A case of a Japanese girl, born and spending the first five years of life in an English/ Japanese bilingual environment outside Japan, was presented in way of discussing possible effects of bilingual environment on a child's language development. The girl's early language milestones were delayed for both English and Japanese. Although a specialist attributed the delay to bilingual exposure, the girl's parents continued to harbor concern and visited a child psychiatrist for evaluation upon returning to Japan when the child was in first grade. Upon examination, it was apparent that the girl was experiencing difficulties in both social interaction and imagination apart from her language problem, culminating in a diagnosis of autism spectrum disorder. Her development of the Japanese language was characterized by limited vocabulary, morpho-syntactic errors, and conversational breaches. Evaluation of these problems in relation to the linguistic characteristics of bilinguals such as transfer, profile effect, and code-switching, led to the conclusion that in this case, the girl's language delay was the result of developmental and intellectual disabilities, and not the exposure to a bilingual environment.
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