two vastly different languages—English and Japanese.
Lastly, his personal determination and ability to engage with language-rich activities, from listening to stories to practicing new words, have been remarkable. These factors, combined with a supportive environment and early interventions, highlight the unique interplay between biology, environment, and individual effort in his bilingual journey.
Looking Ahead
Through this journey, I have come to appreciate the incredible interplay of challenges and opportunities that bilingualism offers in the context of PVL. Every milestone, no matter how small, is a testament to the adaptability of the human brain and the importance of fostering a nurturing, language-rich environment. While PVL presents unique hurdles, our experiences affirm that tailored approaches to education can unlock untapped potential and encourage growth in unexpected ways.
I intend to delve deeper into the specifics of our bilingual education at home in future posts, sharing practical strategies, resources, and reflections that might benefit others walking a similar path. From how we balance two languages to the tools and activities we have found effective I hope to shed light on what has worked for us and spark ideas for other families navigating similar challenges.
As I reflect on our journey so far, I am reminded that raising a child with PVL is not a one-size-fits-all endeavor. It is about embracing their unique strengths and working through their challenges with consistency, patience, and unwavering belief in their potential. Our story, though deeply personal, speaks to a universal truth: every child, no matter their starting point, deserves the opportunity to thrive in a world enriched by language, culture, and understanding.
Conclusion
Raising a child with PVL in a bilingual environment has been both challenging and rewarding. While there are certainly moments of difficulty, the benefits have been undeniable. Bilingualism has not only provided my son with the ability to communicate in two languages but has also given him a cognitive advantage that will serve him well throughout his life. By embracing both his neurological challenges and his capacity for growth, we continue to move forward, day by day, with hope, love, and determination.
Through our journey, I hope to inspire others raising children with PVL or other neurological conditions to embrace the possibilities that bilingualism can offer. It is not an easy path, but it is one full of promise, strength, and the incredible ability of children to learn and adapt.
Works Cited
Baralt, Melissa, and Ashley Darcy Mahoney. “Bilingualism and the Executive Function Advantage in Preterm-Born Children.” Cognitive Development, vol. 55, 2020, p. 100931. Accessed 3 Jan. 2025.
Bialystok, Ellen. “The Bilingual Adaptation: How Minds Accommodate Experience.” Psychological Bulletin, vol. 143, no. 3, 2017, pp. 233. Accessed 3 Jan. 2025.
Costa, Albert, and Núria Sebastián-Gallés. “How Does the Bilingual Experience Sculpt the Brain?” Nature Reviews Neuroscience, vol. 15, no. 5, 2014, pp. 336–345. Accessed 3 Jan. 2025.
National Institutes of Health. “Periventricular Leukomalacia.” National Institutes of Health, U.S. Department of Health and Human Services, 17 July 2019, https://www.ninds.nih.gov/health-information/disorders/periventricular-leukomalacia. Accessed 3 Jan. 2025.
Walch, Elisabeth, et al. “Parental Bilingualism Is Associated with Slower Cognitive Development in Very Low Birth Weight Infants.” Early Human Development, vol. 85, no. 7, 2009, pp. 449–454. Accessed 3 Jan. 2025.
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