Pronoun Use in Monolingual and Bilingual Children with ASD
Monolingual children with Autism Spectrum Disorder (ASD) show deficits in linguistic abilities that involve perspective-taking and pragmatic judgments1. For example, monolingual children with ASD have notorious problems with pronoun use2. In children with typical language development (TLD), pronoun use is related to syntactic knowledge, discourse-pragmatic knowledge, Theory of Mind (ToM) skills and Executive Functioning 3. Little is known about the interface of ASD and bilingualism. Many parents of bilingual children with ASD are fearful of speaking their native language to their children, because they worried that dual-language exposure would confuse the children or exacerbate their impairments4. Moreover, parents receive advice from professionals to refrain from an additional language and to maintain a monolingual environment for children with ASD5.
In the current study, we assessed pronoun production in monolingual and bilingual children with and without ASD and explored the relationship between pronoun use and children's ToM skills, Executive Functioning and complex syntax.
Forty-five monolingual Hebrew-speaking children (28(18f/10m) with TLD and 17 (1f/16m) with ASD and 44 bilingual Russian-Hebrew-speaking children (30 (16f/14m) with TLD and 14 with ASD (3f/11m)) aged 4;6-9;2 participated. Bilingual children with and without ASD were raised in Russian-speaking families in Israel and spoke Russian as their Heritage Language and Hebrew as their Societal Language. Children with ASD received their diagnoses by a multidisciplinary team of specialists prior to the study, and it was verified using the Autism Diagnostic Observation Schedule (ADOS6) as part of the study assessment battery. All children scored within the norm on non-verbal IQ7.
The pronoun elicitation task elicited third person pronouns in subject and object positions in Hebrew. In addition, we measured children’s ToM skills; Executive Functioning (Inhibition and Verbal Working Memory), and complex syntax.
The results indicated an effect of Clinical Group, no effect of Language Status and no interaction between the two variables. The use of pronouns was lower in children with ASD as compare to their TLD peers. Children with ASD omitted pronouns more frequently in obligatory positions and/or produced more noun phrases instead of pronouns as compared to children with TLD. Importantly, bilingual children showed similar performance to their monolingual peers.
In the ASD group, pronoun use was associated with ToM skills and complex syntax, while no associations were detected between pronoun use and Executive Functioning measures. A further step-wise regression analysis showed that 39% of the variance of the pronouns use in children with ASD is explained by complex syntax, and 10% of the variance is explained by ToM skills.
To conclude, the findings show that pronoun use is impaired in children with ASD, yet bilingualism is NOT an aggravating factor for children with ASD, which is reflected in the similar performance of bilingual and monolingual children with ASD. The core deficit of pronoun use in children with ASD is associated with their complex syntax and ToM difficulties.