Narrative macrostructure and microstructure profiles of bilingual children with autism spectrum disorder: differentiation from bilingual children with developmental language disorder and typical development

Children with autism spectrum disorder (ASD) show heterogeneous language profiles beyond early language delays. Understanding the second language profiles of bilingual children with ASD is important for clinical practice in diverse societies. Accordingly, we examined the narrative abilities of bilinguals with ASD, with developmental language disorder (DLD), and with typical development (TD) to determine which narrative components best differentiate bilinguals with ASD from the other groups. Participants were 29 bilingual children with ASD, DLD, and TD who were matched for age (mean = 6;8), nonverbal intelligence, and receptive vocabulary. Narratives were coded for macrostructure (story grammar (SG) scores, number of individual SG components) and microstructure (syntactic complexity, mean length of utterance, lexical diversity, and story length). The TD group had superior SG scores, included more SG components, and used longer utterances and more complex syntax than the ASD group, whereas no differences were found between the clinical groups. For SG components requiring perspective-taking abilities, the ASD group had worse performance than the TD and DLD groups. Our results suggest that bilingual children with ASD show weaknesses in both macrostructure and microstructure, which can overlap with children with DLD. The linguistic profiles of bilingual children with ASD and DLD are thus both overlapping and distinct.