Academic journal article Journal of Medical Speech - Language Pathology

Unintended Consequences: An Ethnographic Narrative Case Series Exploring Language Recommendations for Bilingual Families of Children with Autistic Spectrum Disorders

Academic journal article Journal of Medical Speech - Language Pathology

Unintended Consequences: An Ethnographic Narrative Case Series Exploring Language Recommendations for Bilingual Families of Children with Autistic Spectrum Disorders

Article excerpt

Keywords: bilingualism, language recommendations, autistic spectrum disorders, limited English proficiency

Introduction: This ethnographic narrative case series explores the social consequences of an "English-only" (EO) recommendation for multilingual multicultural families of children with autistic spectrum disorders (ASDs).

Methods: Open-ended ethnographic narrative interviews were conducted with five bilingual families of children with ASD. These families were asked about their experiences and perspectives on their language choices and the effects of the BO recommendations on their everyday lives.

Results: All families were told by professionals to use English exclusively with their children with ASD. The parents reported diverse effects of this language choice on family, school, and community interactions.

Discussion: "English-only" recommendations may alter the linguistic and social environments of children with ASD from bilingual families and may have unintended effects on the children's and families' social networks. The full context of bilingual families' lived experiences should be explored when making language recommendations.

INTRODUCTION

In the 2000 U.S. Census, 17% of households reported that a language other than English was spoken at home primarily (U.S. Census Bureau, 2000). Although this language diversity has obvious implications for the treatment of speech and language pathology, the medical literature on bilingualism has tended to focus on the barriers to quality health care for non-English speakers (including federal language mandates) and the challenges of identifying developmental disorders among bilingual children (Flores, Abreu, Olivar, & Kastner, 1998; Flores, Rabke-Verani, Pine, & Sabharwal, 2002; Office of Minority Health, 2001; Timmins, 2002; Toppelberg, Medrano, Pena Morgens, & Nieto-Castanon, 2002; Toppelberg, Snow, & Tager-Flusberg, 1999; Yu, Nyman, Kogan, Huang, & Schwalberg, 2004). An increasing number of children are being diagnosed with autistic spectrum disorders (ASDs; Rapin, 2002; Rice et al., 2010), and a growing number of bilingual families are seeking care for their children with special communication needs. In the specific case of speech and language pathology guidelines for treating ASD, few studies have addressed whether and how bilingual language environments influence language acquisition for children with ASD (Hambly & Fombonne, 2011) and whether monolingual or English-only (EO) environments have better linguistic and developmental outcomes (Kohnert, Yim, Nett, & Kan, 2005; Seung, Siddiqi, & Elder, 2006). No empirical evidence exists currently to support the notion that bilingualism negatively affects a child's acquisition of the majority language, in this case, English (Gutierrez-Clellen, 1999; Kohnert et al., 2005). Similarly, although the EO recommendation is intended to simplify the linguistic load for a child with ASD, some studies suggest that continuing to nurture the home language results in greater academic gains rather than less (Lugo-Neris, Jackson, & Goldstein, 2010) even among children with learning disorders (Paradis, Crago, Genesee, & Rice, 2003).

Despite the lack of evidence on which to base such language recommendations, clinical experience and limited, but consistent, literature suggest that bilingual parents of children newly diagnosed with ASD are often advised by health care professionals, teachers, and therapists to maintain EO households (Bird, Lamond, & Holden, 2012; McCardle, Kim, Gube, & Randall, 1995) and that the EO recommendation may represent a significant social and emotional investment on the part of bilingual families. One such investment is the increased effort and processing time described in bilingual adults who attempt to suppress their bilingual tendencies in favor of monolingual speech (Hernandez & Kohnert, 1999; Kohnert, 2002; Kohnert, Bates, & Hernandez, 1999; Kohnert & Derr, 2004). …

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