Language Development in Dual Language Learners with Autism Spectrum Disorder and Other Developmental Delays

Background: Many parents and child-development specialists believe that dual language exposure (DLE) delays language development in children with autism spectrum disorder (ASD). Accordingly, parents report limiting communication directed to children with ASD to one language, which confers additional burdens on parents and further isolates the affected children from their family and culture (e.g., Yu, 2013). Few studies have looked at the impact of DLE on language acquisition in very young children with ASD before they receive intervention.

Objectives: This study aims to assess the early receptive and expressive language abilities of children with ASD and other developmental delays (DD; i.e., Global Developmental Delay or Language Delay) from bilingual and monolingual families.

Methods: Participants were 256 children (199 males; mean age 26 ± 4.66 months) evaluated as part of a larger study on the early detection of ASD. Parents were asked to list all languages that primary caretakers used to communicate with their child. 63 dual-language exposed (DLE) children (37 ASD, 26 DD) were compared to 193 single-language exposed (SLE) children (119 ASD, 74 DD). The Mullen Scales of Early Learning (MSEL) was used to assess nonverbal (visual reception (VR), fine motor (FM)) and verbal (receptive and expressive) abilities. Diagnoses were assigned according to DSM-IV-TR, using clinical best estimate judgment of symptoms based on observation, history, and testing. Multiple regression was used to evaluate the relationship of DLE to language abilities, beyond the influence of nonverbal cognitive abilities, diagnosis, and household income.

Results: Language Group (DLE; SLE) did not predict receptive (β = -.09, p=.14) or expressive (β = -.08, p= 0.22) language ability. When household income, diagnosis (ASD; DD), and nonverbal IQ (VR; FM) were added to the model, all variables explained 42% of variance in receptive language scores. Language group remained nonsignificant in predicting receptive language ability, β = -.08, p=.12. Income (β=.05, p=.30) and FM (β = -.01, p=.86) similarly did not predict receptive language, but diagnosis (β=.22, p<.05) and VR scores (β=.58, p<.05) were associated with receptive language. In the prediction of expressive language scores, income, diagnosis, nonverbal IQ, and language group together predicted 35% of variance. Language group (β = -.04, p=.46), diagnosis (β = .04, p= .41), and income (β = .10, p=.06) did not predict expressive language, but VR (β=.41, p<.05), and FM (β =.20, p<.05) did.

Conclusions: This study explored whether very young children with ASD or other delays growing up in DLE households differed in receptive and expressive language development in comparison with children raised in SLE homes, before diagnosis or intervention. The results suggest that young children with ASD and other developmental delays have comparable receptive and expressive language abilities, regardless of whether they come from a monolingual or bilingual home. Instead, receptive language development is better explained by visual reception abilities and diagnosis, and expressive language is better explained by visual reception and fine motor skills. This study suggests that bilingual parents can communicate with their children in their preferred language, or in both languages, without harm to language development.