Expert Interview: Dr. Khanh-Van Le-Bucklin

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We are once again honored to be able to share with you the insight of Dr. Khanh-Van Le-Bucklin, pediatrician and author of Twins 101. This week our questions are concentrated on the area of childhood development.

How important is it that babies reach milestones within the “normal” range?

The “normal” range for developmental milestones is quite broad. If a child is a little late in reaching a particular milestone, it doesn’t necessarily mean that the child has a problem. It just serves as a signal to follow that child’s development a little more closely. The reason why following developmental milestones is so important is that children who fall significantly behind can often benefit from early interventions such as physical or speech therapy. The sooner children who need these interventions receive them, the better their chances for improvement.I highly recommend visiting the CDC’s website on developmental milestones. Parents can download a milestones checklist for their children at various ages. The website address is

If a child reaches milestones consistently, but at a later than normal age, is there still cause for concern?

Anytime a child does not reach a milestone at the expected age, it’s a reason for closer monitoring. That being said, in general, if a child reaches milestones somewhat later, but continues to achieve milestones consistently, there typically is not a problem. Healthy premature babies are good examples of babies for whom it may be normal to reach milestones later, but consistently. Pediatricians typically adjust the age when we expect a premature baby to reach their developmental milestones by the number of weeks a baby was premature. We continue to adjust for prematurity until 2 years of age.

Are multiples more likely to be slightly behind?

As a collective group, multiples are more likely to be slightly behind in development compared to singletons. The most common reason for this is that multiples are more likely to be born premature. If you remove the effects of prematurity, speech and language delay is more common in twins than in singletons. However, studies show that the more adult speech a child is exposed to, especially in the first three years of life, the greater their language and academic potential. Therefore, parents can have a positive influence on their twins’ language development by talking, singing, and reading to their twins as much as possible.

While parents can assist with maximizing their twins’ language development as described above, it’s also important to know that sometimes, twins may need more intensive intervention by a speech and language therapist. Parents should never feel that they have somehow failed their children if a child is diagnosed with a delay. A speech and language therapist can assist by providing direct therapy as well as offering parents and caregivers ideas for enriching the language environment at school and at home.

Is it normal for multiples to progress at varying rates as far as hitting milestones?

Absolutely. Each child will develop at his/her own pace. Because the normal range for reaching developmental milestones is quite broad, one twin may develop faster than the other and both can still fall within the normal range.

Are there any behavioral issues that you see develop more often in multiples compared to singletons? What can be done to avoid these?

Sibling competition can be more pronounced in twins. A mild degree of friendly competition can be advantageous. For example, our twins learned to crawl faster by trying to outrace each other to toys. Today, they’re learning to toilet train faster because when one twin sees her sibling use the toilet, the other wants to show that she can do it too. Mild competition can have positive effects, but more severe sibling rivalry can negatively impact both twins. Some ways parents can help reduce sibling rivalry include:

1. Make an effort to spend individual time with each twin.

2. Encourage children to share, but also make sure there are some items that belong to each individual.

3. Praise each child for their unique attributes.

4. Avoid comparing twins to each other.

5. Encourage each child to pursue activities that interest them. However, it’s Ok if they choose the same activity. The key is that they feel their choice was not limited by their co-twin.

6. Don’t be alarmed or force intimacy if one twin shows signs of wanting some distance from their sibling. This is normal for many siblings (not just twins), especially during the teen years. Fortunately, this cry for independence is often temporary, as many adults can attest that their sibling bonds in adulthood are much stronger than they were in their teen years.

7. Shower plenty of love and adoration on each child. The more positive attention they get from you, the less likely they are to seek negative attention.

I’m sure parents on this blog have plenty of other ideas. I’d love to hear them!


Be sure to check out our review of Dr. Le-Bucklin’s book, Twins 101, and she also has a great website here!
Have a great Monday!


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  1. great info! THanks for sharing this!

  2. Awesome tips and information. thanks!

  3. Great interview, thanks for the awesome information.

  4. Great information.

  5. I really enjoy when you do interviews with the experts!! I totally agree with what she said about the friendly competition. That’s how Bella learned to crawl and then walk. Cole did it first and there was no way she was gonna be left behind so she had no choice but to learn how to be mobile!!

  6. 2SetsOfTwins4Me

    Thanks for sharing

  7. A question I often ask other multiple parents is how do you help them learn teir name. I'm constantly saying someone's name and I'm scared they think their name is Cannon, Gunnr, Lauren, Avery!

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