"מגדל בבל שפתי" - העדר שפת אם ברורה כגורם מטה באבחון הפרעת תקשורת בילדים - האם מקרה פרטי ומקומי או תופעה חוצה גבולות ותרבויות?
LINGUISTICAL " TOWER OF BABEL" IN THE HOME SURROUNDINGS- CONFOUNDING THE DIAGNOSIS OF AUTISTIC SPECTRUM DISORDER IN CHILDREN: A LOCAL CASE OR A POSSIBLE GLOBAL TRANS-CULTURAL PHENOMENON?
ד"ר אילן לינדר
ד"ר רונית רוט-חנניה
Ilan Linder MD
Ronit Roth- Hanania, Ph.D
המכון להתפתחות הילד, קופ"ח מאוחדת, הרצליה
Many studies have looked at the effect of bilingualism on autistic children, while others have addressed the issue of multilingualism and multicultural surroundings and their role in ASD (Autistic Spectrum Disorders). Exposure to a mother tongue and its routine use is considered important for HFA (high functioning autism) children.
Suggesting that the lack of formal and fluent mother tongue surroundings due to multilingualism and multiculturaism may result in questionable diagnosis of Autism, as presented in unique "laboratory isolated cases".
Materials & methods
We present a case series of two children (male and female) born to foreign workers in Israel, diagnosed with ASD (Autistic Spectrum Disorder) at the age of 28 months and 26 months respectively. Formal evaluation involved ADOS test and DSM4-R criteria. Parents were of different Asian origins, leading to feeble mastery of a common mother tongue at home (English or Hebrew). Low Socioeconomic factors led the children to stay many hours in non-optimal educational surroundings.
Intensive speech therapy in Hebrew, implemented immediately following ASD diagnosis, improved language abilities substantially. Close follow-up by a regular professional team revealed a PBNC (past but not current) diagnosis of ASD for the male child at three years of age while the female child remained in the autistic spectrum but shifted to HFA (high functioning Autism).
Multilingual home surroundings devoid of a fluent mother tongue, should raise doubts regarding applying formal Autism diagnosis before implementing an initial intense trial of language therapy. Multi-cultural differences could further confound Autism diagnosis.