Authored by: Mirela Cengher, Ph.D., BCBA
University of Maryland, Baltimore County
Mirela Cengher, Ph.D., is an Assistant Professor in Psychology at the University of Maryland, Baltimore County (UMBC). Dr. Cengher began working with children with developmental disabilities as an undergraduate student in Romania. She then moved to the United States to pursue graduate training in behavior analysis. Dr. Cengher received her doctorate in Psychology from The Graduate Center, City University of New York, and completed her Postdoctoral Fellowship at Kennedy Krieger Institute and Johns Hopkins University School of Medicine. Her primary research interest is at the intersection of verbal behavior and stimulus control—specifically, in her research, she evaluates variables that affect the acquisition of verbal behavior and the development of emergent relations. Dr. Cengher serves as an editorial board member, guest Associate Editor, and Associate Editor for several scientific journals (e.g., Journal of Applied Behavior Analysis, The Analysis of Verbal Behavior, Behavior Analysis in Practice).
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The Lowdown on Bilingualism and Autism Spectrum Disorder (ASD)
The fastest and most diverse vulnerable group in the U.S. consists of immigrants and their children (Zhou, 1997)—currently, there are as many as 21% of school-age children in the U.S. speaking a language other than English at home (Lowry, 2000). Autism Spectrum Disorder (ASD) occurs across all racial, ethnic, and socioeconomic groups (Durkin et al., 2017); therefore, it is fair to assume that the prevalence of children with ASD who have diverse cultural and linguistic backgrounds (i.e., are bilingual[1]) is high.
Bilingualism is defined as proficiency in two languages (Lee, 1996). Grosjean (1989) cautioned that a bilingual is not the equivalent of two monolinguals—in other words, learning two languages is not an additive process. Instead, there are interaction effects between the two languages that make bilingualism an area of study in and of itself. For example, after learning to tact (label) a ball in two languages (e.g., ball in English and minge in Romanian), a sophisticated speaker should generate bidirectional intraverbals (translations between languages) in the absence of direct instruction (e.g., when asked “What is ball in Romanian?” they should respond “Minge” and when asked “What is minge in English?” they should respond “Ball”).
Why Teach In More Than One Language?
One of the diagnostic criteria for ASD consists of deficits in social communication (American Psychiatric Association, 2013), and it has long been (erroneously) assumed that exposing children with ASD to two or more languages can exacerbate these deficits. As a result, professionals have often recommended that caregivers and teachers only teach these children one language, English, despite their diverse cultural and linguistic backgrounds (Beauchamp & MacLeod, 2017). However, research comparing monolingual and bilingual children’s language abilities demonstrated that bilingualism does not lead to language delays in children with ASD, beyond those that are due to the disability (e.g., Beauchamp & MacLeod, 2017).
Another argument in favor of bilingual instruction is that the caregiver-child relationship may be negatively affected if the child is only taught in English when caregivers are not proficient in this language. This, in turn, can impact the child’s treatment outcomes. For example, children may learn to mand (request) preferred items in English at school; however, caregivers could fail to honor these requests at home if they don’t understand English. As a result, children may engage in alternative behaviors to access preferred items at home, and some of these behaviors may be undesirable (e.g., aggression).
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So….What’s the Best Way to Introduce a Second Language?
If you’re already convinced of the advantages of bilingual instruction, a logical question that follows is how to introduce the two languages. Children can learn two languages concurrently, usually from infancy (i.e., simultaneous bilingualism), or they can learn one language first, followed by the second language, usually when beginning school (i.e., sequential bilingualism). The difference between simultaneous and sequential bilingualism is important because it highlights the role of experience in learning (Flynn et al., 2005). Studies on this topic have shown that, in general, neurotypical children exposed to simultaneous bilingualism perform better than children exposed to sequential bilingualism on vocabulary tests, possibly due to prolonged exposure to both languages (Thordardottir, 2019). However, it is unclear whether these differences are due to the timing of instruction (i.e., sequential versus simultaneous), or the overall difference in the duration and amount of exposure. My students and I completed several research projects on this topic while trying to control for these limitations (e.g., Zhao et al., 2024). Overall, we found that both simultaneous and sequential instruction are effective when teaching tacts (labels) to children with ASD. However, simultaneous instruction produces superior outcomes, especially with respect to the emergence of listener responses (pointing at pictures) and intraverbals (translations between languages). Stay tuned for more information as we publish these manuscripts and disseminate our work at professional conferences!
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A related question is what the optimal procedures for teaching two languages might be. While other fields in psychology focused on the topics we covered so far, not surprisingly, behavior analysts have largely focused on this topic. In most of the behavior analytic studies to date, researchers compared the effectiveness and efficiency of different types of instruction (i.e., speaker and listener; requests versus labels in the environment). Hereafter, we will focus on the comparison that generated the most consistent findings across studies—that of the speaker and listener instruction. For example, Hu et al. (2023) taught participants with ASD to mand (request) preferred items in a foreign language. The authors found that participants not only learned to mand for preferred items, but once they acquired this repertoire they also demonstrated tacts (labels) and listener responses (pointing to objects) for the respective vocabulary words. In short, the authors’ findings suggest that mand instruction is not only effective, but also efficient in that it generates emergent responses (in this case, tacts and listener responses). Future research could extend this work by comparing the effectiveness and efficiency of other types of instruction for this population.
In summary, research on bilingualism in ASD is still in its infancy and, at this point, it is difficult to make evidence-based recommendations about how to teach two languages beyond the fact that clinicians and caregivers should do so. Clinicians may find sufficient guidance in the existing literature to begin teaching children a bilingual speaker and listener repertoire, while researchers can continue to explore questions that can have meaningful implications for clinical practice.
[1] It is likely that many children are exposed to more than two languages growing up; however, we will focus on the bilingual population in this blog post.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Beauchamp, M. L., & MacLeod, A. A. (2017). Bilingualism in children with autism spectrum disorder: Making evidence based recommendations. Canadian Psychology/Psychologie Canadienne, 58(3), 250-262.
Durkin, M. S., Maenner, M. J., Baio, J., Christensen, D., Daniels, J., Fitzgerald, R., … & Yeargin-Allsopp, M. (2017). Autism spectrum disorder among US children (2002–2010): socioeconomic, racial, and ethnic disparities. American Journal of Public Health, 107(11), 1818-1826. https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2017.304032
Flynn, S., Foley, C., & Vinnitskaya, I. (2005). New paradigm for the study of simultaneous v. sequential bilingualism. In Proceedings of the 4th International Symposium on Bilingualism (pp. 768-774).
Grosjean, F. (1989). Neurolinguistics, beware! The bilingual is not two monolinguals in one person. Brain and Language, 36(1), 3-15. https://doi.org/10.1016/0093-934X(89)90048-5
Hu, X., Lee, G. T., Pan, Q., Gilic, L., & Zeng, S. (2023). Effects of foreign mand training on the emergence of foreign tact and listener responses for Chinese‐speaking children with autism spectrum disorder. Behavioral Interventions, 38(2), 437-455.https://doi.org/10.1044/2014_AJSLP-13-0026
Lee, P. (1996). Cognitive development in bilingual children: A case for bilingual instruction in early childhood education. Bilingual Research Journal, 20(3-4), 499-522. https://doi.org/10.1080/15235882.1996.10668641
Lowry, L. (2024, July 7th). Bilingualism in your children: separating fact from fiction. Retrieved from: http://www.hanen.org/helpful-info/articles/bilingualism-in-young-children–separating-fact-fr.aspxThordardottir, E. (2019). Amount trumps timing in bilingual vocabulary acquisition: Effects of input in simultaneous and sequential school-age bilinguals. International Journal of Bilingualism, 23(1), 236-255. https://doi.org/10.1177/1367006917722418
Zhao, X., Cengher, M., Li, T. (2024, May 25th-27th). Identifying the optimal procedures to teach two languages to children with Autism Spectrum Disorder [Conference presentation]. ABAI 2024 annual convention, Philadelphia, PA, United States.
Zhou, M. (1997). Growing up American: The challenge confronting immigrant children and children of immigrants. Annual Review of Sociology, 23(1), 63-95. https://doi.org/10.1146/annurev.soc.23.1.63