Teaching children with autism to read for meaning: challenges and possibilities

Management of critical care emergencies in children with autism spectrum disorder

BACKGROUND

Managing critical care emergencies in children with autism spectrum disorder (ASD) presents unique challenges due to their distinct sensory sensitivities, communication difficulties, and behavioral issues. Effective strategies and protocols are essential for optimal care in these high-stress situations.

AIM

To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD. The review focuses on key areas, including sensory-friendly environments, communication strategies, behavioral management, and the role of multidisciplinary approaches.

METHODS

A comprehensive search was conducted across major medical databases, including PubMed, Embase, and Cochrane Library, for studies published between 2000 and 2023. Studies were selected based on their relevance to critical care management in children with ASD, encompassing randomized controlled trials, observational studies, qualitative research, and case studies. Data were extracted and analyzed to identify common themes, successful strategies, and areas for improvement.

RESULTS

The review identified 50 studies that met the inclusion criteria. Findings highlighted the importance of creating sensory-friendly environments, utilizing effective communication strategies, and implementing individualized behavioral management plans. These findings, derived from a comprehensive review of current evidence, provide valuable insights into the best practices for managing critical care emergencies in children with ASD. Sensory modifications, such as reduced lighting and noise, visual aids, and augmentative and alternative communication tools, enhanced patient comfort and cooperation. The involvement of multidisciplinary teams was crucial in delivering holistic care. Case studies provided practical insights and underscored the need for continuous refinement of protocols.

CONCLUSION

The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD. Sensory-friendly adjustments, effective communication, and behavioral strategies supported by a multidisciplinary team are integral to improving outcomes. Despite progress, ongoing refinement of care practices and protocols is necessary. This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.

Increasing Vocabulary and Listening Comprehension During Adapted Shared Reading: An Intervention for Preschoolers with Autism Spectrum Disorder

PURPOSE

This study examined the improvement in vocabulary and listening skills of children with ASD through adapted shared reading. It also investigated the generalisation effect of this increase to new books and social validity.

METHODS

A multiple probe across participants design was used to investigate the effect of ASR (adapted shared reading) on the vocabulary and listening comprehension skills of young children with autism spectrum disorder (ASD). The participants were Turkish-speaking children diagnosed with ASD attending a preschool special education institution in Turkey. The researcher analysed the data obtained from the baseline, intervention, generalization and mastery phases using the visual analysis method.

RESULTS

Following the intervention, all three participating children gradually improved their vocabulary and listening comprehension skills. The findings suggest that young children with ASD can participate in and benefit from shared reading interventions with support.

CONCLUSION

The adapted shared reading method (ASR) is an effective method for increasing the vocabulary and listening comprehension skills of young children with ASD.

Impact of reading intervention on the phonological awareness of children with autism spectrum disorder: a systematic review and meta-analysis

PURPOSE

To review studies that have intervention in reading with impacts on phonological awareness in children with autism spectrum disorder.

RESEARCH STRATEGIES

Searches took place until February 2021 in Cochrane, Embase, ERIC (Education Resources Information Center), LILACS (Latin American and Caribbean Health Sciences Literature), PubMed/Medline, Scopus, Web of Science and gray literature databases.

SELECTION CRITERIA

The review included experimental studies with preschoolers and schoolchildren with ASD. Two independent reviewers selected the studies and, in case of disagreement, a third reviewer was consulted.

DATA ANALYSIS

Joanna Briggs Institute checklists were used for risk of bias. A random effects meta-analysis was performed and the certainty of the evidence was assessed using the GRADE tool.

RESULTS

Eight studies with some impact on phonological awareness were reviewed. The risk of bias was low and moderate. The certainty of the evidence was low for randomized trials and very low for non-randomised trials. Comparison of pre- and post-therapy on the Preschool Literacy Test (TOPEL) showed that children with ASD improved phonological awareness, with a mean difference between baseline and post-therapy of 6.21 (95% CI = 3.75-8.67; I2 = 0%).

CONCLUSION

Shared reading and software activities with words and phrases can alter phonological awareness. These results support further research with larger samples and a detailed description of the intervention to observe its effectiveness in phonological awareness.

Reasons for alcohol use and non-use by underage U.S. autistic youth: A qualitative study

LAY ABSTRACT

What is already known about the topic? Hazardous alcohol use is when a person's drinking puts them at increased risk for negative events (e.g. health problems or car crashes). Some studies show that autistic people may be at greater risk for hazardous alcohol use than non-autistic people, while other studies have found that hazardous alcohol use is less common among autistic people than non-autistic people. We need to learn why autistic underage youth choose to drink alcohol or not. The goal of this study was to learn from US autistic youth about their attitudes and behavior related to alcohol. Forty autistic youth aged 16-20 years old were interviewed.What this article adds? Youth described several reasons why they choose to drink alcohol, including feeling like non-autistic people are more accepting when drinking, that it puts them in a less irritable or bored mood, helps them cope with problems, and helps them fit in. Reasons for not drinking alcohol include worries about becoming addicted, medication interactions, not liking the taste, fear of experiencing hangover and other health problems, and concern about acting foolish when drunk.Implications for practice, research, or policy Results reveal that hazardous alcohol use in autistic adults could have its roots in underage experiences that give autistic youth temporary relief from social anxiety, feeling lonely, and challenges with sensory processing. Right now, there are no evidence-based alcohol prevention programs in the United States for autistic people. One or more such programs may be needed. The results from this study could be used to adapt existing programs for non-autistic youth to the unique needs and risk factors of autistic youth.

Reading Intervention for Students with ASD in the Middle Grades: An Alternating Treatment Study of Embedded Interests Reading and Expository Text Conditions

AIM

We conducted two separate but related multiple baseline with alternating treatment single-case design studies to investigate the effect of the same reading intervention for students with autism spectrum disorder being implemented under different conditions.

METHOD

We conducted a researcher-implemented study in a public school (Study 1) and a teacher-implemented study in a specialized private charter school for children with ASD (Study 2). In each study, we compared a typical intervention approach with interest-based text intervention that included reading on each child's interest area. The treatment included systematic vocabulary instruction and main-summarization strategy instruction.

RESULTS

Findings from Study One showed consistent increases in comprehension and vocabulary outcomes compared to baseline. In Study Two the baselines phases were unstable with small differences in mean scores detected for vocabulary during the intervention phase favoring the interest-based treatment for three of four participants.

CONCLUSION

The results across studies were mixed indicating the importance of taking into account contextual factors including student characteristics and learning environment.

Does Embedding Restricted Interests of Students with Autism in Text Improve Reading Comprehension?

Reading comprehension deficits are common for students with Autism Spectrum Disorder (ASD) but there are few studies that have examined specific strategies for teaching reading comprehension to this population. The current study investigated the effect of embedding the restricted interests (RI) of two high school students with ASD in text on reading comprehension performance using a single-subject, multi-element research design. Neither participant showed an increase in the number of relevant words shared during oral retell and only one participant showed an increase in the percent of correctly answered reading comprehension questions. Embedding the RI in text more frequently did not impact reading comprehension performance. The results indicate there are potential variables that may limit the effect of embedding the RI of students with ASD in text on reading comprehension.

Early Reading Comprehension Intervention for Preschoolers with Autism Spectrum Disorder and Hyperlexia

Children with autism spectrum disorder (ASD) and hyperlexia (HPL) have both advanced word reading skills and a reading comprehension disorder, alongside impaired oral language. We developed a unique, parent-supported, tablet-based intervention aiming to improve oral and reading comprehension at the word-, phrase- and sentence-level, for preschoolers with ASD and hyperlexia (ASD + HPL). English-speaking preschoolers (N = 30) with ASD + HPL (N = 8), ASD without HPL (N = 7) and typical development (N = 15) underwent a 6-week no-intervention period followed by a 6-week intervention period. Findings revealed a significant increase in reading comprehension scores for the group with ASD + HPL as compared to the TD group (p = .023). Gains were also found for receptive but not expressive language for all groups. Implications for early intervention for preschoolers with ASD + HPL are discussed.

Combining Readers Theater, Story Mapping and Video Self-Modeling Interventions to Improve Narrative Reading Comprehension in Children with Autism Spectrum Disorder

Individuals with Autism Spectrum Disorder (ASD) demonstrate atypical development, resulting in significant deficits in perspective-taking and observational learning. Children with ASD tend to have challenges in social interactions and academic performance, such as comprehending narrative texts, which heavily rely on accurate understanding of the thoughts and feelings of others. However, the current literature provides limited information on effective interventions to address these areas. The present study expands the existing research base by combining Readers Theater, story mapping, and video self-modeling, three separate research-based interventions, into an intervention package for children with ASD. A multiple-baseline across participants design was utilized. Overall, the results indicate that the intervention package successfully improved reading comprehension. Implications and suggestions for future research are discussed.

Building Meaning: Meta-analysis of Component Skills Supporting Reading Comprehension in Children with Autism Spectrum Disorder

The ability to understand what one reads, or reading comprehension, is central to academic success. For many children with autism spectrum disorder (ASD), reading comprehension is a noted area of challenge. For children with typical development, it is well established that successful reading comprehension requires two broad skills: word reading and oral language. For children with ASD, word reading is often believed to be relatively intact, even in the face of poor reading comprehension, suggesting that deficits in oral language, more than in word reading, underlie reading comprehension deficits. Yet, extant research has suggested the importance of both skills. To clarify the role of these skills in the reading comprehension of children with ASD, we conducted a meta-analysis. ERIC, PsycINFO, PubMed, and Proquest Dissertation & Theses were searched for studies of reading comprehension in children with ASD, published up to May 2019. We identified 26 relevant studies about children with ASD (aged 6-18 years) that included both a measure of word reading and reading comprehension. Hunt-Schmidt Random Effects Models showed similar mean correlations between reading comprehension and the component skills of word reading (M r = 0.65 [0.27-1.03]) and oral language (M r = 0.61 [0.33-0.88]). These findings demonstrate that these skills are essential for reading comprehension in children with ASD, making contributions of similar size. This study advances our understanding of the mechanisms by which children with ASD understand what they read, providing a foundation on which to build programmatic research into each of these mechanisms. LAY SUMMARY: Academic progress is closely tied to children's ability to understand what they read. Yet reading comprehension is difficult for many children with autism spectrum disorder (ASD). We used a statistical method to summarize existing research on the skills that children with ASD use to understand what they read. We found that the reading comprehension of children with ASD was related to a similar extent to both their ability to read individual words and their oral language skills. These findings suggest that both areas should be assessed in order to determine appropriate interventions to support reading comprehension for children with ASD. Autism Res 2021, 14: 840-858. © 2021 International Society for Autism Research, Wiley Periodicals LLC.

Examining the Relationship Between the Readability and Comprehensibility of Practice Test Questions and Failure Rates on Learner's Permit Knowledge Tests

Purpose The readability and comprehensibility of Learner's Permit Knowledge Test practice questions and the relationship with test failure rates across states and the District of Columbia were examined. Method Failure rates were obtained from department representatives. Practice test questions were extracted from drivers' manuals and department websites and examined for readability using Flesch-Kincaid Grade Level and comprehensibility using Question Understanding Aid. The influence of readability and comprehensibility on test failure rates was explored. Results The average failure rate from reporting jurisdictions was 42.76%. In total, 11 out of 28 jurisdictions reported that test takers fail more than half the time, while 25 out of 28 reported that test takers fail at least a quarter of the time. While 33.09% of the variability in failure rates could be accounted for by syntactic complexity of the questions, 54.18% could be accounted for by the reading ease. Discussion With few exceptions, test failure rates are systematically high across the United States. The current findings suggest that these tests may be inappropriately biased against individuals with lower levels of literacy and language ability. Implications for test developers and clinicians are discussed.

The Promise of Comprehensive Early Reading Instruction for Children With Autism and Recommendations for Future Directions

Purpose

Children with autism have an increased likelihood of reading difficulties. The reasons for this are numerous and varied, but many children with autism can learn to read when they are provided with evidence-based early reading instruction.

Method

Here, we provide an overview of some of the factors that impact early reading development for children with autism and a rationale for the provision of comprehensive early reading instruction consistent with the recommendations of the National Reading Panel (NRP). We discuss research on NRP instruction for children with autism, including some of our own empirical studies. We also discuss some areas of research that were not emphasized by the NRP but that we view as important. We offer recommendations that extend beyond NRP guidelines in order to advance knowledge and improve practice.

Conclusions

Comprehensive early reading instruction holds great promise for children with autism, but there are gaps in our understanding that need to be addressed. These include the most effective method(s) for tailoring reading instruction to the needs of the individual while optimizing delivery to small groups of children, supporting skills and making other accommodations not outlined by the NRP, and consideration of bilingualism and of reading instruction in languages other than English, among other issues. While our focus in this review article is early reading instruction for children with autism who use oral language, we acknowledge that there is a major gap in the literature concerning reading instruction for those who do not use oral language. We hope that this review article will be helpful to clinicians, educators, and researchers alike, as well as children with autism and their families, friends, and support networks.

Developmental Profile of Social Communication: Findings in Typical Developing Greek Children

OBJECTIVES

The Developmental Profile of Social Communication (DPSC) is based on the communication and language development in children with social communication difficulties. DPSC facilitates understanding of the challenges these children face in social interaction, communication, and linguistic development. It utilizes clinician and parent responses to build the developmental profiles of individuals. The profile allows clinicians to determine the therapeutic goals for improved cooperation and communication in various contexts. In addition, it provides insight into the parents' perspective. The aim of this study is to present the preliminary results of the DPSC in typically developing Greek children.

METHODS

The DPSC, a 112-item questionnaire, was administered to 357 parents of typically developing children aged 2-7.5 years using a 3-scale rating of answers. It was applied electronically via Google forms, and parents were able to ask for clarification on questions. All answers were categorized and then analyzed under independent variables.

RESULTS

Descriptive and hypothesis testing were used to summarize participant characteristics and performance. Findings suggest that children >7.5 years tended to develop most of the rated skills of DPSC adequately.

CONCLUSIONS

It was determined that the DPSC questionnaire is an easily administered tool that enables the evaluation of the social communication abilities of children of different ages.

Secondary Analysis of Reading-Based Activities Utilizing a Scripted Language Approach: Evaluating Interactions Between Students With Autism and Their Interventionists

Students with autism spectrum disorder (ASD) often exhibit challenges with reading development. Evidence-based interventions and specialized approaches to reading instruction are currently being implemented across educational contexts for learners with ASD (Machalicek et al., 2008), yet there is limited understanding of how core ASD features may impact effective delivery of instruction and student participation. We begin to address this need by evaluating the reciprocity between instructional talk and student participation within a reading intervention utilizing a scripted language approach that was being piloted on students with ASD. Method This study used archival video-recorded observations from the beginning of a reading intervention to examine the interactions between 20 students (18 boys, two girls) with ASD (7-11 years old, M = 9.10, SD = 1.74) and their interventionists (n = 7). Lag sequential analysis was used to examine the frequency of student initiations and responses following the interventionists' use of responsive, open-ended, closed-ended, and directive language. Results Findings describe the types of and illustrate the variability in interactions between students and their interventionists, as well as highlight language categories that are linked to student participation. Conclusions These data provide a snapshot of the nature and quality of interactions between students with ASD and their interventionists. Findings suggest that delivery of instruction, including the language that interventionists use, may be an important area of focus when evaluating the effectiveness of reading-based practices across educational settings for learners with ASD, even within the confines of highly structured interventions.

Improving the Ability to Write Persuasive Texts in a Boy with Autism Spectrum Disorder: Outcomes of an Intervention

In this paper, we describe an intervention implemented to assist a 13.2-year-old boy with Autism Spectrum Disorder, G, without intellectual disability, aimed at improving his ability to compose persuasive texts. There was an initial assessment (baseline), an intermediate assessment after two weeks, a six-session intervention phase, and a post-intervention assessment. Our intervention applied two procedures. The first aimed at enhancing general composition abilities in terms of picking (P) ideas, organizing (O) notes, and writing (W) them down (POW), while the second specified the steps to write a persuasive text addressing a possible reader: a topic sentence (T), reasons (R), an explanation (E) for the reasons and the end of the sentence (E) (TREE). These procedures were termed POW + TREE. To analyze G’s texts, three types of measures were used by two raters at baseline, intermediate and post-test time: (a) the presence of the TREE components; (b) the quality of the reasons and explanations for the reasons; (c) the number of mental state terms. All these measures showed relevant quantitative improvements, as well as qualitative changes. In addition, when G’s performance at the end of the intervention was compared to that of typically developing controls, no statistical difference appeared. The results are discussed in light of the potentialities offered by the type of intervention described here.

A Developmental Study of Mathematics in Children with Autism Spectrum Disorder, Symptoms of Attention Deficit Hyperactivity Disorder, or Typical Development

This study examined mathematics achievement in school-aged children with autism spectrum disorder (ASD), symptoms of attention-deficit/hyperactivity disorder (ADHD), or typical development (TD) over a 30-month period and the associations between cognitive and reading abilities with mathematics achievement in children with ASD. Seventy-seven children with ASD without intellectual disability (ASD-WoID), 39 children with ADHD, and 43 children with TD participated in this study. The results revealed that the ASD-WoID and ADHD samples displayed significant and comparable delays in problem solving and calculation abilities. Lower VIQ was related to lower math achievement across all subgroups. The ASD-WoID sample differed from comparison samples in terms of their pattern of mathematical achievement and the role of cognitive abilities in the development of mathematics competence.

Effects of an adapted story grammar intervention on the listening comprehension of children with autism

Children with autism spectrum disorder (ASD) often develop the word reading skills necessary to read text but struggle with reading comprehension. Comprehension skills are often under addressed in early elementary settings leaving children with ASD at a disadvantage once they are expected to read for meaning. This study investigated the impact of an adapted story grammar intervention on the listening comprehension of five children with ASD in kindergarten through second grade. The intervention embedded evidence-based practices shown to support the learning of children with ASD during story grammar instruction. All participating children demonstrated increased correct responding to fact and inference questions following intervention. Data suggest that all participants required visuals to participate in and learn from the intervention. Social validity data indicate the classroom teacher perceived the intervention as helpful and feasible. Implications for instruction and future research are discussed.

A Hyperlexic-Like Reading Style Is Associated With Increased Autistic Features in Girls With ADHD

OBJECTIVE

Hyperlexic-like reading (defined as word decoding much better than comprehension) has been associated with autism spectrum disorder (ASD). Here we study correlates of a hyperlexic-like reading style (HPL) in ADHD, a condition known to co-occur both with reading difficulties and ASD.

METHOD

We compared 10 girls with an ADHD diagnosis plus HPL with 26 with ADHD minus HPL.

RESULTS

Girls with HPL scored marginally lower in reading comprehension but did not differ from non-HPL girls in IQ, vocabulary, or in the severity of ADHD ratings. However, in addition to scoring much better on word decoding, HPL readers also displayed higher levels of social-communication deficits on the ADOS-G and the ADI-R. Moreover, correlation analysis in the full sample revealed an association between increasing autistic features and word reading.

CONCLUSION

The study underscores the heterogeneity of reading skills in ADHD, and shows the relevance of subclinic autistic features for understanding this variability.

Longitudinal stability of reading profiles in individuals with higher functioning autism

The reading difficulties of individuals with autism spectrum disorders have been established in the literature, with particular attention drawn toward reading comprehension difficulties. Recent papers have highlighted the heterogeneous nature of reading abilities in this population by utilizing statistical methods that allow for investigations of unique reading profiles. This article extends this literature by investigating reading profiles longitudinally, to investigate the stability of reader profiles across time. Latent profile and transition analyses were conducted to establish categorically distinct reading profiles at two time points, 30 months apart. This study also examined whether age and autism symptom severity were related to the profiles at each time point. Finally, transitions between profiles at each time point were identified. Age did not predict profile membership, but there were significant differences in symptom severity that were largely stable over time. Results indicate that heterogeneous reading profiles exist within the autism population, ranging from average reading ability to severe difficulties across different reading subskills. The data from this study demonstrate that reading profiles of children and adolescents with autism spectrum disorders shift when examined across time.

Improving Reading in Adolescents and Adults With High-Functioning Autism Through an Assistive Technology Tool: A Cross-Over Multinational Study

People with autism spectrum disorder (ASD) experience reading comprehension difficulties, often misinterpreting complex texts, metaphors, and idioms. We have developed and tested a new assistive technology tool for adaptive, personalized text simplification, called Open Book. This tool is an open-sourced, online platform that uses Natural Language Processing with the specific aim of assisting reading and aiding understanding of written text for people with ASD. The accessibility and effectiveness of Open Book was tested by examining the differences in text comprehension scores between the original texts and texts that were simplified by Open Book tool, randomly allocated to study participants. Two hundred forty-three participants (153 adults and 90 adolescents) with high-functioning ASD were recruited in the UK, Spain, and Bulgaria. Regarding the primary outcome, results showed that both adults and adolescents with ASD gave more correct answers for the simplified (M = 11.2, SD = 4.1) than original texts (M = 10, SD = 4.1; p < 0.001). This finding was consistent across age groups and countries. Regarding the secondary outcome, when participants were asked to blindly rate how easy was to understand each text, simplified texts were rated as easier (M = 7.6, SD = 2.4) to understand than the original texts (M = 8.7, SD = 2.6; p < 0.001). The Open Book software seems to have the potential to be a useful tool in assisting reading among people with ASD. Our findings support our primary hypothesis that texts simplified through Open Book were easier to comprehend compared to original texts.

The Scope and Nature of Reading Comprehension Impairments in School-Aged Children with Higher-Functioning Autism Spectrum Disorder

This study of 8-16-year-olds was designed to test the hypothesis that reading comprehension impairments are part of the social communication phenotype for many higher-functioning students with autism spectrum disorder (HFASD). Students with HFASD (n = 81) were compared to those with high attention-deficit/hyperactivity disorder symptomatology (ADHD; n = 39), or typical development (TD; n = 44), on a comprehensive battery of oral language, word recognition, and reading comprehension measures. Results indicated that students with HFASD performed significantly lower on the majority of the reading and language tasks as compared to TD and ADHD groups. Structural equation models suggested that greater ASD symptomatology was related to poorer reading comprehension outcomes; further analyses suggested that this relation was mediated by oral language skills.

Direct and Reciprocal Effects among Social Skills, Vocabulary, and Reading Comprehension in First Grade

Social skills and vocabulary are important areas of development involved in early reading achievement, yet little attention has been given to understanding the dynamic associations among them during the elementary years. This study examined the relations among three dimensions of social skills-cooperation, assertion, and self-control-vocabulary and developing reading comprehension (RC) skills in a longitudinal sample of first graders (n = 468). Using Structural Equation Modeling, reciprocal effects were observed between vocabulary and RC as well as direct effects among social skills, vocabulary, and RC after controlling for the influence of problem behaviors. This study highlights the reciprocal nature of students' vocabulary and RC skills as well as provides preliminary evidence suggesting that social skills play a role in developing vocabulary and RC skills, and further, vocabulary and RC skills play a role in social development during middle childhood. Implications for policy and practice are discussed.

Teaching Literacy Skills to French Minimally Verbal School-Aged Children with Autism Spectrum Disorders with the Serious Game SEMA-TIC: An Exploratory Study

Learning to read is very challenging for children with Autism Spectrum Disorders (ASD), but also very important, as it can give them access to new knowledge. This is even more challenging in minimally verbal children, who do not have the verbal abilities to learn through usual methods. To address the learning of literacy skills in French minimally verbal school-aged children with ASD, we designed the serious game SEMA-TIC, which relies on non-verbal cognitive skills and uses specific learning strategies adapted to the features of autistic individuals. This study investigated the usability of SEMA-TIC (in terms of adaptability, efficiency, and effectiveness) for the acquisition of literacy skills in French minimally verbal school-aged children with ASD. Twenty-five children with ASD and no functional language participated in the study. Children in the training group received the SEMA-TIC training over 23 weeks (on average), while no intervention was provided to children in the non-training group. Results indicated that SEMA-TIC presents a suitable usability, as all participants were able to play (adaptability), to complete the training (efficiency) and to acquire significant literacy skills (effectiveness). Indeed, the literacy skills in the training group significantly improved after the training, as measured by specific experimental tasks (alphabet knowledge, word reading, word-non-word discrimination, sentence reading and word segmentation; all p ≤ 0.001) compared to the non-training group. More importantly, 3 out of 12 children of the training group could be considered as word decoders at the end of the intervention, whereas no children of the non-training group became able to decode words efficiently. The present study thus brings preliminary evidence that French minimally verbal school-aged children with ASD are able to learn literacy skills through SEMA-TIC, a specific computerized intervention consisting in a serious game based on non-verbal cognitive skills.

Attention and written expression in school-age, high-functioning children with autism spectrum disorders

High-functioning children with autism spectrum disorders often find writing challenging. These writing difficulties may be specific to autism spectrum disorder or to a more general clinical effect of attention disturbance, as these children are often comorbid for attention-deficit/hyperactivity disorder (ADHD) symptomatology (and children with attention-deficit/hyperactivity disorder often also find writing challenging). To examine this issue, this study investigated the role of attention disturbance on writing in 155 school-age children across four diagnostic groups: high-functioning autism spectrum disorder (HFASD) with lower ADHD symptoms (HFASD-L), HFASD with higher ADHD symptoms (HFASD-H), ADHD symptoms but no autism spectrum disorder symptoms, and typical development. Both HFASD subgroups and the ADHD group displayed lower word production writing scores than the typical development group, but the clinical groups did not differ. The HFASD-H and ADHD groups had significantly lower theme development and text organization writing scores than the typical development group, but the HFASD-L and typical development groups were not significantly different. The findings support prior research reporting writing problems in children with autism spectrum disorder but also suggest that children with HFASD-H may be at greater risk for writing difficulties than children with HFASD-L. Better understanding the role of attention in writing development could advance methods for assessment and intervention for children with high-functioning autism spectrum disorder at risk for writing difficulties.

Executive dysfunctions, reading disabilities and speech-language pathology evaluation

BACKGROUND

Many students with reading disabilities exhibit persisting reading problems despite intervention. The crucial difference between effective and struggling readers is their executive functions (EFs), and improved functions impact positively on learning to read and reading to learn.

OBJECTIVES

Firstly, to show that high-risk and struggling students' persisting language and reading difficulties are accompanied by executive dysfunctions. Secondly, to present one student's daily struggles at school in a narrative based on teacher, parent and child interviews.

METHOD

This retrospective study is based on speech-language pathology (SLP) evaluations of a clinical sample of 23 girls and boys aged 6-16 from a range of middle class families. While language and reading evaluations were tailored to the students' particular situation, i.e. age, grade, languages or complaint, EFs were examined in all with the Behaviour Rating Inventory of Executive Function teacher questionnaire.

RESULTS

Virtually all students exhibited executive dysfunctions, and many showed a high risk of attention deficit hyperactivity disorders.

CONCLUSIONS

This study demonstrated that inclusion of EFs in SLP evaluations is valuable in uncovering executive dysfunction comorbidity that may underlie persisting reading disorders. It is proposed that speech-language pathologists explicitly and routinely braid language and reading with EFs in their evaluations so to effectively predict, uncover and prevent persisting reading disabilities in students.

A randomized controlled trial of an inference generation strategy intervention for adults with high-functioning autism spectrum disorder

PURPOSE

The present intervention study investigated the efficacy of the ACT & Check Strategy intervention to improve inference generation when reading, metacognitive ability, general reading comprehension, and social inference ability in adults with high-functioning autism spectrum disorder (HF-ASD).

METHOD

Twenty-five adults with HF-ASD were randomly assigned to either a treatment or a control group. Treatment sessions were conducted in 1-hr sessions, twice a week, for a total of 6 weeks. Treatment focused on explicit instruction of components of inference generation, categories of inferences, and increasingly independent strategy use.

RESULTS

The treatment group demonstrated significantly superior performance on 1 of 2 measures of inference generation in reading and 1 measure of metacognitive ability compared with the control group. Significant differences between groups were not found on measures of reading comprehension or social inference ability.

CONCLUSION

These findings suggest that the ACT & Check Strategy was effective in improving participants' ability to generate inferences in reading and certain metacognitive abilities, but the skills do not appear to generalize to other social communication contexts, such as social inference generation. This research provides a measure of support for explicitly teaching inference generation to address a reading inference deficit in adults with HF-ASD.

Orthography Facilitates Vocabulary Learning for Children with Autism Spectrum Disorders (ASD)

This study investigated the extent to which children with autism spectrum disorders (ASD) can use orthography to facilitate vocabulary learning, as is the case for typically developing (TD) children. Forty-one children aged 7–12 years, 20 with a formal diagnosis of ASD and 21 TD peers, were taught 16 low-frequency concrete science words, such as “breccia”. Half of the stimuli had the written word presented alongside a picture of the target item (orthography present: OP) while the remaining items were taught with orthography absent (OA). During the learning phase, eye movements were recorded; there were no group differences in the time spent fixating the written form. Production, comprehension, and recognition of orthographic forms of new words were assessed immediately after learning and again after a 24-hour delay. The vocabulary learning of both groups was facilitated by the presence of orthography. Overall, the groups did not differ in comprehension of new words or recognition of new orthographic forms, although the children with ASD demonstrated superior phonological learning (as measured by a picture naming task) relative to TD peers. Additionally, both groups retained or increased new knowledge after 24 hours. The results suggest that presenting the written form during oral vocabulary teaching will enhance learning and provide a mechanism for children with ASD to increase word knowledge despite potential limitations in social learning.

Neural bases of Theory of Mind in children with autism spectrum disorders and children with conduct problems and callous-unemotional traits

Individuals with autism spectrum disorders (ASD) have difficulty understanding other minds (Theory of Mind; ToM), with atypical processing evident at both behavioural and neural levels. Individuals with conduct problems and high levels of callous-unemotional (CU) traits (CP/HCU) exhibit reduced responsiveness to others' emotions and difficulties interacting with others, but nonetheless perform normally in experimental tests of ToM. The present study aimed to examine the neural underpinnings of ToM in children (aged 10–16) with ASD (N = 16), CP/HCU (N = 16) and typically developing (TD) controls (N = 16) using a non-verbal cartoon vignette task. Whilst individuals with ASD were predicted to show reduced fMRI responses across regions involved in ToM processing, CP/HCU individuals were predicted to show no differences compared with TD controls. The analyses indicated that neural responses did not differ between TD and CP/HCU groups during ToM. TD and CP/HCU children exhibited significantly greater medial prefrontal cortex responses during ToM than did the ASD group. Within the ASD group, responses in medial prefrontal cortex and right temporoparietal junction (TPJ) correlated with symptom severity as measured by the Autism Diagnostic Observation Schedule (ADOS). Findings suggest that although both ASD and CP/HCU are characterized by social difficulties, only children with ASD display atypical neural processing associated with ToM.

Excellent Word-Reading Ability in the Context of an Autism Spectrum Disorder: A Case Study of a Swedish-Speaking 7-Year-Old Boy

This case study seeks to extend our knowledge of the phenotype associated with excellent word reading in autism spectrum disorder by a detailed examination of psycholinguistic, neuropsychological/cognitive, and classroom/academic functioning of a Swedish-speaking 7-year-old boy (called “Jonas”). On age-referenced word reading-decoding assessment, Jonas scored among the top 7%. Reading comprehension status varied as a function of information source. Jonas’s phonological processing and phonological memory performance was found to be normal to strong. In contrast, he scored poorly on tests of oral semantic, syntactical, and narrative language. On the WISC-III, Jonas performed highly uneven across subtests from impaired to above average levels. On the Kaufman factors, Jonas had a peak in perceptual organization (IQ score 119), thus reflecting very strong visual attention skills, which together with normal to strong phonological abilities might underlie his excellent word reading. Finally, both his parents and teacher reported on other classroom-learning skills and difficulties.

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.

Can monitoring in language comprehension in Autism Spectrum Disorder be modulated? Evidence from event-related potentials

The present study examined language comprehension in Autism Spectrum Disorder (ASD) in light of monitoring. It was studied whether individuals with ASD monitor their language perception, and whether monitoring during language perception could be modulated with instructions. We presented higher-level (semantic) linguistic violations and lower-level (orthographic) linguistic violations in a free reading condition and in an instructed condition, recording event-related potentials. For control participants, a monitoring response as tapped by the P600 effect was found to semantically and orthographically incorrect input in both conditions. For participants with ASD, however, a monitoring response to semantically implausible input, tapped by the P600, was found only in the instructed condition. For orthographic errors monitoring was observed both in the free reading and in the instructed condition. This suggests that people with ASD are less inclined than typical individuals to monitor their perception of higher-level linguistic input, but that this can be enhanced with instructions.

Reading comprehension in autism spectrum disorders: the role of oral language and social functioning

Reading comprehension is an area of difficulty for many individuals with autism spectrum disorders (ASD). According to the Simple View of Reading, word recognition and oral language are both important determinants of reading comprehension ability. We provide a novel test of this model in 100 adolescents with ASD of varying intellectual ability. Further, we explore whether reading comprehension is additionally influenced by individual differences in social behaviour and social cognition in ASD. Adolescents with ASD aged 14-16 years completed assessments indexing word recognition, oral language, reading comprehension, social behaviour and social cognition. Regression analyses show that both word recognition and oral language explain unique variance in reading comprehension. Further, measures of social behaviour and social cognition predict reading comprehension after controlling for the variance explained by word recognition and oral language. This indicates that word recognition, oral language and social impairments may constrain reading comprehension in ASD.

Do Apparent Overlaps between Schizophrenia and Autistic Spectrum Disorders Reflect Superficial Similarities or Etiological Commonalities?

STUDY BACKGROUND: Schizophrenia and autism are both neurodevelopmental disorders that were once considered to be the same disorder expressed in different developmental periods. Although they were separated diagnostically about 40 years ago, they share several clinical and possibly, etiological features. This paper reviews overlaps in four domains of function to consider the issue of whether these similarities are sporadic and likely to represent superficial similarities, or whether the disorders are more likely to share some features in common. METHODS: Representative areas of function were reviewed and compared for aspects of cognition (nonverbal reasoning, memory and language), social function (orienting/joint attention, eye contact and theory of mind), brain function (structural differences) and genetics. To facilitate comparisons with schizophrenia, a focus on high functioning autism/Asperger's disorder was utilized, particularly in the sections on cognition and social function. RESULTS: Significant similarities (and differences) characterized comparisons in each domain. CONCLUSIONS: Disturbed function in similar clinical (in cognition and social function), neurobiological (brain volumes) and genetic (e.g., involvement of the same genes or chromosomal locations) domains in autism and schizophrenia supports the hypothesis that while they are distinct disorders, they are not entirely unique. Additional studies of similarities and differences between them may thus shed light on common etiological mechanisms and hopefully, facilitate the development of novel treatment targets.