Language Skills in Young Children with Autism Spectrum Disorder (ASD): Are there differences between Monolingual English and Bilingual English-Spanish Toddlers?

Background: Bilingual infants with typical development achieve language milestones at comparable ages to monolinguals and are reported to have more gestures. It is unknown whether there are differences in language skills between monolingual English and bilingual English-Spanish children with ASD. Objectives: To assess expressive and receptive language skills in monolingual English children with ASD, as compared to bilingual English-Spanish children with ASD. Methods: Retrospective chart review of 50 toddlers who underwent a multidisciplinary evaluation in a University Affiliated Center between 2002-2005 and were diagnosed with ASD. Data included demographics, maternal education, cognitive testing, autistic characteristics (Childhood Autism Rating Scale), and formal speech and language evaluation(expressive and receptive language skills and information about communicative means and functions and speech production). A Bilingual child was defined by the speech pathologist as a child who is exposed to both English and Spanish in the home, regardless of their expressive and/or receptive abilities in either language. Statistical analysis included chi square and independent t-test. Results: Sixty percent were boys, with a mean age of 27 ± 5 m.and 13(26%) children were bilingual. There were no differences in demographics, maternal education, cognitive testing and autistic features between the groups. Compared to monolinguals, bilinguals were more likely to use 2 or > gestures, including pulling (73%vs32% p=0.003) and using other's hands as an object (77%vs.35%, p=0.001), with no other differences in their expressive skills, communicative function or speech production. Parents of monolinguals reported more frequently that their child followed 1-step commands without gesture (86% vs 17% p=0.001), with no other differences in receptive skills. Conclusions: Although language skills are deviant in young children with ASD, those who are bilingual (English-Spanish) present more gestures. This difference has been observed in children with typical development and it seems to be preserved in children with ASD.