Psychiatr Q

DOI 10.1007/s11126-017-9532-9

R E V I E W A RT I C L E

Positive Cognitive Effects of Bilingualism

and Multilingualism on Cerebral Function: a Review

Cibel Quinteros Baumgart 1 & Stephen Bates Billick

2

# Springer Science+Business Media, LLC 2017

Abstract A review of the current literature regarding bilingualism demonstrates that bilingual-
ism is linked to higher levels of controlled attention and inhibition in executive control and can
protect against the decline of executive control in aging by contributing to cognitive reserve.
Bilinguals may also have smaller vocabulary size and slower lexical retrieval for each language.
The joint activation theory is proposed to explain these results. Older trilingual adults experi-
ence more protection against cognitive decline and children and young adults showed similar
cognitive advantages to bilinguals in inhibitory control. Second language learners do not yet
show cognitive changes associated with multilingualism. The Specificity Principle states that
the acquisition of multiple languages is moderated by multiple factors and varies between
experiences. Bilingualism and multilingualism are both associated with immigration but
different types of multilingualism can develop depending on the situation. Cultural cues and
language similarity also play a role in language switching and multiple language acquisition.

Keywords Bilingualism . Trilingualism . Multilingualism . Cerebral function . Cognitive

function . Cultural effects

Introduction

Studies over the last ten years have shown evidence for both benefits and detriments to cognitive
functioning linked to bilingual language skills. Multiple mechanisms for these effects have been
proposed along with the anatomical and physiological changes associated with them. Benefits to
cognitive performance include higher levels of controlled attention and inhibition linked to

* Cibel Quinteros Baumgart

cibel.quinteros@gmail.com; cbq2000@cumc.columbia.edu

Stephen Bates Billick

Stephen@billick.com

1
Columbia College of Physicians and Surgeons, 630 W 168th St, New York, NY 10032, USA
2
New York University School of Medicine, New York, NY, USA
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executive function. Cognitive inhibition is the act of tuning out irrelevant stimuli. Multiple tasks
across age groups that rely on conflict resolution and switching skills demonstrate a clear executive
control advantage in bilingual individuals. Bilingualism has also been shown to help protect
against the decline of executive control in aging by contributing to the cognitive reserve and better
memory generalization in bilingual infants. The disadvantages associated with bilingualism are
generally linguistic in nature, mainly smaller vocabulary size and slower lexical retrieval for each
language. The preponderance of the evidence for the mechanism behind these effects points to a
challenge of attentional control for the target language system over the competing system. This
requires more effort for lexical tasks but involves executive control in linguistic functions, which
inadvertently strengthens the pathways and increases executive control skills for nonverbal tasks.
Trilingualism has its own consequences for cognitive function. Older trilingual adults
generally have even more of a delayed onset of Alzheimer’s and dementia compared to
bilinguals and children and young adults showed similar cognitive advantages to bilinguals
in inhibitory control. Advantages in memory generalization, however, were not seen in
trilingual infants when compared to monolingual infants. A framework of cognitive plasticity
relying on cognitive supply and demand has been proposed to account for these results.
Results from studies on second language learners indicate that they have not yet developed
cognitive improvements found in multilingual subjects.
The cultural effects of bilingualism and multilingualism are vast as the majority of the
world’s population is bilingual or multilingual. Nevertheless, the Specificity Principle states
that there are many factors that affect the acquisition of multiple languages and the experience
of multilingualism can vary greatly between populations. In the United States especially,
bilingualism and multilingualism are often linked to immigration, but can lead to additive or
subtractive multilingualism depending on how the languages are developed. Cultural cues and
faces are tools used by early bilinguals to switch languages, and language similarity may
determine other cognitive effects associated with bilingualism.
Bilingualism is generally categorized by equal or near-equal proficiency in two languages
that have been used regularly by the subject for the majority of their life. Trilingualism and
multilingualism are defined similarly, except for trilingualism includes three languages and
multilingualism includes three languages or more. Second language learners are those in the
process of achieving fluency in another language and monolinguals are those who are fluent in
and regularly use only one language.

Benefits of Bilingualism

Bilingualism has been shown to increase cognitive performance through executive functioning
and executive control for tasks unrelated to language acquisition [1–3]. In multiple tasks
involving executive functioning such as inhibition, shifting, and updating information in
working memory, bilingual participants outperformed monolingual participants while control-
ling for all other factors [3–6]. The bilingual advantage was demonstrated in metalinguistic
tasks requiring controlled attention and inhibition, but not those requiring grammatical knowl-
edge [3, 5, 6]. For example, monolingual and bilingual children performed equally on a task
detecting grammatical errors but bilingual children outperformed monolingual controls on a
task accepting that sentences were grammatically correct when they contained false informa-
tion [3]. This is an example of enhanced inhibition and selective attention in bilinguals used to
ignore wrong information and identify correct grammar as instructed by the task.
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Bilingual children also demonstrated the ability to solve problems containing conflicting or
misleading cues at an earlier age and have an enhanced ability to switch criteria during a task [3].
Nine different executive function tasks made up of conflict resolution tasks and impulse control
tasks showed that bilingual kindergarteners only performed better on tasks presenting a conflict for
competing options [3, 7]. This demonstrates that the advantage comes from enhanced executive
control and not general developmental superiority when completing the tasks. Furthermore, in the
dimensional change card sort task, children were asked to sort a set of bivalent stimuli by one
feature before immediately re-sorting them by the other feature [3, 7]. Bilingual children of a
younger age were better able to adapt to the new rule and re-sort the stimuli accurately [3, 7].
Theory of mind tasks, testing the ability to understand that others can have mental states different
than one’s own, showed earlier theory of mind development in bilingual children [3, 8]. Addi-
tionally, bilingual children given a reversing ambiguous figures task where they were asked to see
an alternative image in a reversible figure, performed better than monolingual controls [3, 8]. This
shows further evidence for enhanced executive control in bilingual children.
These benefits are consistent throughout the life stages, as shown by shorter reaction times
in children, young adults, middle-aged adults, and older adults on the Simon task [3, 9]. The
Simon task asks participants to respond to bivalent colored stimuli with location based
responses, i.e. a red light corresponds to the left arrow regardless of where it is displayed on
the screen. The better ability of bilinguals to ignore incongruent stimuli when not relevant to a
task was confirmed by shorter reaction time, smaller conflict effects and smaller switching
costs in the flanker task, which asks participants to respond to target stimuli flanked by
incongruent, congruent or neutral stimuli based on a previously assigned directional response
[3]. In the stroop task, where participants are asked to list the printed colors of words spelling
out either the same color or different colors as the text, and the Proactive Interference task,
which tests the effect of previous events and learning on the ability to remember new
information, bilingual participants consistently performed better in tasks requiring executive
control despite a minimally lower proficiency in vocabulary [3, 7]. This evidence supports the
independence of the lexical and executive processes despite their joint networks.
Bilinguals performed better on memory tasks based on executive control and memory general-
ization tasks, but had no advantage in general tasks testing working memory alone [1, 3, 5]. A short-
term memory task asking children to recall a growing list of animals showed no difference between
bilingual and monolingual participants [3]. Another composite analysis of bilingual and monolin-
gual adults re-ordering an auditory sequence from memory again showed no difference [3]. In
nonverbal memory tasks, and specifically ones relying on executive control, however, bilinguals
performed better as demands for control and inhibition were increased while monolinguals
performed more poorly [3]. The task was based on a colored stimulus moving around a matrix
where the order and location of the stimulus must later be recalled by a certain set of rules varying in
difficulty [3]. Together, this evidence shows that bilingualism does not benefit memory on its own,
but that the benefits of enhanced executive control are applicable to many other processes. Multiple
studies on memory generalization in infants and toddlers, where subjects were asked to apply
learned information to a new situation, showed increased performance in bilingual participants [5,
10]. 6-month-old bilingual infants were able to imitate behavior in a difficult task where the target
object changed in two features while monolingual infants were only able to complete the task when
the object changed in one feature [10]. 18-month-old bilinguals were also able to outperform
monolinguals in deferred imitation performance in a difficult generalization task [10]. These results
were confirmed with further studies where bilingual children were able to place a new target object
in the same category as an old one despite surface level differences [5]. It is possible that bilinguals
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are better at remembering information in the face of a context change or that enhanced executive
functioning allows bilinguals to focus only on the important features of a target [5].
Bilingualism has also been shown to protect against the decline of executive control in
aging by contributing to cognitive reserve [1–3]. In a study comparing the age of onset of
dementia symptoms in 184 people diagnosed with dementia after visiting a memory clinic,
bilinguals showed signs of dementia 4 years later than monolingual controls [2, 3]. There was
no difference in the duration of their symptoms or their cognitive function at the time they
visited the clinic, although the monolinguals had more years of formal education on average
[2, 3]. Another study looking at the effects of bilingualism on Alzheimer’s disease showed
more severe brain atrophy in the medial temporal lobe in bilinguals at the same cognitive status
as monolinguals with less severe brain atrophy [2]. Bilinguals are thus able to function at a
higher cognitive level during later stages of the disease as both groups were matched on other
relevant lifestyle factors [2, 3]. In a study assessing age of mild cognitive impairment onset, a
precursor to Alzheimer’s dementia, bilinguals showed a 4.5-year delay compared to monolin-
guals [5, 11]. Bilingualism may enhance cognitive function in the frontal, temporal and parietal
lobe processes underlying memory performance, contributing to better neural preservation in
the inferior parietal lobule and anterior temporal lobe in older bilingual adults [5].
Better metalinguistic awareness, awareness that words are symbols for concepts and of how
grammar is constructed, as well as better metacognitive awareness, awareness of one’s
thinking and mental strategies, was found in young bilinguals acquiring bilingualism early
in life with two similar languages [1]. These are only found for certain bilingual groups and not
for others, such as Chinese-English bilinguals or those acquiring bilingualism later in life [1]. It
is possible that there are certain benefits that can only be garnered through developing
bilingualism in two languages with similarities in grammar structure and alphabet.
Because of these cognitive advantages offered by bilingualism, bilingual education is often
recommended over monolingual education [5, 12]. Bilingualism also clearly promotes social
and vocational advantages, which will not be the focus of this paper.

Disadvantages of Bilingualism

While bilingualism can provide executive control benefits, it has some disadvantages for
linguistic performance. On average, bilingual children control a somewhat smaller vocabulary
for each language, which is often used as the central measure of language development and a
proxy for a representational base of language [3]. Standardized Peabody Picture Vocabulary
Test scores, where children are asked to select a picture matching an auditory vocabulary word,
showed lower mean scores for bilingual children ages 5 to 9 years old [3]. Although the
differences in vocabulary are not great, they do rise to statistical significance [3]. The bilingual
children tested were raised in English speaking communities and participated in academic and
extracurricular activities in English but spoke another language at home [3].
Bilingual adults also perform less well on rapid lexical retrieval tasks [3]. They can be
slower in picture identification, score somewhat lower on verbal fluency tasks, have slightly
more Btip of the tongue^ experiences, poorer auditory word identification, and more interfer-
ence in lexical decisions [3]. All of these studies provide evidence that these challenges come
from the interference of the non-target language and bilingual performance on the tasks can be
altered by changing the relationship between the words in the two languages [3]. An English
vocabulary test where the participant is shown four pictures and must select the one
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corresponding to an auditory vocabulary word was administered to younger and older adult
bilinguals and monolinguals with the bilinguals scoring lower [3]. A Boston Naming Test,
where participants must name a series of line drawings of objects showed similar results, as did
a series of fluency tests where participants had to say as many words as possible starting with a
certain letter or adhering to a certain category in one minute [3]. These effects persist with
aging, although there is a smaller deficit for older bilinguals perhaps due to increased cognitive
reserve [3]. Bilinguals also perform somewhat more poorly on memory tasks based primarily
on verbal recall, although there is no effect on non-verbal recall short-term memory tasks [3].
Thus, there is no evidence for a general memory disadvantage due to bilingualism, although
other processes depending on language acquisition can be affected.

Mechanisms for Bilingualism

The mechanism of bilingualism with the most evidence is the theory of joint activation. Fluent
bilinguals that use both languages regularly have both languages active and available when
either one is being used [2, 3]. This creates a problem of attentional control for the target
language system over the competing system that involves the executive control system in a
way not required by monolingual people [3]. The extra effort required for lexical decision-
making and recall thus creates compromises in lexical access [3]. On the other hand, executive
control is enhanced because of the involvement of the pathways and strengthening of the
system from more use [1, 3]. The competition of language selection improves code switching
and code blending abilities, which transfers to other tasks to create an executive control
advantage [3]. As mentioned earlier, memory is only affected in tasks depending on executive
control or lexical retrieval where it shows advantages and disadvantages respectively.
Evidence for this mechanism comes from studies of speech-sign bilinguals who lack the
language conflict as both languages can be performed concurrently, i.e. speaking and signing
at the same time as opposed to speaking two languages at the same time [2, 3, 7]. Speech-sign
bilinguals performed the same as monolinguals on the flanker task while verbal language
bilinguals performed better [2, 3, 7]. Well-documented brain imaging has also shown different
brain patterns between monolinguals and bilinguals during executive control tasks while
behavioral studies show evidence for interference from the non-target language [2].
Bilinguals switch between languages with the help of a language control center, shown by
meta analysis of fMRI experiments involving stimulus naming in both of the bilingual
participant’s fluent languages [2, 3]. This is true in both single language and mixed-
language conditions [2]. This center contains six significant regions, at least four of which
are generally included as part of the executive control network [2]. Each time the language is
switched, bilinguals activate this network, strengthening it for later use [2, 3].
The bilingual executive control network has also been expanded to include Broca’s area, an
area usually reserved for speech [2]. While performing the Simon task during magnetoen-
cephalography (MEG), bilingual participant’s brain activity patterns included Broca’s area
during the conflict condition when they were presented with both congruent and incongruent
trials [2, 3]. Monolinguals did not show this pattern [2, 3]. fMRI results during the flanker task
performed by monolingual and bilingual participants also indicated that different brain regions
were involved for the two groups with the differences heightened during incongruent trials [2].
Because bilingualism is controlled by networks of activation, broader processes are impacted
by the strengthening of the network [3]. Systems normally specialized for nonverbal conflict
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resolution like the dorsolateral prefrontal cortex, anterior cingulate gyrus, and caudate nucleus
are recruited during bilingual language conflicts and become networked with language areas
like Broca’s area [2, 3]. This creates a larger, stronger conflict resolution network for bilinguals
even in situations when language is not involved [2, 3].
The effects of bilingualism on nonverbal tasks, like conflict resolution tasks, do not come
from a single source and cannot be attributed to a single component of executive control [2, 3].
Instead, there is an effect on a variety of nonverbal tasks throughout the lifespan of bilinguals
originating from their linguistic experience strengthening executive control networks [3, 13].
This is supported by global-local tasks in young children, which test their ability to inhibit
attention, switch criteria, and use working memory [2]. These tasks ask children to identify
stimuli, often letters or shapes, made out of smaller stimuli that are the same or different.
Bilingual children outperformed monolingual children in all conditions requiring executive
control [2]. This was consistent in all processes requiring executive control [2]. Dual-task
conditions in 8 year-old bilingual children, where they were asked to classify both a picture
and a sound that were presented simultaneously, yielded significantly more accuracy in the
bilingual group [2, 3]. With both studies, the bilingual advantage became apparent as the tasks
became more challenging and required more executive control, but did not show salience in
one aspect of executive control over another [2, 3]. Bilingual advantages on the stroop test in
adults further supported this [2, 3].

Anatomy of the Bilingual Brain

There is evidence for an increased density of grey matter in the left inferior parietal cortex of
bilinguals [3]. This is more pronounced in early bilinguals and those with greater proficiency
[3]. Frontal regions of the brain are activated when bilinguals switch or select languages,
supporting the joint activation mechanism [3]. There is also evidence for a series of connec-
tions between the prefrontal cortex, anterior cingulate cortex, inferior parietal region, and basal
ganglia used for bilingual language production [2, 3]. The network of activation used by
bilinguals requires conflict resolution areas like the dorsolateral prefrontal cortex and anterior
cingulate gyrus as well as language production areas like the inferior parietal cortex or Broca’s
area to be connected by subcortical structures in the basal ganglia [3]. The basal ganglia is also
involved in conflict resolution. Finally, fMRI meta analysis of stimulus naming tasks demon-
strates the role of the entire nonverbal executive control center during language switching in
bilinguals, pointing to the broadness of the network and difficulty in compartmentalizing it [2].

Cognitive Effects of Trilingualism

Current research indicates that the cognitive effects of trilingualism are not just an extension of
the cognitive effects of bilingualism but have distinct consequences for cognitive function [5].
Early research shows that the effects of trilingualism and multilingualism on cognitive function
can vary depending on the situation [5, 13]. A study comparing the onset of Alzheimer’s
disease in multilinguals, bilinguals, and monolinguals using records from 632 patients at a
memory clinic in Montreal found that trilinguals and other multilinguals were diagnosed
marginally later than bilinguals and thus had more cognitive reserve [5]. Monolinguals spoke
either English or French, bilinguals spoke both English and French and multilinguals spoke
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English, French, and at least one more language [5, 14]. Standard and neuropsychological tests
performed on 232 older adults in Luxembourg showed that trilingual adults were significantly
less likely than bilingual adults to have mild cognitive impairment [5, 15]. Trilingualism thus
not only seems to provide the same cognitive reserve benefits afforded by bilingualism, but
extends these benefits to better protect cognitive function in older age.
In studies of inhibitory control in children and young adults, trilinguals outperformed
monolinguals, but did not differ from bilingual participants [5]. This was assessed using the
flanker task in 8–11 year old children that were either monolingual, bilingual, or trilingual [5].
The same results were found in 5–8 year-old children on both the Simon and flanker arrow
tasks, demonstrating that while trilingualism still provides an advantage over monolingualism,
it does not necessarily provide cognitive benefits beyond those of bilingualism [5].
A study of memory generalization in infants and toddlers showed that bilingual participants
outperformed both monolingual and trilingual participants [5]. 18 month old bilinguals
successfully generalized a task, removing a mitten from a toy animal, 30 min later while
monolinguals and trilinguals did not [5, 10]. 24-month-old bilingual toddlers were also
successful at a 24 h memory generalization task while trilingual and monolingual toddlers
once again were not [5, 10]. It is important to note that these are only a small set of studies
from a single lab and also that trilinguals did not show a deficit compared to monolinguals.
One theory used to explain these varying effects of bilingualism on cognitive function is the
framework of cognitive plasticity [5]. This theory proposes a supply-demand framework of
experience dependent plasticity where multilingualism is viewed as a form of mental training
[5]. Cognitive improvements occur when the demand imposed on a cognitive process is higher
than the current supply of cognitive resources [5]. If a person is repeatedly challenged in the
same way, cognitive improvements occur. In the case of older multilinguals, the cognitive
demands of trilingualism were higher than the bilingual demands and the person’s cognitive
supply, resulting in cognitive improvement to navigate three languages [5]. For younger
trilinguals, trilingualism may not have increased the demands for inhibitory control enough,
or may have relied on skills already developed through bilingualism [5]. Additionally, younger
adults may already be at their peak level of cognitive inhibition and there may be no more
room for improvement. In the case of trilingual toddlers, it could be that the cognitive demands
of learning three languages are too steep for toddlers so early in development [5].
Further research needs to be done comparing the effects of trilingualism across the lifespan.
It could be that trilingual advantages, unlike bilingual advantages, only become apparent later
in life or that they are reliant on successive language learning. Furthermore, there is a concern
of self-selection biases in trilingualism research where people who become trilingual could
have cognitive advantages at the outset. Immigrant status has also been proposed as a
confounding variable, however the advantages are still seen in non-immigrant populations.

Cognitive Effects for Second Language Learners

Research on bilingualism and trilingualism generally relies on the idea that participants are
equally fluent in two or more languages. Second-language learners, however, are those with
one dominant language who are in the process of learning another [13]. A Simon task given to
5–8 year-old German- English bilinguals, trilinguals, monolinguals and second language
learners showed that the Simon effect for second language learners did not differ significantly
from monolinguals or bilinguals/trilinguals, but was somewhere in the middle [13]. Trilinguals
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and bilinguals displayed conflict resolution superior to monolinguals but not different from
each other [13]. This suggests that second-language learner’s enhanced attentional control was
emerging but had not yet reached the levels of bilinguals and trilinguals [13].
In the attentional networks task, bilinguals and trilinguals displayed enhanced conflict
resolution over second-language learners within the same group of children [13]. The atten-
tional networks task asks participants to respond to the direction of a center stimulus pointed at
the left or right that is flanked by stimuli pointing in the same or different directions (congruent
or incongruent trials respectively) [13]. Participants are required to make a decision between
two competing responses. Child and young adult bilinguals have been shown to display
enhanced executive control on this task [13, 16]. While the overall performance of the three
groups did not differ, bilinguals and trilinguals displayed significantly greater orienting effects,
conflict resolution effects, and less interference than the second-language learners on incon-
gruent trials [13]. This study further suggests that the cognitive benefits of bilingualism are not
yet fully developed before fluency and that negotiating three languages as opposed to two
languages does not offer more attentional control benefits at a young age.

Cultural Effects of Multilingualism

Multiple reports and studies show that the consequences of bilingualism are largely positive [1–3,
11, 17]. Using multiple languages is a natural circumstance of human experience, and multilin-
gualism can be an entry card for the global economy [11, 17]. There is no evidence that children
need to give up their heritage language, as this will not result in improved language outcomes in a
culturally dominant language [18]. In other words, there is no reason that parents should not speak
their native language to their children at home thus promoting the development of bilingualism in
the children. Fluent multilingualism is associated with high academic achievement and positive
personality adjustment in youths [18]. Children who speak their parents’ heritage language often
enjoy better relationships with their families and are less likely to feel alienated from them [11].
Although bilinguals appear to activate both languages while reading, listening, and speaking one
language, they do not suffer notable disruptions [11, 17]. Studies of monolingual language
development demonstrate that increased language exposure results in more language learning
[18]. Relative and absolute amounts of exposure to each language can predict children’s levels of
vocabulary and grammatical development in each language [18].
Multilingualism around the world is already very common. Two thirds of the world’s
population speaks two or more languages [18]. Bilingualism in the United States is on the rise
and the percentage of multilingual children is larger among the youngest in public education
[18]. Of the U.S. multilingual population, 72% speak Spanish at home [18]. Bilingualism is
often linked to immigration and first and second generation children of immigrants are the
fastest growing sectors of the U.S. child population [18]. This is important to note for research
on bilingualism in the United States, as immigrant families are disproportionately low-income
which could be a confounding factor in the research [18].
While immigrant families often also have strengths such as being two parent households
and highly valuing education, research on the language of poverty has shown that children in
households with a low socioeconomic status generally receive less language input, less varied
language input, and less positive language input than peers in higher socioeconomic
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environments [18]. Although this gap widens with age, research with dual-language learners
from high socioeconomic backgrounds indicates children generally catch up during elementary
grades [18]. This gap could occur because immigrant parents often have lower education levels
and may not engage in as many oral and literary activities with their children [18]. It may also
be difficult to access books in their native language, resulting in lower rates of book reading
[18]. Additionally, over reliance on oral commands and oral directives rather than complex
open-ended discussion may limit the vocabulary that children learn from their parents because
children are only required to respond behaviorally [18]. Thus, the receptive language is more
limited and there is no requirement for expressive language. In this way, lags in language
development in multilingual children could be from confounding family characteristics such as
poverty and/or limited language engagement [11, 18].
Another important factor in understanding multilingualism is that there are different types of
multilingualism depending on a person’s circumstances. Additive multilingualism occurs when
both the home language and the second language are supported and viewed as assets [11]. This
requires early exposure to quality input in both languages and generally results in enhanced
outcomes for both languages as well [11, 18]. Children must not only hear quality input from
fluent parents, but must hear substantial input from multiple speakers [11, 18]. Children who hear
two languages from infancy start to learn them simultaneously [11]. The course of development in
each language looks similar to the trajectory followed by monolingual children [11, 18]. In these
cases, an assessment of the overall rate of language growth is equal to that of monolingual children
[11]. Subtractive multilingualism, on the other hand, occurs when a second language is learned in
preschool but the original home language is then neglected [11]. In this case, when a child begins
learning the second language, it replaces the first language and the original home language is either
temporarily lost or stunted in fluency [11].
Multilingualism is further moderated by the Specificity Principle in multiple language learning
[11]. The Specificity Principle asserts that the acquisition of multiple languages is moderated by six
key specifics: (1) setting condition, (2) person, (3) language, (4) time, (5) mechanism, and (6)
outcome [11]. Bilingualism is not a categorical phenomenon but instead is a spectrum ability [11,
18]. One factor is that children learn a second language faster than adults. Immigrant youth are thus
more likely to be multilingual than their parents [11]. The Three Generation Rule posits that usually
the first generation of immigrants maintains the heritage language and learns little English [11].
Their children born in the U.S. become multilingual and the third generation is typically mono-
lingual in English. Language learning is also moderated by the specific languages involved
because similarity between the languages makes the learning easier [11]. Because of these different
factors, programs for multilinguals must be designed to focus on specific experiences and
situations to be successful instead of using a one-size-fits-all design [18].
Bilingual speakers are sensitive to cultural cues in the environment that indicate which
language should be used [17]. This can sometimes result in slower speech when speaking the
second language in the presence of the first language [17]. Ethnic Chinese who were Chinese-
English bilinguals were shown to speak English more hesitantly to other ethnically Chinese
bilinguals as opposed to Caucasian bilinguals even though they were raised in the U.S. with
English as their dominant language [17]. For infants exposed to two languages at birth, faces
are a special cue for which language to use, not solely due to ethnicity, and the ability to
distinguish between languages both visually and auditorily is developed at a very young age
[17, 19, 20]. Crib bilinguals fluent in Spanish and Catalan are even able to discriminate
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between two languages spoken in a silent video of speaking faces, even when the faces in the
videos switched between languages unfamiliar to the infants such as French and English [17,
20]. Crib monolinguals fluent in one of the languages were not able to discriminate between
languages in the video [17, 20].
Future research should consider how cultural cues and context may modulate the scope of
the inhibitory mechanism that allows multilinguals to switch between languages and how the
mechanism develops over time. Outreach and research should take into account the range of
differences in the bilingual/multilingual experience in order to best support language devel-
opment in multilingual children [18].

Conclusion

There is clear evidence that bilingualism provides significant benefits to executive control
function and minimal disadvantages to linguistic performance as well as the clearly docu-
mented increased cognitive reserve in older age. The proposed mechanism of joint activation
of competing language systems is supported by both cognitive tests and brain imaging to show
that the executive control network is both strengthened and expanded by the bilingual
language experience. Research on trilingualism demonstrates an increased benefit for cognitive
reserve in older adults, similar benefits to bilingualism for inhibitory control in children, but no
benefits for memory generalization in infants. More comparable research across the lifespan is
necessary to understand how trilingualism and bilingualism differ in their effects on cognitive
function. Research on second language learners shows that executive control benefits are not
yet developed before fluency but that changes in cognitive function can begin to be seen. The
largely positive effects of bilingualism on cognitive function call for not just the support of
bilingual families, but bilingual education for children from monolingual households.
In a largely bilingual world, the cognitive effects of bilingualism are largely moderated by
cultural background and vary greatly. The Specificity Principle encourages the idea that
multilingualism is a spectrum experience as opposed to a singular one and that there are many
factors that affect multilingualism. Immigration and low socioeconomic status could be
confounding factors in the current research on the cognitive effects of multilingualism,
especially research done in the United States, and more research on the experience of
immigrant multilinguals as opposed to native ones is needed. So far it is clear that bilingualism
should be encouraged in both populations, but is especially important in immigrant families to
promote strong language development and cultural inclusion for immigrant children. Many
other factors besides immigration status affect the bilingual experience, and must be taken into
account when developing future resources for these populations. As the rate of multilingualism
increases both in the United States and abroad, it is important to understand not only the
cognitive effects of bilingualism and multilingualism, but the cultural ones as well.

Compliance with Ethical Standards

Conflict of Interest Cibel Quinteros Baumgart declares that she has no conflict of interest. Stephen Bates
Billick declares that he has no conflict of interest.

Ethical Approval This article does not contain any studies with human participants or animals performed by
any of the authors.
Psychiatr Q

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Cibel Quinteros Baumgart is a first year medical student at the College of Physicians and Surgeons of
Columbia University in New York City.

Stephen Bates Billick MD is past President of the American Academy of Psychiatry & the Law, past President
of the NY Council on Child & Adolescent Psychiatry, and past President of the American Society for Adolescent
Psychiatry; he is Clinical Professor of Psychiatry and Clinical Professor of Child & Adolescent Psychiatry, both
at the New York University School of Medicine and a practicing child, adolescent, adult clinical and forensic
psychiatrist.