Welcome to the July edition of Ask Dr. Emily!

We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Rastall, a clinical psychologist at Seattle Children’s Autism Center, will share insights in a question and answer format.

We welcome you to send us your questions and Dr. Rastall will do her best to answer them each month. Send your questions to [email protected].

Q: I am a student and I recently started interning at a child development center. We care for a child who is on the autism spectrum who deliberately burps during his tasks. I’m assuming that this is one of his repetitive, stereotypical behaviors. Is this correct? Would you suggest some ways to reduce or stop the behavior?

A: Thank you for your work and for your question. Before we call this behavior “deliberate,” we will want to determine the function that this behavior is serving. Behaviors can be categorized into serving one or more of the following three purposes: Getting something (like attention or the iPad), avoiding something (like an unpleasant task), and/or self-stimulation (a repetitive, non-functional behavior that serves to stimulate a sensory response). You will also want to consider whether the behavior is a safety risk and/or whether it significantly impacts an individual’s daily functioning. Your intervention (or lack thereof) will vary based on what function the behavior is serving and how impactful it is on the child’s life.

In summary, it sounds like a functional behavior assessment (FBA) is in order. An FBA can help you determine what purpose a behavior is serving, which will determine the intervention you will choose to use. You will want to consult with your team of supervisors regarding how best to go about scheduling an FBA with a trained professional.

Q: I am a father of a child with autism who just turned five. My child’s mother and I do not live in the same home. My daughter speaks only Spanish in her mother’s home. I speak only English with her in my home, and her educators and therapists speak English with her as well. Historically, I have been against her learning Spanish, as I was concerned that her language development would suffer as a result of being bilingual. Although my daughter’s language development has grown dramatically over the last year, I have heard mixed opinions about the impact of being bilingual on language development in children with autism. Given that she is bilingual (whether I like it or not), I wonder if I should make an effort to seek out a bilingual teacher and/or speech therapist. Should I be concerned that my child with autism is being raised bilingual?

A: Thank you for writing in. Rest assured, the research is telling us that there are no ill effects for kids with autism who are exposed to two languages. In fact, the research even points to benefits of being bilingual for children with ASD; for example, bilingual children with ASD have been observed to vocalize more and use gestures more frequently. Seeking out a bilingual speech therapist might help your daughter advance in both languages and could be helpful in coaching you and your daughter’s mother to foster her bilingual growth.