Bilingualism is Associated with Executive Function in Children With Autism Spectrum Disorder: A Systematic Review and Bayesian Meta-Analysis

Purpose: Families and clinicians often express concern that bilingual exposure may place additional communicative or cognitive demands on children with autism spectrum disorder (ASD), potentially hindering development. In contrast, researchers generally report no negative effects, though it remains unclear whether bilingualism may confer cognitive benefits. We conducted a systematic review and Bayesian meta-analysis in order to evaluate the association between bilingualism and executive function (EF) in children with ASD. Methods: We systematically searched five electronic databases and identified 11 studies comparing bilingual and monolingual children with ASD on EF measures (e.g., working memory, inhibitory control, cognitive flexibility). Across studies, 44 effect sizes and 809 participants were included. We implemented a multilevel Bayesian random-effects meta-analysis to estimate the overall association between bilingualism and EF. Results: We found a small-to-moderate positive association between bilingualism and EF enhancement (Hedges’ g = 0.43, 95% CrI = [0.16, 0.71]). Importantly, the measured EF subdomain and EF measure type moderated this effect, whereas age and gender did not. Generalizability is limited by the predominance of Western, Indo-European samples (10/11 studies) and by heterogeneity across studies. Conclusion: Contrary to the concerns about cognitive burden, we found limited pooled evidence for small-to-modest EF advantages, which varies across EF measures. Theoretically, our findings are consistent with accounts linking bilingual experience to EF processes. Clinically, maintaining bilingual environments for children with ASD can be beneficial with positive cognitive effects. To address issues of heterogeneity and limited linguistic and cultural diversity, future research should adopt standardized EF measures and clearer definitions of bilingualism using a longitudinal design to inform practice.