Family Experiences in Bilingual Children with Autism Spectrum Disorder (ASD)

Background: Many parents of children with autism spectrum disorders (ASD) have been discouraged by clinicians and medical practitioners from exposing their child to more than one language (Wharton et al., 2000; Kremer-Sadlik, 2005; Jegatheesan, 2011; Yu, 2013). Four studies have explored the relationship between multiple language exposure and language development in children with ASD (Hambly & Fombonne, 2012; Ohashi et al, 2012; Peterson et al., 2012; Valicenti-McDermott et al., 2012). All rejected the claim that multiple language exposure has an adverse effect on language and social development for children with ASD. Whereas bilingual children with ASD are more likely to vocalize and utilize proto-imperative gestures than monolingual counterparts (Valicenti-McDermott et. al, 2012), and have larger total production vocabularies (Peterson et al., 2012), with similar patterns to typically developing bilingual children (Pearson et al., 1993). Furthermore, non-native English parents elicit greater responsiveness from their children when communicating in their native language then in English (Wharton et al., 2000). To date, there is a lack of data regarding the effect of advice on language choices to bilingual parents of children with ASD.

Objectives: We investigated the relationship between language environments and the impact of family dynamics on language choices based on the advice given by health and educational professionals in diagnosed bilingual children with ASD. 

 Methods: Preschool aged children with ASD (N=13) averaging from 24-60 months from bilingual families were selected for this study. The study included a standardized observational testing for social interaction, communication and autism severity (ADOS), nonverbal (visual) reasoning (Mullen Scales of Early Learning) and expressive and receptive language (Preschool Language Scale IV). Measures were repeated at three time points in English. Parents answered 25-questions for the Family Experience Bilingual Questionnaire regarding their child’s ASD diagnosis, language choices and ability in both languages, and advise regarding bilingualism four years after their initial entry to the study.

Results: Bilingual parents with children with ASD expressed three common concerns: language and social development and behavioral issues. Their children had different levels of exposure in both languages, beginning their first year of 71% English and 28% non-English and current exposure as 78% English vs. 20% non-English. Parents reported anxiety over their language choices, leading to consultation with professionals and peers. This consultation process was often uninformative: 66% of parents received no recommendation, while 17% of the families were encouraged, and 17% discouraged about bilingualism. Overall, parents who raised their child bilingually reported positive experiences, while parents who raised their child monolingually reported negative experiences specifically, family relationships and dynamics.

Conclusions: While evidence suggests that bilingual children with ASD have similar language development in comparison to monolingual children with ASD, parents reported a lack of advice from professionals on language choices. Specifically parents that raised their child bilingually reported more positive experiences than their monolingual counterparts because of the maintenance of communication and cultural exchange with extended family members. Supporting families in maintaining more than one language, even if English is the dominant language, is critical in supporting social skills and family relationships.