As families of children with Autism Spectrum Disorders (ASD) become more culturally and linguistically diverse, they often seek clarity about bilingualism and its effects on their children’s communication patterns. They are apprehensive about speaking to their children in their language other than English (LOTE) because they recognize the life barriers that stem from ASD and if they perceive that communicating in their LOTE further worsens the situation, they are likely to minimize or stop speaking it (Yu, 2013). 61.8 million U.S. residents spoke a LOTE in 2013; this is an increase of 2.2 million since 2010 (Camarota & Ziegler, 2014) and one in 68 individuals is identified as having ASD (Christensen et al., 2016). Given the increased number of individuals who speak a LOTE and the increased prevalence of ASD, it is imperative that professionals understand how bilingualism and ASD function together so that they can provide important and appropriate guidance to parents of children with ASD who speak a LOTE.
According to Yu (2013), parents of children with ASD are advised by some physicians, speech-language pathologists (SLP), teachers, and psychologist to speak exclusively in English because doing so will boost language acquisition and reduce linguistic demands. This advice according to Ijalba (2016), is unethical, incompatible with evidence-based practice, and disadvantageous to families. It also refutes the American Speech-Language Hearing Association’s (ASHA, 2014) position on cultural competence and service delivery. ASHA encourages clinicians to demonstrate compliance to families’ linguistic and cultural preferences. Cultural competence is progressively important in service delivery and in responding to the demographic changes in the U.S.
When professionals erroneously advise parents to speak “only English,” they often do this without considering the parents’ English proficiency. The Center for Immigration Studies revealed that, based on self-assessments from the U.S. Census Bureau’s 2013 American Community Survey, 25.1 million individuals reported that they “Speak English less than very well” (Camarota & Zeigler, 2014). How can parents bond with their child if they are encouraged to speak “only English” in light of their limited English proficiency? According to Ijalba (2016), caregivers use their most proficient language to interact and engage with their children in reciprocal activities such as having a conversation, reading a book, playing and problem solving. The parent-child interaction is interrupted when limited English proficient parents are told to speak “only English.” Ijalba (2016) goes on to explain that a parent’s role can shift from being a communicator to that of exclusively being the person who provides care (i.e. only feeding and dressing). When this exchange is made, parents who speak LOTE are limited in their capacity to engage in literacy activities and to have meaningful social-verbal interactions.
The language socialization paradigm (Och & Schleffelin, 1984 as cited in Kremer-Sadlik, 2005) explains that language and socialization are integrated. Children are socialized through language and are socialized to use language. Preventing them from communicating in the home language could lead to socialization deficits. “Only English” contradicts the desired social communication outcomes for children with ASD. How can they develop relationships, increase social acceptance, and effectively participate and function in society, if their families are being guided to dismiss speaking to them in their LOTE? Kremer-Sadlik (2005) explains that this “only English” advice exacerbates the social communication challenges children with ASD. “Only English” encourages social isolation from parents, siblings, and caretakers and therefore results in lost cultural identity, obstructed bonding between parent and child, and severed attachment.
The language usage patterns that families elected to use with their child with ASD are also informed by their beliefs about bilingualism and its effects on learning development (Yu, 2013). These families’ concerns about bilingualism are uniform with misperceptions about bilingualism. They feel that it is best for their child with ASD to establish a strong foundation in English first and have proficiency in one language (English) because it is better than limited proficiency in two languages. They speak only in English at home because it is the language of the classroom and this would accelerate their child’s English language acquisition. Overall, they feel that bilingualism might complicate matters or further delay language development.
Little is known about bilingualism and its effects on ASD. The emerging research is showing that bilingualism and ASD do not interact in a detrimental way that would give rise to a delayed or deviant profile of language acquisition (Reetzke, Zou, Sheng, & Katsos, 2015). Hambly and Fombonne (2011) compared the language and pragmatic skills of bilingual and monolingual children with ASD. They concluded that parents and caregivers of children with ASD should not be prevented from speaking with their children with ASD in dual languages because they do not experience additional delays in language development when compared to monolingual children with ASD. When the expressive and receptive language abilities of monolingual English speaking children with ASD and those of age-matched bilingual English/Chinese speaking children with ASD were compared, the results revealed that children with ASD have the linguistic capacity to be bilingual without experiencing impediments in their language development (Petersen, Marinova-Todd, & Mirenda, 2012). In a related research, Ohashi, et.al (2012) compared the severity of ASD related communication impairment, age of first words, age of first phrases, expressive and receptive language, and functional communication scores of bilingual (English or French and one more language) and monolingual (English or French only) children with ASD. They found no statistical difference between bilingual children with ASD and monolingual children with ASD on any of the language measures. When the expressive and receptive language development of bilingual (English/Spanish) children with ASD were compared to that of age-matched monolingual (English) children with ASD, the findings, again, demonstrated that expressive and receptive language of bilingual children with ASD did not fall behind the monolingual children with ASD (Valicenti-McDermott, et.al, 2013).
While there is a shortage of research about how bilingualism interacts with ASD, the studies that have emerged are revealing evidence that shows that bilingualism is not affiliated with language development challenges in children with ASD. This has clinical and educational implications. Health care professionals, Speech-language pathologists and other educators need to demonstrate increased cultural competence and engage in evidence based service delivery in order to be responsive to culturally and linguistically diverse populations. It is imperative that they are aware that exposure to two languages in the home environment does not have an impact on language competence in children with ASD. They should therefore advocate for families to communicate with their children with ASD in their LOTE and not speak only English.
Tamara Sterling, MS, CCC-SLP, TSSLD is a Speech-Language Pathologist in Westchester County in New York. She has eight years of experience working with children and adults with articulation, stuttering, language, and autism spectrum disorders. She is an ASHA Mentor and a recent recipient of ASHA’s ACE award. For more information, please email sterling.tamara20@gmail.com.
References
American Speech-Language-Hearing Association. (2014). Cultural competence [Position statement]. Available from http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935230=Overview
Camarota, S.A., & Ziegler, K. (2014). One in Five U.S. Residents Speaks Foreign Language at Home, Record 61.8 million.[PDF file]. Retrieved from: http://cis.org//sites/cis.org/files/camarota-language.pdf
Christensen, D.L., Baio,J., Braun, K.V., et al. (2016). Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012. Morbidity and Mortality Weekly Report, 65(No. SS-3)(No. SS-3) 1–23. Available from http://www.cdc.gov/mmwr/volumes/65/ss/ss6503a1.htm#suggestedcitation
Hambly, C., & Fombonne, E., (2011). The impact of bilingual environments on language Development in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42, 1342-1352.
Ijalba, E., (2016). Hispanic immigrant mothers of young children with autism spectrum disorders: How do they understand and cope with autism? American Journal of Speech-Language Pathology, 25,1-14.
Kremer-Sadlik, T., (2005). To be or not to be bilingual: Autistic children from multilingual families. Proceedings from the Fourth International Symposium on Bilingualism (pp. 1225-1234). Somerville, MA: Cascadilla Press.
Ohashi, J.K., Mirenda, P., Marinova-Todd, S., Hambly, C., Fombonne, E., Szatmari, P., Thompson, A. (2012). Comparing early language development in monolingual-and bilingual-exposed young children with autism spectrum disorders. Research in Autism Spectrum Disorders, 6, 890-897.
Petersen, J.M., Marinova-Todd, S.H., & Mirenda, P. (2012). Brief report: An exploratory study of lexical skills in bilingual children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 42, 1499-1503.
Reetzke, R., Zou, X., Sheng, L., & Katsos, N. (2015). Communicative development in bilingually exposed chinese children with autism spectrum disorders. Journal of Speech, Language, and Hearing Research, 58, 813-825.
Valicenti-McDermott, M., Tarshis, N., Schouls, M., Galdston, M., Hottinger, K., Seijo, R., Shinnar, S. (2013). Language differences between monolingual English and bilingual English-Spanish young children with autism spectrum disorders. Journal of Child Neurology, 28, 945–948.
Yu, B., (2013). Issues in bilingualism and heritage language maintenance: Perspectives of minority-language mothers of children with autism spectrum disorders. American Journal of Speech-Language Pathology, 22,10-24.
