A Comparison of Parent-Reported and Clinician-Reported Measures of Autistic Traits in Bilingual and Monolingual Autistic Children

Background: There is a growing literature on the cognitive profile of bilingual speakers and its unique advantages and disadvantages. Current evidence suggests that bilingualism confers advantages in the area of executive function, specifically attention control, inhibitory control and cognitive flexibility (Bialystok & Majumder, 1998; Bialystok, 1999; Bialystok, 2003; Bialystok & Viswanathan 2009; Kovacs & Mehler, 2009; Carlson & Meltzoff, 2013). However, evidence from the language development of bilingual children suggests that exposure to more than one language may results in delays in first word acquisitions, compared to monolingual children, (Meisel, 2004) and smaller overall vocabulary size (Ben-Zeev, 1977). In light of the latter evidence, parents of children with primary language impairment or other communication difficulties such as autism have historically often been advised to restrict the language input to one language (Juarez, 1983; Thordardottir, 2002; Kremer-Sadlik, 2005). While evidence is converging that multilingual environments are not detrimental to development in ASD (Uljarevic et al, 2017), it is poorly understand how the convergence between differences in bilingual and autistic language development may impact assessments and interventions for autistic bilingual children.

Objectives: To perform an explorative investigation of parent-reported and clinician measures of autistic symptomatology in bilingual and monolingual children with ASD.

Methods: ADOS and parental SRS data were collected as part of a multi-centre intervention study (Bieleninik et al 2017; TIME-A consortium) and included 45 children with autism raised in a multilingual environment and 319 (314 for the SRS) monolingual children with autism. All children were between the ages of 4 and 7 (mean age = 5.4 years, sd ± 0.99). Multilingualism was identified by the researcher working with the particular child and based on whether the child was exposed to more than one language in their home environment.

Results: Preliminary analyses show that the mean SRS scores for bilingual children were marginally lower (152.31) than for monolingual children (160.53) (p=0.074), indicating less pronounced parent-reported autistic symptoms. On the other hand, ADOS Social Affect scores in the bilingual children were higher (15.84), compared to the monolingual children (13.49) (p=0.001). The differences were primarily the language and communication items (A1-A8) and a few social items (smiling, facial expressions and requesting). Advanced statistical analyses will be reported by the time of the conference.

Conclusions: While the severity of symptoms reported by parents on the SRS was not significantly different between the groups, the ADOS results from the clinicians suggested a higher level of autistic symptoms in the multilingual group. Importantly, the differences seem to arise from items measuring the language and communication of the child, suggesting that additional factors might have to be taken into consideration when clinicians do not have access to all of the languages spoken or comprehended by the children. Further understanding of how the interaction between bilingualism and autism may impact parent reporting and clinical assessments of autism should be our next research priority, to ensure that the currently available tools are appropriate for autistic bilingual individuals.