1. Bilingualism and Autism BY: HENRY, SEPIDEH AND JO

2. Case Study: Mami Yamamoto 3 year old girl with ASD, attends preschool Mami lives at home with: Parents, both fluent in English and Japanese Grandmother, Japanese only Mami’s speech: ~20 English and Japanese words A few 1-2 word phrases, mostly echolalic Frequent tantrums “20 questions” approach

3. Our Goal 1. To answer the question, “should we expose Mami to English? Japanese? Or both languages?” Bilingualism: Mom, grandmother, speech-language pathologist Bilingual household Forced monolingualism: Dad, developmental pediatrician, preschool teacher Mami already has a language delay “Making matters worse” 2. To increase Mami’s communication and language skills

4. Introductory Video  https://www.youtube.com/watch?v=Nqd_gqneyRM https://www.youtube.com/watch?v=Nqd_gqneyRM

5. What is your experience with bilingualism and forced monolingualism? Forced Monolingualism: Forced to speak only one language – sometimes the non-native language Bilingualism: Exposed to two different language (native and non- native language)

6. Common “Wisdom” Language system overload  negative overall language development “Language handicap,” “semi-lingualism”

7. Common Professional Advice Use only one language regardless of the family’s proficiency in the language (6) Use two languages, but: Divide time so 50% speaking each language Use different languages with different people Use different languages in different places 16% encouraged natural bilingual exposure (6)

8. Common Concerns for Forced Monolingualism Social distance between family, community, peers Child is left out from conversations and interactions Parents are forced to speak a language they are not fluent in Incorrect grammar models, pronunciations, etc. Impact the child’s language development

9. Common Concerns for Bilingualism Confusion (6) Difficulty learning multiple languages (6) Further detriment language development

10. What is the impact of bilingualism or forced monolingualism on early language development in children with ASD?

11. Impact of bilingual environments on language development of children with ASD Hambly & Fombonne, 2012 45 bilinguals with ASD, 30 monolinguals with ASD Average 56 months old Study found: No language delays in bilinguals with ASD Language achievements are possible regardless of environment No additional vulnerabilities to bilingual ASDs Childcare options, special education choices, rights as immigrants influenced families’ language usage decisions “Social impairments causing additional language delays in bilinguals with ASD” is a misconception - bilingualism is OK!

12. Are there language differences between monolinguals and bilinguals in children with ASD? Valicenti et al., 2013 40 bilingual Spanish-English toddlers with ASD 40 monolingual English toddlers with ASD Compared expressive and receptive language skills Found that bilingualism did not negatively affect language development Bilinguals coo-ed and gestured (pointing, hand- leading) more often than monolinguals More bilinguals showed pretend play skills Conclusion: bilingualism does not add any extra vulnerabilities to the group

13. What about the language of instruction and intervention outcomes?

14. Effects Of Language Of Instruction On Response Accuracy And Challenging Behavior In A Child With Autism Lang, Rispoli, Sigafoos, Andrews, & Ortega, 2011 Effects of language of instruction on response accuracy and challenging behavior One participant 4 year old girl with autism with limited spontaneous speech and mild challenging behavior who attended a bilingual school (Spanish and English) Child’s family spoke only Spanish Child received DTT in English and Spanish Compared sessions to see if language instruction influenced challenging behaviors and correct responses

15. Lang et al., 2011 Higher number of correct responses, fewer challenging behaviors in Spanish Higher learning history in home environment because it was highly reinforcing Verbal praise during Spanish DTT more powerful reinforcer than verbal praise in English Best to give instruction using different languages that the child has been exposed to Use of a standardized tests in one language may be insufficient for those who speak multiple languages

16. Intervention Outcomes of Bilingual Children with ASD Seung et al., 2006 Purpose: efficacy of a Korean-English bilingual intervention Method Longitudinal study that followed one child with ASD, 3.5 years Speech language intervention provided 2x per week in Korean for first 12 months next 6 months intervention gradually delivered in English Results- child made significant gains in expressive and receptive language development in both languages and a decrease in challenging behaviors

17. Compared to monolinguals, what do the language skills of children with ASD who are bilingually exposed look like?

18. What is the effect of bilingual language exposure and dominant language (L1) language skills on a child’s L2 vocabulary size? Hambly & Fombonne, 2014 23 French-English, 10 English children with autism Significant difference between direct vs. indirect language exposure Direct = direct conversations/interactions Indirect = overhearing Recent, direct exposure to L2 correlated with larger L2 vocabulary sizes Matches typically developing populations Indirect exposure to L2 does not guarantee expressive bilingual vocabularies Language loss Social impairments hypothesis

19. Lexical skills in bilingual children with ASD Peterson, Marinova-Todd, & Mirenda, 2012 Purpose: investigate lexical skills of monolingual and bilingual children with ASD Method: similar to ones used to assess typically developing bilingual children Participants: 28 children were chosen from a metropolitan area in Canada 14 exposed to both Chinese and English 14 exposed to English only Average age 59 months

20. Peterson et al., 2012 Results: Bilingual children had larger total vocabulary production Had equal conceptual vocabulary and English vocabulary compared to same aged monolingual children with ASD Bilingualism does not negatively affect the development of language in children with ASD

21. Bilingualism and Families

22. Parent’s role in language development Kreker-Sadlik, 2005 Parents are one of the primary sources for language input, imitation, and development in children with ASD Parents act as trainers;teach children to attend to socio cultural beliefs, norms and expectations Parents teach children through role play and modeling Important to have this type of interaction especially if the parent speaks the primary language only Author suggests that, “to be or not to be bilingual is NOT the question”

23. Kreker-Sadlik, 2005 “…children are brought up in a multilingual, multicultural society and need to be given the chance to learn both languages so that they can become members of their community…”

24. Multilingual Development In Kids with ASD Jegathessan, 2011 Purpose: Examine parents’ beliefs regarding the acquisition of multiple languages of their children with ASD Participants: Three multilingual Muslim immigrant families living in large US cities Children with ASD 2 to 8 years old Qualitative study Interviews conducted with parents, on-site fieldwork and observation sessions

25. Jegathessan, 2011 If only English used, communication and relationship between the child and their non-English- speaking family members would be strained Parents stated: important for their kids to be multilingual English- needed to participate in school and workplace in the mainstream American society→ increased quality of life Native languages- maintain their traditions and customs to ensure full participation in their own ethnic communities, and more chances for social interactions

26. Jegathessan, 2011 “It’s important for Raqib to be with his grandmother and aunts, uncles, and be able to talk to them. His grandmother, older aunts cannot speak English well.….We did not stop him from speaking to his grandmother in whatever language he wants. Raqib and his grandmother understand one another.….Even if it is a few words, he responds and it makes my mother-in-law happy. Being able to talk to one another has allowed them to have their own special relationship.”

27. Intergenerational Language Practices- Chinese- American Parents With Kids With ASD Yu, 2013 Purpose: Explore what factors affect parents’ choices for language use with their children with ASD Participants: 15 parents from 10 families fluent in both English and Cantonese and/or Mandarin Each parent had at least one child with a diagnosis with ASD Children ranged from ages of 3 to 8 years Exploratory with detailed interviews with families using open-ended questions ○ Interviews audio recorded

28. Yu, 2013 Parents wanted their children to be fluent in both English and Cantonese/Mandarin English a priority- attend school, participate in community and integrate into mainstream society Cantonese/Mandarin- communicate fully with family members, express intimacy and to associate with their own culture Parents more effective in communicating using Cantonese/Mandarin with their children with ASD; affective displays also enhanced

29. Yu, 2013 “Mainly, we feel that Chinese is an important language too. For us, the parents, it’s the mother tongue. Victor and I speak to each other at home and I think Jessica should understand what we’re saying. Also, as we age and they grow up, our English is probably not going to keep pace with theirs; then we would have difficulties communicating, I think.”

30. Overview of bilingually-exposed children with ASD population Kay-Raining Bird, Lamond, & Holden, 2012 Survey, participants: 49 parents 75% (37) exposed child with ASD to 2+ languages Factors influencing families’ decisions: Community’s dominant language, living environment’s language, life opportunities, job outcomes Concerns No professional help, limited access to services, (perceived) difficulty and confusion in learning a 2nd language

31. An Ethnographic Narrative Case Series Exploring Language Recommendations For Bilingual Families Of Children With ASD Fernandez y Garcia, Breslau, Hansen, & Miller, 2012 Purpose: explore the social consequences of English-only recommendation for multilingual families with children with ASD Open-ended narrative interviews Participants: 5 mothers from bilingual families, total of 8 children with ASD English-only advice: increased effort and stress for bilingual parents who attempt to suppress their bilingual tendencies in favour of speaking only English Deep personal loss and sadness

32. Fernandez y Garcia et al., (2012) “.....mothers reported a great sense of relief when they began to reintroduce their native language into family life. “I felt like a parent again,” said one mother, and another poignantly described the sense of deep emotional attachment she rediscovered with her children as she began to sing songs in her native non-English language.”

33. To be or not to be bilingual? As consultants for the family, based on the above research we would advise them to use both languages at home

34. Questions? Comments?

35. References 1. Elder, H. J., Hyekeyeung, S., & Siddiqi, S. (2006). Intervention outcomes of a bilingual child with autism. Journal of Medical Speech-Language Pathology, 14, 53-59. 2. Fernandez y Garcia, E., Breslau, J., Hansen, R., & Miller, E. (2012). Unintended consequences: an ethnographic narrative case series exploring language recommendations for bilingual families of children with autistic spectrum disorders. Journal of Medical Speech-Language Pathology, 20(2), 10-16 3. 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, 1342- 1352. 4. Hambly, C., & Fombonne, E. (2014). Factors influencing bilingual expressive vocabulary size in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 8, 1079-1089. 5. Jegatheesan, B. (2011). Multilingual development in children with autism: perspectives of South Asian Muslim immigrant parents on raising a child with a communicative disorder in multilingual contexts. Bilingual Research Journal, 34, 185-200 6. Kay ‐ Raining Bird, E., Lamond, E., & Holden, J. (2012). Survey of bilingualism in autism spectrum disorders. International Journal of Language & Communication Disorders, 47, 52-64. 7. Kremer-Sadlik, T. (2005). To be or not to be bilingual: autistic children from monolingual families. Cascadilla Press. Somerville, MA: Cascadilla Press. 8. Lang, R., Rispoli, M., Sigafoos, G. L., Andrews, A., & Ortega, L. (2011). Effects of language of instruction on response accuracy and challenging behavior in a child with autism. Journal of Behavioral Education, 20, 252-259.

36. References 9. Peterson, J. M., Marinova-Todd, S. H., & Mirenda, P. (2012). Brief report: an exploratory study of lexical skills in bilingual children with autism spectrum disorder. Journal of Autism Developmental Disorder, 42, 1499-1503. 10. Ohashi, J, K., Mirenda, P., Marinova-Todd, S., Hambly, C., Fombonne, E., Szatmari, P., Bryson, S.,...Zwaigenbaum, L. (2012). Comparing early language development in monolingual and bilingual- exposed young children with autism spectrum disorders. Research in Autism Spectrum Disorders, 6, 890-897. 11. Seung, H., Siddiqi, S., & Elder, J.H. (2006). Intervention outcomes of a bilingual child with autism. Journal of Medical Speech-Language Pathology, 14, 53-63 12. Valicenti-McDermott, M., Tarshis, N., Schouls, M., Galdston, M., Hottinger, K., Seijo, R.,... & Shinnar, S. (2013). Language differences between monolingual English and bilingual English-Spanish young children with autism spectrum disorders. Journal of child neurology, 28, 945-948. 13. Yu, B. (2013). Issues in bilingualism and heritage language maintenance: perspectives of minority- language mothers of children with autism spectrum disorders. American Journal of Speech-Language Pathology, 22, 10-24