Understanding the Linguistic Needs of Diverse Individuals with Autism Spectrum Disorder: Some Comments on the Research Literature and Suggestions for Clinicians

A survey of speech and language therapists' opinions of bilingualism and the advice they give to bilingual families of children with speech, language and communication needs - a comparative study between the UK and Singapore

There is emerging evidence that bilingualism is advantageous to children with speech, language and communication needs (SLCN), reflected in recommendations to promote maintenance of the home language. However, little is known about Speech and Language Therapists (SLTs)' opinions on bilingualism and practices with bilingual families. To survey the opinions and practices of SLTs on this topic, a questionnaire was developed and delivered as an anonymous web-based survey. We recruited SLTs from Singapore, where bilingualism is the norm amongst the general population and enshrined in government policies, and the UK, where bilingualism is less prevalent and not embedded in government policy. Questions probed SLTs' opinions, advice given to parents/carers, personal and professional experience of bilingualism, and knowledge of and opinions on official guidelines from the Royal College of Speech and Language Therapy (RCSLT). The survey revealed variability in opinions and practices of SLTs working with bilingual families. Amongst the UK-based respondents, the RCSLT bilingualism guidance was generally perceived positively, however, many were unfamiliar with its content, or found barriers to its implementation. Most SLTs reported recommending bilingualism to families of children with SLCN and suggesting that parents/carers speak in all languages they are proficient in, but a minority reported views and practice based on outdated assumptions: practitioners who believed bilingualism can cause or contribute to SLCN were less likely to recommend that parents/carers speak languages they are proficient in. These findings can help identify areas to target within training and continuing professional development to increase evidence-based advice given to bilingual families.

Parent-led Communication Therapy for Young Bilingual Autistic Children: A Scoping Review

A scoping review of the literature was undertaken using JBI guidelines to map the evidence of parent-led therapy (PLT) for young autistic children (≤ 6 years) raised in bilingual environments. Reviewers used Covidence to screen located sources. Sixteen papers met inclusion criteria. A strong acceleration of reports of PLT for young autistic children measured in bilingual environments was observed, with 93.8% of papers (n = 15) published since 2015. Reporting of participants' language environments (home language(s)/L1s and societal language(s)/L2s) was inconsistent. A large majority of these studies, 87.5% (n = 14) were conducted in North America or in collaboration with a North American institution. Diverse PLT programs and methodologies were identified. There is variation in demographic information collected and outcomes reported. Evidence gaps in the literature are identified and the value of undertaking systematic review on this topic is considered. This scoping review points to the necessity of further empirical research and practice that centres parents in early and specific support for autistic children raised in bilingual environments. Suggestions for improving reporting standards of language profiles are provided.

Examining Cultural and Linguistic Sensitivity of Pathways Early Autism Intervention with Hispanic Families

PURPOSE

This research aimed to evaluate evidence of Pathways parent-mediated early autism intervention as a culturally and linguistically sensitive intervention (CLSI) for Hispanic families with autistic children.

METHODS

We used Bernal et al.'s ecologically valid (EV) framework to evaluate current practice and Hispanic parents' perceptions of Pathways 1 ½ years after completing the intervention. Both quantitative and qualitative methods were used. Nineteen parents were contacted, of which 11 completed a semi-structured interview about their experience with Pathways.

RESULTS

On average, the group that completed the interview was less educated, had more monolingual Spanish speakers, and rated their general experience with the intervention slightly more positively than those who did not agree to complete the interview. A review of Pathways's current practices through the lens of the EV framework suggested that Pathways was a CLSI for Hispanic participants in the domains of context, methods, language, and persons. Parental interviews echoed these strengths. However, Pathways did less well balancing evidence-based intervention strategies for autistic children with the heritage value of respeto.

CONCLUSION

Pathways demonstrated strengths regarding cultural and linguistic sensitivity for Hispanic families with young autistic children. Future work with our community stakeholder group will integrate heritage and majority culture perspectives to strengthen Pathways as a CLSI.

Early years autism and bilingualism: An interpretative phenomenological analysis of parent perceptions during lockdown

AIM

This study explores how bilingual parents of autistic children made language decisions for their families, how the event of the SARS-CoV-2 pandemic and subsequent lockdown impacted the communication environment of their households, and whether these experiences affected their language habits.

METHOD

Semi-structured interviews were conducted with five bilingual parents of autistic children who lived through lockdown in France. Data were analysed using interpretative phenomenological analysis. Demographic and background information was collected using an adapted version of the Questionnaire for Parents of Bilingual Children.

RESULTS

Participants reported conflicting advice given by a range of practitioners. Parents expressed differing beliefs about the impact of language choices on their children. Parents described active engagement with their children's home-learning as generally positive. Parents identified an increase in children's exposure to their first language during the lockdown. Parents reported an increase in children's overall communication abilities.

CONCLUSION

Parents believed that their children's positive communication development during lockdown was related to increased exposure to their first language(s), and direct involvement in their children's learning programs.

Often Encountered but Rarely Reported: Challenges in Selecting Language(s) for Intervention in Bi/Multilingual Children with Autism Spectrum Disorder

India is a socioculturally and linguistically diverse country. Most often individuals grow up exposed to more than one language. Apart from exposure to native and community languages, there is a growing preference for English as the language of formal education and employment. Previous studies demonstrated that bilingual children with autism spectrum disorder (ASD) develop language similar to their monolingual nonverbal IQ-matched ASD peers. However, most of these studies have been conducted in countries in which English is the primary language for majority of the population. Although existing studies support a bilingual environment for children with ASD, professionals still seem to advise families' use of a monolingual approach. This paper reviews and discusses factors that influence the selection of language(s) for intervention in young children with ASD in bi/multilingual environments. These are discussed under three areas namely, (1) language environment of the child, (2) parent/caregivers' perspectives regarding bi/multilingual exposure, and (3) medium of education and availability of intervention services. This paper also highlights the complexities involved in the language selection process for intervention using four case vignettes. Based on the review and findings from the case vignettes, it is evident that there is a need for (1) sensitizing fellow professionals regarding the increasing shift toward a bi/multilingual approach, (2) formulating guidelines for this decision-making process, and (3) continuing to develop an evidence base for adopting multilingual approach for intervention in a socioculturally and linguistically diverse country like India.

Bilingualism effects in pronoun comprehension: Evidence from children with autism

The prevalence of autism worldwide has risen steadily in the last two decades, while bilingualism is also becoming increasingly prevalent in today's rapidly globalizing world. The current study aimed to investigate bilingualism effects in the pronoun resolution skills of children with autism in comparison to age-matched monolingual children with autism, as well as monolingual and bilingual children of typical development (Ν = 20 participants per group). Results showed that autistic children had general difficulty anchoring ambiguous pronouns to entities that were linguistically expressed in discourse, yet, the bilingual children with autism were more sensitive to the topicality of the entities in syntactic subject position and more prone to identify them as suitable referents of ambiguous null pronouns as compared to their monolingual peers. The findings suggest that bilingualism is not detrimental to autistic children's pronoun resolution skills. The current study aimed at determining how bilingualism influences ambiguous pronoun comprehension in children with autism as compared to bilingual and monolingual children of typical development. The findings show that bilingualism was not detrimental to the autistic children's pronoun resolution skills, further suggesting that having acquired more than one language does not exacerbate autistic children's deficits in the comprehension of pronouns.

Parental Perceptions and Decisions Regarding Maintaining Bilingualism in Autism

A growing body of evidence suggests that bilingual exposure does not negatively impact children on the autism spectrum. This study sought to illuminate parents’ perceptions and choices regarding maintaining bilingualism in autism. Semi-structured interviews were conducted with 16 family members in England and Wales. Data were analysed using interpretative phenomenological analysis (IPA). Although parents expressed positive attitudes towards bilingualism, these views were not always congruent with their language practices. Instead, several factors influenced decisions about language maintenance in autism, including the severity of the child’s autism, advice received, and the importance of English as the dominant societal language. This article calls for greater support for families in making language decisions that are suitable for the individual child and their family.

Perceptions, Experiences, and Needs of Parents of Culturally and Linguistically Diverse Children with Autism: a Scoping Review

A scoping review of studies carried out in the UK and the USA was conducted to explore the perceptions, experiences, and needs of culturally and linguistically diverse families of children with autism. Overall, 32 articles met the inclusion criteria, 25 studies were conducted in the USA and 7 studies in the UK. Four themes emerged including (a) knowledge and beliefs about autism and their impact on the family; (b) autism and family life; (c) family experiences of accessing services and support, and parents’ needs; and (d) multilanguage. Findings highlighted that family perceptions of autism are influenced by an often-reported lack of knowledge; experiences include social stigma as well as difficulties in having access to services. Needs indicate the development of culturally sensitive interventions, information in multiple languages, and parent–professional collaboration. Implications for research, policy, and practice are included.

Question-response-evaluation sequences in the home interactions of a bilingual child with autism spectrum disorder

BACKGROUND

Prior research has described the prevalence and utility of questions in children's language learning environment. However, there has been little empirical investigation of the interaction sequences that ensue following caregiver questions. Understanding these interactions may be especially important for children with autism spectrum disorder (ASD), who may have difficulty engaging in reciprocal interactions. Question-response-evaluation sequences (QRE) are a particular type of interaction sequence launched by questions that have been examined primarily in classroom contexts. Less research has been devoted to understanding how caregivers and children with ASD leverage this interactional format in the context of home interactions.

AIMS

We focus on QRE sequences within interactions between a 5-year-old bilingual child with ASD and his parents. In these sequences, the adult poses known-answer questions, the child responds and the adult evaluates the response. QRE sequences are primarily structured by the questioner (i.e., the parents in our context), and we examine the interactive work done by parents to initiate, maintain and close these sequences. We also examine the child's contributions to these sequences.

METHODS & PROCEDURES

We applied conversation analysis (CA) to video recordings of home routines, such as play, book-reading and schoolwork. Videos were fully transcribed using CA conventions, and 55 QRE segments were isolated from the data corpus for further analysis.

OUTCOMES & RESULTS

Q-word questions (i.e., where, what, why, when, how questions) were the most prevalent question format, and repetition of the child's response was the most prevalent form of evaluation. We found that QRE sequences were embedded within a variety of action trajectories that extend beyond pedagogical functions. These included repairing a prior utterance, extending collaborative play routines and engaging in topically connected labelling rituals.

CONCLUSIONS & IMPLICATIONS

QRE sequences appeared to strike a balance in terms of the level of constraint they placed on the child's contributions to interactions, and the affordances they provide for participating in and progressing through interactions. This study can help clinicians understand the types of interactions that can be pursued with QRE sequences in their work with children with ASD. The findings may also aid intervention researchers' efforts to leverage caregivers' existing strengths for adapting their interactional overtures to maximize children's engagement. Finally, this study provides an illustration of caregiver-child interactions in a population that is currently under-represented in the literature.

Social Differences Between Monolingual English and Bilingual English-Spanish Children With Autism Spectrum Disorders

OBJECTIVE

Bilingualism is increasingly prevalent; however, research in bilingual children with autism is sparse. The purpose of this study was to compare social skills and autistic features in monolingual English and bilingual English-Spanish children with autism spectrum disorder.

METHODS

We conducted a review of the multidisciplinary evaluations done in all children aged one to six years diagnosed with autism spectrum disorder in an inner city, university-affiliated clinic from 2003 to 2013. Collected information included demographics, developmental testing, and autistic characteristics.

RESULTS

We identified 462 children; 165 were bilingual English-Spanish and 297 were monolingual English. Parents of bilingual children reported stereotyped or repetitive use of language more often (66% vs 48% P = 0.002) than monolinguals. Significant differences were not found in social interaction, use of nonverbal behaviors, peer relationships, sharing or social or emotional reciprocity, mannerisms, or autism severity.

CONCLUSIONS

Bilingualism does not seem to confer an extra vulnerability on children with autism spectrum disorder; however, differences in qualitative use of language were observed.

Should Heritage Languages be Incorporated into Interventions for Bilingual Individuals with Neurodevelopmental Disorders? A Systematic Review

Special education policies recognize the need for developing and preserving the heritage languages of individuals with disabilities. Yet there seems to be a disconnect between policy and practice. Should the heritage languages of bilingual individuals with neurodevelopmental disorders be incorporated into interventions? This review evaluated 18 studies that examined the effects of heritage language instruction on treatment outcomes for individuals with neurodevelopmental disorders. Overall, results suggest a small effect favoring interventions delivered in the heritage language versus interventions delivered solely in the majority language. In general, studies were also found to be of high-quality according to What Works Clearinghouse Standards. Findings are discussed in terms of recommendations for future research and practice.