Growing up in a bilingual family can be a gift.
Children and parents all can benefit from the exposure to two different languages, cultures and family traditions — old and new — that accompany life in different places. It’s very apparent here in California, where so many families also have roots from different countries.
Over time, as family members become more proficient speaking English in addition to native languages, children and parents can help each other communicate, and understand and take advantage of different opportunities.
But for families with a child who has autism spectrum disorder (ASD), a bilingual home environment can also be a struggle. Language issues, in particular, can be a problem, especially since some amount of English is necessary to access many services and resources, and since so many healthcare and education professionals in the U.S. speak just English.
Language isn’t the only issue. Based on our experience providing healthcare services to people with autism, we’ve observed three challenges faced by many bilingual households.
Challenge #1: Culture
In many cultures there can be resistance to acknowledging that a child has a developmental disorder, be it autism or something else. Some family members may want to believe that the child is just going through a phase and will grow out of it, even when the evidence — such as challenging behaviors or limited language skills — persists. Some cultures have stubbornness or self-consciousness built in, which can delay or even prevent diagnosis and treatment.
In other ways culture can interfere with the delivery and follow-through of a treatment program. For example, if a child with autism is prone to tantrums, the therapy may advise that the child be left alone – if only briefly – while the outbursts run their course.
In some cultures, however, it is considered rude, disrespectful or uncaring to ignore a child who is acting out. In these cases it’s important that parents understand that often the most helpful response is the opposite of what they may think, because the “natural” response may be interpreted by the child as a reward for his or her behavior. The consequence is that the child doesn’t learn new or replacement behaviors and instead repeats the problematic behavior because he or she is rewarded for it with attention.
Behavioral therapists, including healthcare professionals trained in applied behavior analysis, can explain and teach this to parents as part of the program.
Challenge #2: Coordination of Care
Many healthcare providers and school teachers speak only English, so it can be difficult to access and coordinate care for a disabled child, especially when the predominant caregiver in a family does not speak English or when the child is very young and may not be able to speak.
Picture a situation where Mom speaks only Spanish, Dad works full time, and Mom is responsible for the child’s care. In this case Mom needs help understanding the situation so she can secure resources for the child. Explanations about how a treatment program works and what she should do to support the program with her child can be very beneficial and can help the child and parents get on the right track.
There can also be issues with doctors and medications. Imagine a situation where a child is not yet talking, and also happens not to be sleeping well. Mom and the child go to see the doctor. Because of language issues, the child’s health history is not fully explained to the doctor, who thus has a lack of understanding of the situation. In that case, the doctor’s treatment — maybe it is medication—may not be best for the situation. Or maybe Mom leaves the doctor’s office not understanding what a medication is for or how it works, so she is unable to fully support the child’s treatment because she doesn’t know what the medication is for and can’t explain the importance of it to the child.
Similar situations and outcomes can occur with other healthcare professionals, such as speech therapists, and at the child’s school with teachers and administration officials.
Challenge #3: Knowledge of Available Resources
Most communities have resources available for families, but not everyone is aware of how to gain access to these resources. Not being familiar with the predominant language causes a barrier to accessing the resources. For example, a family that is searching for speech therapy might not know where to apply, fill out the required forms or communicate the needs of the child.
Fortunately, there is help available for parents and children with ASD, including service providers who are bilingual and can help parents access care, coordinate care, and overcome some cultural obstacles to successful therapy and training. There also are resources for parents to learn English, which can help in so many ways.
If you think your child needs care and you are not sure where to begin, contact us to schedule a complimentary 30-minute in person or phone consultation. If you need a consultation in Spanish, be sure to add that into the notes in the “comments” section of the form.