Hyperlexia in infantile autism

The time-locked neurodynamics of semantic processing in autism spectrum disorder: an EEG study

Language processing is often an area of difficulty in Autism Spectrum Disorder (ASD). Semantic processing-the ability to add meaning to a stimulus-is thought to be especially affected in ASD. However, the neurological origin of these deficits, both structurally and temporally, have yet to be discovered. To further previous behavioral findings on language differences in ASD, the present study used an implicit semantic priming paradigm and electroencephalography (EEG) to compare the level of theta coherence throughout semantic processing, between typically developing (TD) and ASD participants. Theta coherence is an indication of synchronous EEG oscillations and was of particular interest due to its previous links with semantic processing. Theta coherence was analyzed in response to semantically related or unrelated pairs of words and pictures across bilateral short, medium, and long electrode connections. We found significant results across a variety of conditions, but most notably, we observed reduced coherence for language stimuli in the ASD group at a left fronto-parietal connection from 100 to 300 ms. This replicates previous findings of underconnectivity in left fronto-parietal language networks in ASD. Critically, the early time window of this underconnectivity, from 100 to 300 ms, suggests that impaired semantic processing of language in ASD may arise during pre-semantic processing, during the initial communication between lower-level linguistic processing and higher-level semantic processing. Our results suggest that language processing functions are unique in ASD compared to TD, and that subjects with ASD might rely on a temporally different language processing loop altogether.

Vocabulary and Main Idea Reading Intervention Using Text Choice to Improve Content Knowledge and Reading Comprehension of Adolescents With Autism Spectrum Disorder

This simultaneous replication single-case design study investigated a vocabulary and main idea intervention with an aspect of text choice provided to students with autism spectrum disorder (ASD). Five middle school students with ASD participated in two instructional groups taught by school-based personnel. Results were initially mixed. These results were followed by upward and stable trends, indicating a functional relationship between the independent and dependent variables. Social validity measures indicated that students appreciated the opportunity to make choices on text selection.

Reading between the Lines: A Case Study on Facilitated Communication

This is a qualitative study that examines the facilitated communication method within the context of general communication. “Reading” another person, or understanding the intent and meaning of an individual's communication, is a complex process that encompasses verbal and nonverbal messages. Various strategies employed by both the facilitated communication user and communication partner to interpret and clarify messages are examined in depth.

Visually Cued Instruction for Children with Autism and Pervasive Developmental Disorders

Visually cued instruction involves the use of pictographic and written language as instructional supports in both structured and natural learning contexts. This article discusses the theoretical rationale for visually cued instruction, followed by examples of pictographic and written language cues that enhance children's organizational skills, general skill development, academic learning, communication, socialization, and selfcontrol.

Linking Reading with Meaning: A Case Study of a Hyperlexic Reader

The research presented in this paper is a two-part case study of a 14-year-old mentally handicapped girl, Rachelle, who is hyperlexic. That is, she is able to easily decode the printed word, yet has great difficulty comprehending what she has read. We describe the characteristics of hyperlexia in a diagnostic case study of Rachelle and then outline an instructional program, implemented over a 1 1/2-year period, which we based on current research and theory about the normal processes of reading and learning. Using a learner-centered, literature-based approach, we directed instruction toward helping Rachelle to connect reading with making meaning. Her reading and writing competency and attitudes improved steadily throughout the intervention, as shown through collected work samples and a variety of assessment procedures. We suggest that instruction for hyperlexics and for all readers should focus on linking reading with meaning.

Embedding perseverative interest of a child with autism in text may result in improved reading comprehension: A pilot study

OBJECTIVE

We investigated the effects of embedding the perseverative interest (PI) of a child with autism (i.e. cars) within texts on reading comprehension.

METHODS

A PI text condition (text altered to include cars) was compared with a non-PI text condition (same story without cars inserted) in an alternating treatment design. Dependent variables were responses to reading comprehension questions and number of words uttered during an oral retell (i.e. curriculum-based measures [CBMs]). The reading level, instructional routines, and therapist where held constant across the randomly alternated conditions.

RESULTS

Both CBMs suggested that reading comprehension was enhanced when the story included the child's PI.

CONCLUSIONS

These preliminary findings suggest that embedding the PIs of students with autism spectrum disorder within readings may result in more accurate responses to reading comprehension questions and more detailed oral retelling. These findings are discussed in terms of potential directions for future research.

Brain routes for reading in adults with and without autism: EMEG evidence

Reading utilises at least two neural pathways. The temporal lexical route visually maps whole words to their lexical entries, whilst the nonlexical route decodes words phonologically via parietal cortex. Readers typically employ the lexical route for familiar words, but poor comprehension plus precocity at mechanically 'sounding out' words suggests that differences might exist in autism. Combined MEG/EEG recordings of adults with autistic spectrum conditions (ASC) and controls while reading revealed preferential recruitment of temporal areas in controls and additional parietal recruitment in ASC. Furthermore, a lack of differences between semantic word categories was consistent with previous suggestion that people with ASC may lack a 'default' lexical-semantic processing mode. These results are discussed with reference to dual-route models of reading.

The relationship between parent report of adaptive behavior and direct assessment of reading ability in children with autism spectrum disorder

PURPOSE

This study was designed to shed light on the profile of reading ability in children with autism spectrum disorder (ASD). A key aim was to examine the relationship between parent report of adaptive behavior and direct assessment of reading ability in these children.

METHOD

The authors investigated children's reading ability using the Wide Range Achievement Test—Fourth Edition (Wilkinson & Robertson, 2006) and the Neale Analysis of Reading Ability—Third Edition (Neale, 2007). Parent report data was collected using the Vineland Adaptive Behavior Scales—Second Edition (Sparrow, Cicchetti, & Balla, 2005). Participants were 21 children with ASD (6-11 years) and their primary caregivers.

RESULTS

Direct assessment of children's reading ability showed that some children with ASD have difficulty learning to read and exhibit particular weaknesses in comprehension. The results revealed positive relationships between Vineland Adaptive Behavior Scales scores in the Adaptive Communication domain and direct assessment of children's reading ability across 3 measures of reading (word-level accuracy, passage-level accuracy, and passage-level comprehension).

CONCLUSIONS

Although literacy levels vary among children with ASD, some clearly struggle with reading. There is a significant relationship between parent self-report of adaptive behavior and direct assessment of children's reading ability.

Right hemisphere dysfunction and metaphor comprehension in young adults with Asperger syndrome

This study examined whether the known difficulties in metaphor comprehension exhibited by persons with Asperger syndrome (AS) can be explained by a dysfunctional right hemisphere (RH). Using the divided visual field paradigm, 27 AS participants and 36 matched controls were presented with word pairs of four types (literal, conventional metaphors, novel metaphors, and unrelated word pairs), and were asked to perform a semantic judgment task. The main hypothesis was that whereas the control group participants will show RH superiority for novel metaphor processing, no RH superiority will be found in the AS group. Results indeed indicate much less RH contribution to novel metaphor comprehension in AS, and are discussed in light of linguistic models and the neurobiology of autism.

Vision in autism spectrum disorders

Autism spectrum disorders (ASDs) are developmental disorders which are thought primarily to affect social functioning. However, there is now a growing body of evidence that unusual sensory processing is at least a concomitant and possibly the cause of many of the behavioural signs and symptoms of ASD. A comprehensive and critical review of the phenomenological, empirical, neuroscientific and theoretical literature pertaining to visual processing in ASD is presented, along with a brief justification of a new theory which may help to explain some of the data, and link it with other current hypotheses about the genetic and neural aetiologies of this enigmatic condition.

Orthographic and phonological pathways in hyperlexic readers with Autism Spectrum Disorders

Children with Autism Spectrum Disorders (ASD) often present poor text comprehension relative to their ability to read individual words. Some of them have been considered hyperlexic because of their oustanding word-reading abilities. Although it has been suggested that these children access word reading in an atypical way, there is conflicting evidence on their use of phonological and orthograhic pathways. Fourteen adolescents with ASD with word reading to text comprehension discrepancy and 12 typically developing children, all matched on word reading and chronological age, were administered different lexical and sublexical tasks exploring semantic, orthographic, and phonological word representations and processes. No differences were found on any of the tasks between the children with ASD and the typically developing group. The children with ASD were further subdivided into two groups matched on word reading, one with outstanding word reading rela0tive to verbal IQ and another with word reading consistent with verbal IQ. The first group outperformed the second on tasks involving lexical orthographic and phonological representation. However, they were no different on sub-lexical phonological processing, on rapid naming or working, and short-term memory tasks.

Hyperlexia in children with autism spectrum disorders

We compared the reading-related skills of children with Autism Spectrum Disorders who have hyperlexia (ASD + HPL) with age-matched children with ASD without HPL (ASD - HPL) and with single-word reading-matched typically developing children (TYP). Children with ASD + HPL performed (1) better than did children with ASD - HPL on tasks of single-word reading and pseudoword decoding and (2) equivalently well compared to word-reading-matched TYP children on all reading-related tasks except reading comprehension. It appears that the general underlying model of single-word reading is the same in principle for "typical" and hyperlexic reading. Yet, the study revealed some dissimilarities between these two types of reading when more fine-grained cognitive and linguistic abilities were considered; these dissimilarities warrant further investigations.

Patterns of Nonverbal Cognitive Functioning in Young Children with Autism Spectrum Disorders

Previous research demonstrates an uneven pattern of cognitive abilities in children with autism spectrum disorders (ASDs). This study examined whether this uneven pattern exists within the nonverbal domain in young children. We hypothesized relative strengths in perceptual abilities and weaknesses in nonverbal conceptual abilities in preschoolers with ASDs compared to groups with non-autism developmental delays and typical development. Profiles were examined using the Leiter International Performance Scale-Revised. The ASD group displayed clear relative strengths in visuospatial disembedding and detail-focused processing, with relative weaknesses in abstraction and concept formation. This contrasted with patterns of roughly equivalent abilities in both comparison groups. These findings have implications for subsequent development and may represent key features of the cognitive profile of autism.

A double dissociation between sensorimotor impairments and reading disability: A comparison of autistic and dyslexic children

Does sensorimotor dysfunction underlie reading impairment? To investigate this question, a battery of literacy, phonology, auditory, visual, and motor tests were administered to age- and ability-matched groups of dyslexic, autistic, and control children. As in previous studies, only a subset of the dyslexic children had sensory and/or motor impairments, whilst some dyslexics were entirely spared, suggesting that sensorimotor impairments are not necessary to cause reading disability. A subset of autistic children was also found to have sensorimotor impairments; however, some of these children did not have reading problems, suggesting that sensorimotor impairments are not sufficient to cause reading disability. We conclude that sensorimotor and reading impairments are doubly dissociable. Sensorimotor impairments do not seem to be the cause of reading disability, but can be seen as nonspecific markers for developmental disorder.

Exploration of strategies for facilitating the reading comprehension of high-functioning students with autism spectrum disorders

Many students with autism spectrum disorders show good decoding combined with poor comprehension. Twenty adolescent students with autism spectrum disorders participated in a study concerning the effects of three kinds of facilitation on reading comprehension. In a within-subjects design, each students read passages under four conditions: answering prereading questions, completing cloze sentences embedded in the text, resolving anaphora by identifying relevant antecedents, and control (reading only). A repeated measures analysis of variance indicated that conditions differed significantly in their effects on reading comprehension. Post hoc contrasts showed that the effects of anaphoric cuing were statistically significant and medium in size; the effects of prereading questions and cloze completion were small and not statistically significant. Instructional implications for text preparation, remedial instruction, and the design of educational software are discussed.

Autism as a disorder of neural information processing: directions for research and targets for therapy

The broad variation in phenotypes and severities within autism spectrum disorders suggests the involvement of multiple predisposing factors, interacting in complex ways with normal developmental courses and gradients. Identification of these factors, and the common developmental path into which they feed, is hampered by the large degrees of convergence from causal factors to altered brain development, and divergence from abnormal brain development into altered cognition and behaviour. Genetic, neurochemical, neuroimaging, and behavioural findings on autism, as well as studies of normal development and of genetic syndromes that share symptoms with autism, offer hypotheses as to the nature of causal factors and their possible effects on the structure and dynamics of neural systems. Such alterations in neural properties may in turn perturb activity-dependent development, giving rise to a complex behavioural syndrome many steps removed from the root causes. Animal models based on genetic, neurochemical, neurophysiological, and behavioural manipulations offer the possibility of exploring these developmental processes in detail, as do human studies addressing endophenotypes beyond the diagnosis itself.

Contributions of memory circuits to language: the declarative/procedural model

The structure of the brain and the nature of evolution suggest that, despite its uniqueness, language likely depends on brain systems that also subserve other functions. The declarative/procedural (DP) model claims that the mental lexicon of memorized word-specific knowledge depends on the largely temporal-lobe substrates of declarative memory, which underlies the storage and use of knowledge of facts and events. The mental grammar, which subserves the rule-governed combination of lexical items into complex representations, depends on a distinct neural system. This system, which is composed of a network of specific frontal, basal-ganglia, parietal and cerebellar structures, underlies procedural memory, which supports the learning and execution of motor and cognitive skills, especially those involving sequences. The functions of the two brain systems, together with their anatomical, physiological and biochemical substrates, lead to specific claims and predictions regarding their roles in language. These predictions are compared with those of other neurocognitive models of language. Empirical evidence is presented from neuroimaging studies of normal language processing, and from developmental and adult-onset disorders. It is argued that this evidence supports the DP model. It is additionally proposed that "language" disorders, such as specific language impairment and non-fluent and fluent aphasia, may be profitably viewed as impairments primarily affecting one or the other brain system. Overall, the data suggest a new neurocognitive framework for the study of lexicon and grammar.

The Neural Basis of Hyperlexic Reading

Children with autism spectrum disorders in very rare cases display surprisingly advanced "hyperlexic" reading skills. Using functional magnetic resonance imaging (fMRI), we studied the neural basis of this precocious reading ability in a 9-year-old hyperlexic boy who reads 6 years in advance of his age. During covert reading, he demonstrated greater activity in the left inferior frontal and superior temporal cortices than both chronological age- and reading age-matched controls. Activity in the right inferior temporal sulcus was greater when compared to reading age-matched controls. These findings suggest that precocious reading is brought about by simultaneously drawing on both left hemisphere phonological and right hemisphere visual systems, reconciling the two prevailing, but seemingly contradictory, single hemisphere theories of hyperlexia. Hyperlexic reading is therefore associated with hyperactivation of the left superior temporal cortex, much in the same way as developmental dyslexia is associated with hypoactivation of this area.

Annotation: Hyperlexia: disability or superability?

BACKGROUND

Hyperlexia is the phenomenon of spontaneous and precocious mastery of single-word reading that has been of interest to clinicians and researchers since the beginning of the last century.

METHODS

An extensive search of publications on the subject of hyperlexia was undertaken and all available publications were reviewed.

RESULTS

The literature can be subdivided into discussions of the following issues: (1) whether hyperlexia is a phenomenon that is characteristic only of specific clinical populations (e.g., children with developmental delays) or whether it can also be observed in the general population; (2) whether hyperlexia is a distinct syndrome comorbid with a number of different disorders or whether it is a part of the spectrum of some other clinical condition(s); (3) whether hyperlexia should be defined through single-word reading superiority with regard to reading comprehension, vocabulary, general intelligence, any combination of the three, or all three characteristics; (4) whether there is a specific neuropsychological profile associated with hyperlexia; (5) whether hyperlexia is characterized by a particular developmental profile; and (6) whether hyperlexia should be viewed as a disability (deficit) or superability (talent).

CONCLUSIONS

We interpret the literature as supporting the view that hyperlexia is a superability demonstrated by a very specific group of individuals with developmental disorders (defined through unexpected single-word reading in the context of otherwise suppressed intellectual functioning) rather than as a disability exhibited by a portion of the general population (defined through a discrepancy between levels of single-word reading and comprehension). We simultaneously argue, however, that multifaceted and multi-methodological approaches to studying the phenomenon of hyperlexia, defined within the research framework of understanding single-word reading, are warranted and encouraged.

Learning disability subtypes: classification of high functioning hyperlexia

This study examined 30 children with hyperlexic reading patterns and average intelligence to determine if established learning disability subtypes could be applied to these children with hyperlexia. Two groups emerged. One type showed language learning disorder patterns with good visual memory. This group also showed a high percentage of phonetic word errors. A second hyperlexic group showed signs of nonverbal learning disorder with visual spatial deficits and impaired visual memory. This latter subgroup showed few phonetic errors with more sight word errors. These findings suggest subtypes of high functioning hyperlexia, one showing language deficits characteristic of dysphasia and one showing patterns similar to visual spatial dyslexia.

A descriptive study of hyperlexia in a clinically referred sample of children with developmental delays

In this study, we evaluated the incidence of hyperlexia in a clinically referred sample of 80 children with developmental delays. Based on hypotheses previously formulated in the literature, the study investigated the frequency of hyperlexia among boys and girls, the incidence of hyperlexia in children with Pervasive Developmental Disorders (PDD)-spectrum compared with non-PDD diagnoses, the range of IQ and of various cognitive skills in children with and without hyperlexia, and the developmental outcomes of children with and without hyperlexia. The results revealed no significant differences in the frequency of hyperlexia in girls compared with boys. However, the frequency of hyperlexia was significantly elevated among children with PDD compared with children with non-PDD diagnoses. The range of IQ and other cognitive skills and the developmental outcomes of children with hyperlexia were comparable to those of children without hyperlexia.

Social stories, written text cues, and video feedback: effects on social communication of children with autism

This study investigated the effects of written text and pictorial cuing with supplemental video feedback on the social communication of 5 students with autism and social deficits. Two peers without disabilities participated as social partners with each child with autism to form five triads. Treatment was implemented twice per week and consisted of 10 min of systematic instruction using visual stimuli, 10 min of social interaction, and 10 min of self-evaluation using video feedback. Results showed increases in targeted social communication skills when the treatment was implemented. Some generalized treatment effects were observed across untrained social behaviors, and 1 participant generalized improvements within the classroom. In addition, naive judges reported perceived improvements in the quality of reciprocal interactions. These findings support recommendations for using visually cued instruction to guide the social language development of young children with autism as they interact with peers without disabilities.

Reading of kana (phonetic symbols for syllables) in Japanese children with spastic diplegia and periventricular leukomalacia

In 31 Japanese children with spastic diplegia and periventricular leukomalacia (PVL), the age at which they could read Hiragana (phonetic symbols for syllables) and psychometric data were examined. Reading of Hiragana was achieved between 2 and 8 years of age in all subjects except one. Four children could read Hiragana at 2 to 3 years of age, an age which is considered early among Japanese children. Performance IQs of the Wechsler Scale were lower than Verbal IQs in 18 of 19 children who were administered this test, and DQs of the cognitive adaptive (C-A) area of the K-form developmental test (a popular test in Japan) were lower than those of the language social area in all 12 children taking this test. Among eight children having performance IQs or DQs of C-A less than 50, seven acquired reading ability of Hiragana at 8 years of age or below. A visuoperceptual disorder manifested by diplegic children with PVL does not affect the acquisition of Kana-reading ability.

Instructional considerations for young children with autism: the rationale for visually cued instruction

Instructional considerations for children with autism who continue to struggle with current treatment models are discussed. Specifically, the use of instructional strategies for children who may be characterized as visual learners are addressed. The discussion begins with a review of research that illuminates the learning style differences associated with autism. Next, the instructional strategies of both behavioral and incidental teaching methods are examined in light of the research. Finally, using a case study as the backdrop, the discussion concludes with a description of how visually cued instruction can be applied in various contexts.

Facilitated communicators' performance on a task of receptive language

Most controlled studies of facilitated communication (FC) have not validated it. One task, however, on which positive effects of FC have been demonstrated without facilitator influence is the Peabody Picture Vocabulary Test-R (PPVT-R). The present study investigated if the use of FC could be validated for either a group of subjects with autism or a group with severe to profound cognitive impairments, on the PPVT-R when facilitators were effectively screened from all visual and auditory stimuli. Additionally, the effect of mode of input-auditory or visual-on subjects' performance was investigated. Results did not validate the use of FC for the administration of the PPVT-R nor did they show any notable advantage of one mode of input over another.

Academic achievement in high functioning autistic individuals

Academic achievement levels in 54 high functioning (IQ > 70) autistic subjects were compared with those of 41 normal controls, who did not differ significantly in age, IQ, gender, race, or SES from the autistic subjects. The measures of academic achievement used included portions of the Detroit Tests of Learning Aptitude-2, the Woodcock Reading Mastery Test, and the Kaufman Test of Educational Achievement. Based on prior neuropsychological findings, it was hypothesized that autistic subjects would not differ from controls on subtests assessing mechanical and procedural skills, but would differ on subtests measuring comprehension and interpretive skills. As predicted, the autistic subjects performed significantly less well than controls on comprehension tasks, but not on mechanical reading, spelling, and computational tasks. This pattern is at variance with the typical academic profile of individuals with disabilities in reading or spelling, but shares some features with the nonverbal learning disabilities.

Assessment and skill remediation of hyperlexic children

Assessment and remedial approaches derived from the field of learning disabilities were applied in two studies of hyperlexic children. Information-processing strengths and weaknesses of hyperlexic children were assessed in the first study, and the hypothesis that hyperlexic children have superior abilities to retain sound/symbol associations was investigated. Results supported this hypothesis, and indicated that the exceptional reading skills of hyperlexic children are not simply a result of repeated exposure to words. In the second study, a hyperlexic child's ability to decode words was used to increase her functional speech. Written prompts resulted in rapid increases in appropriate verbal responses in naturalistic settings. Furthermore, our results demonstrated maintenance and generalization of the positive effects of written prompts.

Autism and Piaget's theory: are the two compatible?

Autism is interpreted in Piagetian terms with particular reference to the question of whether the atypical cognitive development represents an exception to the similar sequence hypothesis. Findings from relevant research applying Piaget's theory to mental retardation, psychosis, and autism are reviewed. The apparent exceptions to the hypothesis presented in autistic individuals are explained by Piaget's two-factor theory of figurative versus operative functions. Many autistic individuals show an arrest in operative functions at the sensorimotor level while continuing to progress in figurative functions. The early arrest interferes with subsequent development of higher-level conceptual, symbolic, and social skills. Questions for research are offered.

Comprehension in "hyperlexic" readers

Mentally retarded children who can read aloud written words better than one would expect from their Mental Age are often called hyperlexic. The reading comprehension thought to be impaired in such children was investigated in four experiments. Mentally retarded advanced decoders, including autistic and nonautistic children, were compared with younger nonretarded children matched for Mental Age and Reading Age. Experiment 1 established that mildly mentally retarded readers could match sentences to pictures as well as could be expected from their verbal ability. This was the same whether they read the sentences or heard them. Experiment 2 demonstrated that only the more able retarded subjects, but not the less able ones, used sentence context in a normal way in order to pronounce homographs. Experiments 3 and 4 showed that these same more able children could extract meaning at both sentence and story level, and their performance was indistinguishable from that of normal controls. Hence, it is doubtful whether these advanced decoders should be called hyperlexic. In contrast, the readers of relatively low verbal ability performed much worse than their normal controls. Although they could be induced under certain conditions to read sentence-by-sentence rather than word-by-word, they did not do so spontaneously. Furthermore, they did not make use of already existing general knowledge in order to answer questions about the stories they had read. The ability to comprehend in terms of large units of meaning seems to be specifically impaired in these low verbal ability fluent readers. We suggest that it is this impairment that marks true hyperlexia. Since there were no differences between autistic and nonautistic readers on any of our tasks, we conclude that hyperlexia is not an autism-specific phenomenon.

Hyperlexia and dyslexia: A family study

The condition of hyperlexia, often associated with autism, is a rare disorder in which children read words precociously but show little comprehension, markedly poor language, behavioral, and interpersonal skills. The relationship of hyperlexia and dyslexia has never been investigated, although suggestions have been made that the two conditions may be related. In light of current research on familial factors in autism, language disorder, dyslexia, and, recently, hyperlexia, this study investigated family histories of twelve hyperlexic children in regard to language, reading, writing, spelling, and other learning problems, handedness, and presence of allergies. Results suggest a distinct familial tendency to disorders of language, reading, writing, and spelling in male relatives, along with an unusually high instance of nonleft-handedness. Allergy information is inconclusive. Descriptive data are presented, and the relationship of symptomatology in hyperlexia and dyslexia is described and discussed. It is suggested that hyperlexia may represent a point of convergence of several genetically-linked developmental disorders.