Pronoun interpretation in bilingual children with Autism Spectrum Disorder: evidence from 400 autistic and neurotypical children

Children with Autism Spectrum Disorder (ASD) often struggle with interpreting deictic pronouns such as I and you, in direct and indirect speech reports. This study examined whether (a) pronoun interpretation differs between direct and indirect speech in children with ASD, (b) performance relates to Theory of Mind (ToM) or Working Memory (WM), and (c) bilingualism enhances pronoun interpretation. A total of 404 monolingual and bilingual children (TD and ASD, ages 3–12) completed a sentence-picture matching task in their first language (English, French, German, Italian, or Spanish). Results showed autistic children were more accurate in direct than indirect speech. Pronoun accuracy was positively associated with age, ToM, and WM. ToM especially supported interpretation in indirect speech for autistic children. Exploratory analyses suggested that more balanced bilingual autistic children were quicker in interpreting pronouns. Findings indicate that both cognitive capacities and bilingual language exposure contribute to how autistic children interpret deictic pronouns.