Bilingualism in Children with ASD

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Myriam L-H Beauchamp, Ph.D(c), SLP Université de Montréal CHU Ste-Justine

Let’s get on the same page • Define bilingualism • Look at bilingualism in TD children

Review the literature on bilingualism in children with autism

Impacts of recommending against bilingualism

Your role as a clinician

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 The

author has received a Ph.D. grant from Social Sciences and Humanities Research Canada.

 There

are no relevant financial or nonfinancial relationships or conflict of interests to disclose. 3

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  



If one language is hard, 2 languages must be harder. False Bilingualism leads to language confusion. False Code-switching (changing languages within a sentence) indicates a deficit in linguistic knowledge. False Ex: «I aime pas ça moi.» (Paradis et al, 2000, p.257) « J’aime pas ça moi » « *I like not that me » Bilingualism leads to metalinguistic advantages True! Paradis et al. 2011

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Majority Language Minority Language

• Language most commonly spoken in a given environment

• Home or heritage language • Language spoken by a minority of individuals in a given environment

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Simultaneous Bilinguals

Sequential Bilinguals

Acquire L1 and L2 fairly simultaneously

Acquire L2 after they have acquired L1

Generally before the age of 3 years

Introduction of L2 generally occurs after the age 3 years 7

Dominant language The language in which an individual receives the most input.

Affected by: • Environment (additive vs. subtractive) • Amount input

Both of these factors (environment and input) are important to consider when identifying dominance. 8

 Children

do not require 100% of their input to be in a given language to become nativelike. • Children are able to spontaneously use a given

language when they receive as little as 20% of their weekly input in their L2 (Pearson et al., 1993). • They only require between 40-60% of weekly input to be nativelike  Particularly with respect to receptive language (Thordardottir et al., 2011). 9



MacLeod et al. (2013) • In subtractive environments, the 1-parent-1-language

strategy lead to children receiving 19-26% of their weekly input in the minority language. 

Beauchamp et al. (in progress) • In minority French speaker, the amount of input they

received in English had a negative impact on their expressive and receptive vocabulary scores, which we did not find in minority English speakers. • Language preference also had a positive impact of expressive vocabulary scores in English, but not in French • WHY??? 10

Neurodevelopmental disorder affecting 1 in 68 children (CDC, 2014).

Characteristics (DSM-5, 2013): • Deficits in social communication • Restrictive interests and repetitive and stereotyped behaviours • Often language disorders (since DSM-5, no longer a DX criteria) 11

Participants

Measures

Results

• 14 English monolinguals • 14 English-Chinese bilinguals • All with an ASD DX 3.5-5 years old

• Communication Development Inventories (CDI) • Peabody Picture Vocabulary Test-III (PPVT) • Preschool Language Scales-III (PLS-III; expressive and receptive language) • Mullen (development)

Similar performances on both expressive and receptive measures when NVIQ was controlled.

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Participants

Measures

Results

• N= 40 monolinguals and 20 bilinguals • Aged 24-52 months • Matched on NVIQ and age

• Autism Diagnostic Observation Schedule (ADOS) • Autism Diagnostic Interview-Revised (ADI-R) • PLS-4 • Vineland Adaptive Behavior Scalesecond Edition (VABS-II)

• Bilingualism had no negative effect on language acquisition in bilinguals with ASD when compared to monolingual peers with ASD

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Participants

Measures

Results

• 45 bilingual and 30 monolinguals • 36-78 months of age • Bilinguals (from multiple language backgrounds) had had contact to both of their languages within the first 12 months of life

• MacArthur Communicative Development Inventories (MCDI); Words and Sentences • VABS • ADI-R • Social Receptive Scale (SRS)

• Language abilities were similar across both groups • Precursors to language development were similar across both groups. • They concluded that bilingualism did not have a negative effect on language acquisition in bilinguals with ASD when compared to monolingual peers with ASD

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Compared the language and pragmatic competences.

Participants were five-year-old simultaneous bilingual and monolingual children with ASD in China

Formal language abilities and pragmatic abilities, assessed through a battery of parent questionnaires. Language and pragmatic performances of bilingual children with ASD (in their dominant language) where similar to those of their monolingual peers. 15

 Similar

results were also found in bilinguals with ASD in Kay Raining-Bird et al. (2012) and Valicente et al. (2013).

 Based

on a variety of assessment methods, children with ASD were not found to present more language difficulties than their monolingual peers. 16

 The

pattern of results found in children with ASD are similar to those found in children with other language and developmental disorders including: • Children with DS (Kay-Raining Bird et al., 2009) • Children with SLI (Paradis, 2007; Kohnert, 2010)

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 What

is the reality on the ground?

 Bilingual

families often receive the recommendation to raise their children with ASD as a monolingual, from professionals in the fields of health-care and education.

Kremer-Sadlik (2005),Yu (2013), Kay-Raining Bird et al. (2012)

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 Belief

that if one language is hard, 2 must be harder.

 Belief

that bilingualism leads to language confusion.

 Misconception

that code-switching indicates a deficit in linguistic knowledge

 May

not be aware that bilingualism leads to metalinguistic advantages 19

Kay-Raining Bird et al. (2012) asked parents the reasons why bilingualism was important to them. These included:

Communicating with family members

Communicating with people in their neighbourhood and/or school

Living in a bilingual city or country

Better job prospects

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Completed interviews with over 1000 immigrant families to the US whose L1 was not English

Reported negative consequences when parents were unable to communicate with their children in their native language. Especially when parents were not fluent in English

Parents’ inability to proficiently communicate with their child had detrimental consequences for the child-parent bond 21

Method Completed interviews with 10 bilingual English-Chinese immigrant families of children with ASD.

Goal 1) To investigate how these bilingual families use language 2) The difficulties and impacts around using the majority language rather than their heritage language

Conclusion Children were brought up monolingually because of 1) Parents’ beliefs around bilingualism 2) Recommendations by professionals. It’s important to note that this choice created a number of challenges for many families.

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“The first few years I was in the United States, I didn’t know what the word was for “itchy.” Later I learned it. You know, this is one example. It is mundane, but we don’t know these terms when we’re talking with our son. These are day-to-day things.” Yu, 2013, p.19

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Decreased ability for minority language parents to communicate easily with their child

Prevents the child from being able to communicate with some family members

Negative implication for child-parent bond

Exclusion from family conversations

Diminished involvement in his cultural community

Diminished opportunities to acquire the social norms associated with their family heritage language

Diminished conversational opportunities Wong-Filmore (1991), Kremer-Sadlik (2005),Yu (2013), Kay-Raining Bird et al. (2012)

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Share the information with minority language parents

Share this information with our Allied Health colleagues

Clinicians should insure that, when ever possible assessments and interventions be completed in both of the child’s languages

Clinician need to familiarise themselves with the research on best-practices regarding bilingual language assessment and intervention

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Language evaluations will be similar to those completed with bilingual TD children

STEP 1: Establishing language dominance

Establish the amount of input in each language during a regular week across environments.

Parent questionnaires may be helpful to determine dominance (MacLeod, submitted) • ALEQ (Paradis et al.,2010) for preschool children • Gutierrez-Clennen & Kreiter (2003) for school-aged children • Beauchamp and MacLeod (in progress) for preschool and school-aged children 26

STEP 2: Parents as a source of information  Language sample in the home language Ask parents to audiotape a language sample in the home language. Ask parents to transcribe it twice (two separate days). Ask parents to write the ungrammatical sentences grammatically. Go through it with the parent to understand the child’s mistakes. 27

Step 3: Non-word repetition • Can be a good strategy to discriminate between a

child with a second language delay and a language disorder. • Whenever possible, complete the non-word

repetition in both of the child’s languages  Important that the items chosen to assess each of the child’s languages reflect the phonology of each of these languages. Dollaghan & Campbell, 1998; Thordadorttir & Brendeker, 2013

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Narrative skills • In TD children narrative skills can often

discriminate between children with language disorders (poor narrative skills) and children with second language acquisition delays (good narrative skills: Cleaves et al., 2010) • But in children with ASD narrative skills are poor,

even in children with strong language skills.

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Ideally done in both of the child’s languages. If possible, include parents in the child’s SLP session • Helpful in transferring intervention targets and generalize skills to the home environment

Encourage family to speak the minority language at home.

Work on things that are not solely language specific such as... 30

Precursors to language development • Follow and using a point • Following and using joint attention

Narrative skills • Sequencing a story • Story telling • Answering questions about a story

Social pragmatic skills • Perspective taking • Turn-taking (in conversation and play) • Picking-up conversational presses

Play skills • Appropriate functional play • Cooperative play • Imaginary play

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does not have a negative effect on the language development of children with ASD

is often not a choice but rather necessary for many families

For children from bilingual families, monolingualism can have important negative consequences

As clinicians it is important that we share this information with parents and others in the fields of healthcare and education

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Clear guidelines for assessments and intervention to help SLPs working with bilingual children. • Currently, no clear guidelines regarding best-practices for speech and language assessments and intervention

Wider array of intervention strategies with bilingual children in general and more specifically with children with ASD.

More studies on language development of older bilingual children with ASD

Increased understanding of the cognitive effects of bilingualism in children with ASD 33

QUESTION 1: Do school-aged bilingual children with ASD develop language at the same rate as: 1) Their monolingual peers with ASD 2) Their NT peers

QUESTION 2: What are the differences between NT bilingual and monolingual and between bilingual and monolingual with ASD, with regards to the development of: • Grammar • Vocabulary • Narrative skills

QUESTION 3: Does bilingual language development lead to better executive functioning in experimental tasks and in daily living skills in children with ASD and in NT children?

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 Question

1 and 2:

• Bilingual and monolingual children with ASD will

perform similarly to one another on language tasks  As found in NT children, the bilingual children with ASD may have slightly lower scores on language tasks than those of their monolingual peers, but these will be within normal limits.  Question

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• Bilingual children with ASD (and NT bilinguals) will

have better performances on EF experimental task AND lower scores on the ADOS and the BRIEF than their monolingual peers. 35

 Have

any of you worked with bilingual children with ASD? • What are your experiences? • What are the barriers that you have observed?

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Thank-you!

Merci!

Questions?

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American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. American Speech-Language-Hearing Association. (2015) Bilingual Service Delivery. http://www.asha.org/Practice-Portal/ProfessionalIssues/Bilingual-Service-Delivery/ Association of Logopedics and Phoniatrics. (2014) FAQs from the Multilingual Affairs Committee. http://ialpasoc.info/FAQs%20from%20the%20Multilingual%20Affairs%20Committee Beauchamp, M. L-H., MacLeod, A. A. N., Trudeau, N., Sutton, A., Lefebvre, P., Schneider, P. (2016) La relation entre le vocabulaire, le montant d'exposition et le contexte socio-culturel chez les enfants bilingues. Présentation par affiche. Congrès International de L’École d’orthophonie et d’audiologie de l’Université de Montréal. Beauchamp M. L-H. & MacLeod A.A .N. (in progress) Language Dominance Questionnaire for Preschool and School-Aged Children. Crago, M. & Westernoff, F. (1997). CASLPA Position Paper on Speech..Language Pathology and Audiology in the Multicultural, Multilingual Contex. Revue d’orthophonie et d’audiologie, 21, 3, 222-226 Centers for Disease Control and Prevention (2014). Prevalence of Autism Spectrum Disorder among children aged 8 years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2010. Cleaves, P.L., Girolametto, L.E., Chen, X. (2010)Narrative abilities in monolingual and dual language learning hcildren with specific language impairment. Journal of Communication Disorders. 43, 511-522. Dollaghan, C., & Campbell, T. F. (1998). Nonword repetition and child language impairment. Journal of Speech, Language, and Hearing Research, 41(5), 1136-1146. Gutiérrez-Clellen, V. F., & Kreiter, J. (2003). Understanding child bilingual acquisition using parent and teacher reports. Applied Psycholinguistics, 24(02), 267-288. Hambly, C., & Fombonne, E. (2012). The impact of Bilingual Environments on Language Development in Children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 42(7), 1342–1352. Kay-Raining Bird, E. (2009). Bilingualism and Children with Down Syndrome. Perspectives on Language Learning and Education, 16 (3), 90 – 96. Kay-Raining Bird, E., Lamond, E., Holden, J. (2012). Survey of bilingualism in autism spectrum disorder. International Journal of Language and Communication Disorders. 47, 1, 52-64. Kremer-Sadlik, T. (2005). To be or not to be bilingual: Autistic children from multilingual families. In J. Cohen, K. McAlister, K Rolstad, & J. MacSwan (Eds.), Proceedings of the 4th internaAonal symposium on bilingualism (pp. 1225-1234). Somerville, MA: Cascadilla Press. Kohnert, Kathryn (2010). Bilingual Children with Primary Language Impairment: Issues, Evidence and Implications for Clinical Actions. Journal of Communication Disorders. 43(6): 456–473. MacLeod, A.A.N., Fabiano-Smith, L., Boegner-Pagé, S. & Fontolliet, S. (2013). Simultaneous bilingual language acquisition: The role of parental input on receptive vocabulary development. Child Language Teaching and Therapy, 29(1), 131-142

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