The impact of educational and medical systems on autistic children from multilingual American homes: A systematic review.
US schools and clinics still tell multilingual families to drop their home language, but the latest evidence says keeping it improves outcomes for autistic kids.
01Research in Context
What this study did
Kim et al. (2024) looked at every US paper that talked about autistic kids who speak more than one language at home. They wanted to see how schools and doctors treat these families.
The team pulled all the studies together and asked: do our systems help or hurt when the home language is not English?
What they found
The review shows most schools and clinics still push English-only. Yet the newer studies say kids do better when their first language is part of teaching and therapy.
In short: systems ignore the home language, but science says keep it.
How this fits with other research
Lee et al. (2019) already found a small win for heritage-language therapy across many disorders. Hyejung’s 2024 review widens the lens and says the same thing holds for autistic kids in the US.
Lim et al. (2018) ran a tiny play study and saw more play and less problem behavior when the therapist spoke the child’s home language. The new review treats that single-case result as one brick in a growing wall of evidence.
Cappadocia et al. (2012) and Griffith et al. (2012) both showed bilingual preschoolers with autism keep pace with monolingual peers. These older null findings look like a contradiction, but they measured different things: the 2012 papers asked 'Does bilingualism hurt?' while the 2024 review asks 'Does using the home language help during intervention?' Once you see that difference, the studies line up fine.
Gonzalez-Barrero et al. (2018) pushed further, showing more bilingual exposure predicts stronger school-age vocabulary. Hyejung’s review folds this in and says the benefit persists as kids grow.
Why it matters
If you serve a family that speaks Spanish, Mandarin, Arabic, or any other language at home, stop asking them to switch to English-only. Use the home language during assessment, play, and teaching. Invite native-speaking aides or train yourself in key phrases. The evidence stack now says this choice lifts learning and cuts behavior problems, and the 2024 review makes it an equity issue, not just a clinical one.
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02At a glance
03Original abstract
Research has found that autistic children can navigate multilingual schools and communities without harming their language skills or school success. However, they may encounter specific challenges within the United States, where educational and healthcare systems are insufficiently equipped to meet their needs. This review examined 46 US-based studies on the topic and findings reveal persistent deficit-based ideas about multilingualism and autism (e.g., professionals recommending that autistic students only speak and learn in English) accompanied by patterns of unequal identification of autism among multilingual children. These findings highlight issues of disproportionality and inadequate access to educational and healthcare resources. However, recent studies indicate that incorporating a child's native language in education not only enhances learning and behavioral outcomes but also boosts cognitive functions like problem-solving and planning. Taken as a whole, current research suggests that intentionally addressing linguistic diversity will allow educational and medical systems to better serve autistic children.
Autism : the international journal of research and practice, 2024 · doi:10.1177/13623613241242839