Sight Word Instruction for Students with Autism: An Evaluation of the Evidence Base

Effectiveness of interventions for children and adolescents with autism spectrum disorder in high-income vs. lower middle-income countries: An overview of systematic reviews and research papers from LMIC

Background

There is a multitude of systematic reviews of interventions for children and adolescents with autism spectrum disorder (ASD). However, most reviews seem to be based on research conducted in High-Income Countries (HIC). Thus, summary findings may not directly apply to Lower Middle-Income Countries (LMIC). Therefore, we conducted a Meta-Review analyzing systematic reviews on the effectiveness of interventions for target outcomes in children and adolescents with ASD to find out whether there are differences in effectiveness between HIC and LMIC and which interventions can be considered evidence-based in LMIC.

Methods

Electronic databases (PsycINFO, PubMed, Cochrane database of systematic reviews) were searched for reviews on interventions for ASD in children and adolescents from January 2011 through December 2021, which included studies not coming from HIC. Systematic reviews with qualitative and quantitative syntheses of findings were included. Two investigators independently assessed studies against predetermined inclusion/exclusion criteria and extracted relevant data including quality and evidence assessments. Evidence for different types of interventions in HIC vs. LMIC was planned to be compared, but none of the reviews assessed potential differences. Therefore, a narrative review of the studies from LMIC was conducted including an assessment of quality and evidence.

Results

Thirty-five reviews fulfilled the inclusion criteria. Eleven considered findings from HIC and LMIC. Sixty-nine percent included studies with various research designs; 63% provided a qualitative synthesis of findings; 77% percent assessed the quality of studies; 43% systematically assessed the level of evidence across studies. No review compared evidence from HIC and LMIC. A review of the studies from LMIC found some promising results, but the evidence was not sufficient due to a small number of studies, sometimes poor quality, and small sample sizes.

Conclusion

Systematic reviews on interventions for children and adolescents with ASD did not look for potential differences in the effectiveness of interventions in HIC and LMIC. Overall, there is very little evidence from LMIC. None of the interventions can be considered evidence-based in LMIC. Hence, additional research and mutually agreed methodological standards are needed to provide a more secure basis for evidence-based treatments in LMIC trying to establish evidence-based practices.

Literacy instruction for autistic children who speak languages other than English

LAY ABSTRACT

Many autistic children across the globe speak languages other than English. However, much of the research about teaching children with autism to read and write is derived from studies including people who speak English and no other languages. Here, we review the research on teaching children with autism to read and write in languages other than English. We did this because the world's languages, and the ways they are represented in written form, vary greatly. A broader overview that encompasses languages other than English can help us better understand how learning to read and write can be supported for autistic children around the world. The studies included in our review highlight some potential differences in effective literacy teaching for autistic children learning to read and write using different writing systems. The studies we reviewed tended to include relatively small samples of autistic children, among other limitations. We hope that our review will increase awareness and research efforts in the area of autism and global literacy.

Effects of a Literacy Feature in an Augmentative and Alternative Communication App on Single Word Reading of Individuals with Severe Autism Spectrum Disorders

The purpose of this study was to investigate the effects of an augmentative and alternative communication (AAC) app with transition to literacy (T2L) software features (i.e., dynamic text and speech output upon selection of a graphic symbol within the grid display), on the acquisition of 12 personally relevant single words for individuals with severe autism spectrum disorder (ASD) who had minimal or no speech. The study implemented a single-subject, multiple-probe, across word sets design with four participants. All four participants in this study demonstrated increased accuracy reading targeted single words and results from this study provide preliminary evidence that the T2L features can positively impact the single word learning of individuals with ASD who have minimal speech and limited literacy skills.

The effects of literacy interventions on single-word reading for individuals who use aided AAC: a systematic review

The purpose of this systematic review was to investigate the effects of instruction on single-word reading of individuals who use aided augmentative and alternative communication (AAC). A systematic search identified nine single-case experimental design studies that involved 24 individuals who used aided AAC. Overall, the evidence indicated that instruction had positive effects on reading at the single-word level for individuals across ages and diagnostic categories (i.e., autism spectrum disorder (ASD), cerebral palsy (CP), Down syndrome, and intellectual disability). The studies revealed that these effects were consistent across a range of participant, intervention, and outcome measure characteristics. Phonological approaches, sight-word approaches, and a combination of these two approaches yielded very large effects. Despite the large effects, the findings must be viewed with caution due to limitations in the number of studies and participants and limitations in the reporting of detailed participant and intervention characteristics across the studies. In order to determine which interventions are most effective for which individuals, future research directions are discussed, including the need for greater specificity in describing participant and intervention characteristics, investigations into how to best measure intervention outcomes without requiring spoken responses, and investigations into longer-term interventions targeting a wider range of reading skills.

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.