Bilingually Exposed Children with Autism Spectrum Disorder: Language and Socio-Communication Outcomes

Background: Despite concerns of many families and healthcare providers, emerging evidence suggests that bilingually exposed children with autism spectrum disorder (ASD) have similar language, behavioural, and cognitive outcomes to their monolingual counterparts. Furthermore, excluding children from exposure to the minority in favor of the majority language could lead to negative consequences, such as reducing engagement and closeness with family and community. Thus, it is important to understand the characteristics of families that maintain minority-language exposure and the associated positive or negative outcomes.

Objectives: The objectives were to (1) determine if families continue to use the minority language from ASD diagnosis until age six, (2) explore child and family characteristics associated with maintaining a minority language, and (3) compare children whose families continue to use the minority language to families who do not and to monolingually exposed children on majority-language and socio-communication outcomes at six years.

Methods: Data from 39 children with ASD exposed to a minority language by primary caregivers (M age =36.0 mo; SD =6.5; 74% males) and 17 monolingually exposed children (M age =35.1 mo; SD =5.5; 88% males) were drawn from the Canadian Pathways in ASD study. Children were assessed within four months of diagnosis (T1), one year later (T2), and at age six (T3). Children’s language skills in the majority language were examined using the PLS-4 and CDI. Social and communication skills were assessed using the VABS-II Communication and Socialization subdomain scores.

Results: Only 30% of caregivers who reported primarily using a minority language with their child at T1 (n =21) still did so by T2. Mann-Whitney U and Chi-squared tests indicated that child age, IQ, ASD symptom severity, and language-level (minimally verbal vs. verbal) at T1, and caregiver level of education did not predict switching to the majority language. None who used a minority language as secondary at T1 (n =18) were using it as primary by T2. Only one of six families using a minority language as primary at T2 stopped by T3. Notably, 38% of caregivers stopped using the minority language entirely by T2: 7/21 who primarily used a minority language and 8/18 who used a minority language as secondary at T1. However, three families from each group re-introduced it by T3. Child and caregiver characteristics at T1 did not distinguish caregivers who stopped using the minority language. Importantly, at age six, ANOVAs with planned contrasts revealed no differences in expressive or receptive language, or socio-communication skills among children whose caregivers continued minority-language exposure (n =18), stopped minority-language exposure (n =14), and monolingually exposed children (n =17), who were matched on child and caregiver characteristics at T1 using propensity score matching.

Conclusions: Child and caregiver characteristics at ASD diagnosis did not distinguish between families who continued and families who stopped minority-language exposure during the preschool years. Further, bilingually and monolingually exposed children had similar majority-language and socio-communication outcomes. Our results add to growing evidence that bilingualism does not hinder majority-language development in ASD.