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

The Effects of Using Adapted Science eBooks Within Shared Reading on Comprehension and Task Engagement of Students with Autism Spectrum Disorder

The purpose of this study was to examine the effects of using adapted science eBooks within shared reading on comprehension and task engagement of high school students with autism spectrum disorder (ASD). A grade-level science textbook was selected and converted into an eBook format, incorporating various visual and auditory features (e.g., text-to-speech, summarized sentences, highlighted keywords) and presented on an iPad. The shared reading intervention included before, during, and after reading strategies (i.e., pre-teaching target vocabulary words, sharing information, retelling), with direct instruction on locating literal information. The intervention effects on reading comprehension and task engagement were evaluated using a single-case multiple probe design. The results of this study indicated that all participants demonstrated improvements in reading comprehension. Despite the longer intervention sessions compared to the baseline, all participants exhibited similar or enhanced levels of task engagement during the intervention sessions. The findings of this study provide empirical evidence supporting the use of adapted eBooks within shared reading as a means to increase access to grade-level science texts for high school students with ASD while maintaining a high level of task engagement. This intervention holds promise for improving the learning outcomes for students with ASD in science content area.

Predictive processing of music and language in autism: Evidence from Mandarin and English speakers

Atypical predictive processing has been associated with autism across multiple domains, based mainly on artificial antecedents and consequents. As structured sequences where expectations derive from implicit learning of combinatorial principles, language and music provide naturalistic stimuli for investigating predictive processing. In this study, we matched melodic and sentence stimuli in cloze probabilities and examined musical and linguistic prediction in Mandarin- (Experiment 1) and English-speaking (Experiment 2) autistic and non-autistic individuals using both production and perception tasks. In the production tasks, participants listened to unfinished melodies/sentences and then produced the final notes/words to complete these items. In the perception tasks, participants provided expectedness ratings of the completed melodies/sentences based on the most frequent notes/words in the norms. While Experiment 1 showed intact musical prediction but atypical linguistic prediction in autism in the Mandarin sample that demonstrated imbalanced musical training experience and receptive vocabulary skills between groups, the group difference disappeared in a more closely matched sample of English speakers in Experiment 2. These findings suggest the importance of taking an individual differences approach when investigating predictive processing in music and language in autism, as the difficulty in prediction in autism may not be due to generalized problems with prediction in any type of complex sequence processing.

Pre-school Skills and School-Age Reading Comprehension in Children on the Autism Spectrum: A Preliminary Investigation

We explored reading comprehension development in children on the spectrum from pre-school to the first (YOS1) and third year of schooling (YOS3). Children were first assessed on meaning-related skills in pre-school. Forty-one children completed follow-up assessments of reading comprehension, reading accuracy, and listening comprehension in YOS1. Nineteen returned for assessments of reading accuracy, reading comprehension, and listening comprehension in YOS3. Children showed poorer reading comprehension than reading accuracy at both timepoints. Reading comprehension, reading accuracy, and listening comprehension were significantly concurrently correlated. Pre-school receptive vocabulary was a significant predictor of YOS3 reading comprehension. Results from this preliminary investigation highlight the potential for early identification of children on the spectrum at risk for reading comprehension difficulties.

Reading comprehension differences between children with Autism Spectrum Disorder and low cognitive abilities and children with Autism Spectrum Disorder and intact cognitive skills: the roles of decoding, fluency and morphosyntax

Introduction

Reading comprehension is one of the most important skills learned in school and it has an important contribution to the academic success of children with Autism Spectrum Disorder (ASD). Though previous studies have investigated reading comprehension difficulties in ASD and highlighted factors that contribute to these difficulties, this evidence has mainly stemmed from children with ASD and intact cognitive skills. Also, much emphasis has been placed on the relation between reading comprehension and word recognition skills, while the role of other skills, including fluency and morphosyntax, remains underexplored. This study addresses these gaps by investigating reading comprehension in two groups of school-aged children with ASD, one with intact and one with low cognitive abilities, also exploring the roles of word decoding, fluency and morphosyntax in each group's reading comprehension performance.

Methods

The study recruited 16 children with ASD and low cognitive abilities, and 22 age-matched children with ASD and intact cognitive skills. The children were assessed on four reading subdomains, namely, decoding, fluency, morphosyntax, and reading comprehension.

Results

The children with ASD and low cognitive abilities scored significantly lower than their peers with intact cognitive abilities in all reading subdomains, except for decoding, verb production and compound word formation. Regression analyses showed that reading comprehension in the group with ASD and intact cognitive abilities was independently driven by their decoding and fluency skills, and to a lesser extent, by morphosyntax. On the other hand, the children with ASD and low cognitive abilities mainly drew on their decoding, and to a lesser extent, their morphosyntactic skills to perform in reading comprehension.

Discussion

The results suggest that reading comprehension was more strongly affected in the children with ASD and low cognitive abilities as compared to those with intact cognitive skills. About half of the children with ASD and intact cognitive skills also exhibited mild-to-moderate reading comprehension difficulties, further implying that ASD may influence reading comprehension regardless of cognitive functioning. Finally, strengths in decoding seemed to predominantly drive cognitively-impaired children's reading performance, while the group with ASD and intact cognitive skills mainly recruited fluency and metalinguistic lexical skills to cope with reading comprehension demands, further suggesting that metalinguistic awareness may be a viable way to enhance reading comprehension in ASD.

Reading comprehension improvement in autism

Introduction

A subset of autistic children excel at word decoding but have difficulty with reading comprehension (i.e., the discrepant poor comprehender reading profile). Prior research suggests the Visualizing and Verbalizing (V/V) for language comprehension and thinking intervention helps improve reading comprehension in autistic children with this reading profile. Previous studies have demonstrated the role of vocabulary, memory, and social functioning in reading comprehension; however, predictors and moderators of reading comprehension within this specific profile of autistic readers have not been thoroughly explored.

Methods

In this study, we examined the effectiveness of the V/V intervention by comparing reading comprehension scores between groups and across time. Participants included a sample of autistic children (AUT-EXP; n=22) and a waitlist control group of autistic children (AUT-WLC; n=17) with reading comprehension difficulties, as well as a sample of non-autistic children (Non-AUT; n=26) (all age 8-13 years). AUT-EXP and AUT-WLC groups completed a battery of cognitive assessments during pre and post tests. We also analyzed whether cognitive assessment scores predicted reading comprehension, and examined the moderating effects of group (AUT-EXP vs. AUT-WLC) on these relationships.

Results

The AUT-EXP group significantly improved in their pre to post reading comprehension scores (t(21)=4.19, p<.001, d=.89), whereas the AUT-WLC group did not. Verbal memory significantly predicted reading comprehension, though group did not moderate relationships between cognitive test performance and reading comprehension.

Discussion

Results suggest that the V/V intervention may help improve reading comprehension for autistic children with the discrepant poor comprehender reading profile. Additionally, strategies for improving verbal memory may indirectly enhance reading comprehension in autistic children with this reading profile.

No evidence for high inflexible precision of prediction errors in autism during lexical processing

Research has shown that information processing differences associated with autism could impact on language and literacy development. This study tested an approach to autistic cognition that suggests learning occurs via prediction errors, and autistic people have very precise and inflexible predictions that result in more sensitivity to meaningless signal errors than non-autistic readers. We used this theoretical background to investigate whether differences in prediction coding influence how orthographic (Experiment 1) and semantic information (Experiment 2) is processed by autistic readers. Experiment 1 used a lexical decision task to test whether letter position information was processed less flexibly by autistic than non-autistic readers. Three types of letter strings: words, transposed letter and substituted letters nonwords were presented. Experiment 2 used a semantic relatedness task to test whether autistic readers processed words with high and low semantic diversity differently to non-autistic readers. Results showed similar transposed letter and semantic diversity effects for all readers; indicating that orthographic and semantic information are processed similarly by autistic and non-autistic readers; and therefore, differences in prediction coding were not evident for these lexical processing tasks.

Verbal Behavior Analysis of Teaching Story Recall to Children with Autism: A Replication and Extension

Children with autism spectrum disorder (ASD) may struggle with verbal behavior related to recall in various contexts. However, relatively little research has evaluated methods for improving recall among this population, and even fewer from a verbal behavior perspective. One socially important set of skills that relies upon a behavioral repertoire of recall is applied reading skills, such as reading comprehension and story recall. Valentino et al. (2015) designed an intervention package to teach children with ASD to recall short stories and conceptualized the behavior as an intraverbal chain. The present study replicated and extended that study with three school-aged children with ASD using a multiple baseline design across stories. For some participants and some stories, story recall was mastered under less intensive intervention conditions than in the previous study. When it was necessary to implement the full intervention package, the effects largely replicated previous research. Improvements in recall were correlated with increases in correct answers to comprehension questions. These data have important implications for clinicians and educators providing reading and recall interventions to children with ASD. Results also have theoretical implications for verbal behavior accounts of memory and recall, and suggest several possible avenues for future research.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40616-023-00183-2.

Story Comprehension Monitoring Across Visual, Listening, and Written Modalities in Children with and Without Autism Spectrum Disorder

Visual, as compared to verbal, tasks are often assumed to be easier for individuals with autism spectrum disorder (ASD), but is this true for story comprehension? This study evaluated story comprehension monitoring across visual, listening, and written modalities and assessed predictors in two closely matched groups (age, socioeconomic status, language, nonverbal cognition, and word reading) of children and adolescents (8-14 years) with ASD (n = 20) and typical development (typically developing [TD]; n = 20). The results of mixed-effects models indicated that story comprehension monitoring was low overall, and performance was comparable across visual, listening, and written modalities for participants with ASD. Age, vocabulary, nonverbal working memory, response and distractor inhibition, and social communication significantly predicted comprehension monitoring.

Using the Question-Answer Relationship Strategy to Improve Listening Comprehension in Young Children with Autism Spectrum Disorder

Our purpose in this study was to examine the effects of an intervention package consisting of shared book reading and an adapted question-answer relationship (QAR) strategy comprised of visual supports and think-aloud scripts on listening comprehension in four preschool children with autism spectrum disorder (ASD). We used a single-subject concurrent multiple-baseline design across participants with continuous acquisition probes to evaluate the effects of the intervention package on producing acquisition and maintenance of listening comprehension across four types of comprehension questions. Visual analysis and Tau-U effect size indicated that the intervention package was effective in producing acquisition and maintenance of listening comprehension in preschool children with ASD. Directions for future research and clinical implications for early education practice are discussed.

"It's about sharing a moment": Parents' views and experiences of home reading with their autistic children with moderate-to-severe intellectual disabilities

BACKGROUND

The home literacy environment plays a critical role in the development of children's literacy and language development. Little is known, however, about the home literacy environment of autistic children, especially those with moderate-to-severe intellectual disabilities.

AIMS

The current study used a sequential mixed-methods design to understand how parents attempt to engage their autistic children in reading activities and support them in learning to read.

METHODS AND PROCEDURE

First, 63 parents (53 mothers) whose autistic children attended an autism-specific special school completed a bespoke questionnaire about the home literacy environments for their children (n = 69, age range = 3-11 years, 61 boys, 8 girls). Second, a subsample of parents (n = 19, 15 mothers) participated in focus groups to understand in-depth their views and experiences of home reading with their children (n = 20, age range = 3-11 years, 19 boys, 1 girl). We used reflexive thematic analysis to analyse the focus group data.

OUTCOMES AND RESULTS

Across questionnaire and focus group methods, parents were united in considering reading to be an important life skill, a sentiment that was reflected both by their often literacy-rich homes and the ingenuity in their efforts to engage their children in shared home-reading activities - even when such engagement could be challenging. They also emphasised, however, the importance of valuing these activities as an opportunity to "catch a moment" with their child.

CONCLUSIONS AND IMPLICATIONS

Parents and teachers should work together to identify ways to enhance autistic children's engagement in shared home-reading activities, listening to and learning from each other's experiences and expertise, and to show what is possible within each learning context.

Word reading skills in autism spectrum disorder: A systematic review

A growing body of research suggests that children with autism spectrum disorder (ASD) are at risk of reading and learning difficulties. However, there is mixed evidence on their weaknesses in different reading components, and little is known about how reading skills characterize in ASD. Thereby, the current study aimed to systematically review the research investigating this function in children with ASD. To this purpose, we reviewed 24 studies that compared (1) children with ASD and children with typical development (TD) in word and nonword reading performance, (2) children with ASD and normative data of word and nonword reading tests, and (3) the results obtained by children with ASD in word and nonword reading tests. Most of the comparisons (62%) contrasting the reading performance of children with ASD and children with TD did not find significant differences between groups in both word and nonword reading. However, all the comparisons that reported standardized results showed that children with ASD had scores that fell within population norms. Regarding the third comparison of interest, about 54% of the studies presented data for both word and nonword reading, but only one study tested the difference between them and showed that children with ASD had higher levels of word than of nonword reading. Despite these results, the heterogeneous and small samples do not allow to draw sound conclusions regarding the strategies that children with ASD use to read words. As consequence, the nature of reading difficulties presented by children with ASD are still unknown, requiring future research conducted with larger and well-characterized samples of ASD and TD, using homogeneous specific tasks designed to assess word reading strategies.

Brief Report: Predictors of Teacher-Rated Academic Competence in a Clinic Sample of Children With and Without Autism Spectrum Disorder

The rising prevalence of autism spectrum disorder (ASD) necessitates a greater understanding of the academic experience of diagnosed children. The present study investigates several predictors of teacher-reported academic competence among a sample of elementary school children. All children in the sample were referred for an ASD evaluation and approximately half received a diagnosis. Children with and without ASD did not differ on overall academic competence, social skills, or problem behaviors. Regression analyses indicated that cognitive ability, social skills, and problem behaviors accounted for significant variance in academic competence. Moderation analyses indicated that the relations between the predictors and academic competence were comparable for children with and without ASD. Implications and future directions are discussed.

Code-related literacy profiles of kindergarten students with autism

LAY ABSTRACT

Many children and young students with autism have difficulties learning how to read. This study investigated early literacy development in children with autism spectrum disorder during their first year of formal schooling. The study found that children with autism spectrum disorder differ greatly on their early literacy skills, with some showing strengths in their understanding of the alphabet, spelling, and reading words. Other students in the sample had difficulties with these early reading skills. The findings of this study are important to better understand the most effective way to teach early literacy skills to children with autism spectrum disorder.

Reading for Comprehension in Individuals with Down Syndrome, Autism Spectrum Disorder and Typical Development: Similar or Different Patterns of Ability?

Reading for meaning is one of the most important activities in school and everyday life. The simple view of reading (SVR) has been used as a framework for studies of reading comprehension in individuals with Down syndrome (DS). These tend to show difficulties in reading comprehension despite better developed reading accuracy. Reading comprehension difficulties are influenced by poor oral language. These difficulties are common in individuals with DS and autism spectrum disorder (ASD), but they have never been compared directly. Moreover, the components of reading for comprehension have rarely been investigated in these populations: a better understanding of the nature of reading comprehension difficulties may inform both theory and practice. The aim of this study was to determine whether reading comprehension in the two populations is accounted for by the same component skills and to what extent the reading profile of the two atypical groups differs from that of typically developing children (TD). Fifteen individuals with DS (mean age = 22 years 4 months, SD = 5 years 2 months), 21 with ASD (mean age = 13 years 2 months, SD = 1 year 6 months), and 42 TD children (mean age = 8 years 1 month, SD = 7 months) participated and were assessed on measures of receptive vocabulary, text reading and listening comprehension, oral language comprehension, and reading accuracy. The results showed similar levels in word reading accuracy and in receptive vocabulary in all three groups. By contrast, individuals with DS and ASD showed poorer non-word reading and reading accuracy in context than TD children. Both atypical groups showed poorer listening and reading text comprehension compared to TD children. Reading for comprehension, investigated through a homograph reading accuracy task, showed a different pattern for individuals with DS with respect to the other two groups: they were less sensitive to meaning while reading. According to the SVR, the current results confirm that the two atypical groups have similar profiles that overlap with that of poor comprehenders in which poor oral language comprehension constrains reading for 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.

Building Comprehension Skills of Young Children With Autism One Storybook at a Time

Purpose Reading involves the ability to decode and draw meaning from printed text. Reading skill profiles vary widely among learners with autism spectrum disorder (ASD). One fairly common pattern is relative strength in decoding combined with weak comprehension skills-indicators of this profile emerge as early as the preschool years. In order for children with ASD to develop a facility with language that prepares them for reading success, practitioners must intentionally create and provide appropriate instruction practices. Method In this tutorial, we describe ways in which practitioners can support language development and comprehension skills for children with ASD within the context of shared reading activities. We begin by providing known information about the reading performance of children with ASD using the Simple View of Reading as our guiding conceptual framework. Next, we present a number of practical, evidence-based strategies that educators can implement within the context of shared book reading activities. Case studies are embedded throughout the tutorial to demonstrate how practitioners may apply these strategies in their instructional settings. Conclusions Shared book reading interventions are a well-studied, developmentally appropriate approach for bringing about change in language and literacy in early childhood. The success of shared reading depends upon rich communication and interaction between the adult reader and the child. Many children with ASD will require strategies to support social communication and emergent literacy skill development (e.g., vocabulary knowledge, language comprehension) that are specifically linked to future reading comprehension.

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.

Stability of Literacy Profiles of Adolescents With Autism Spectrum Disorder and Associations With Stakeholder Perceptions of Appropriate High School Support Needs

Purpose For many individuals with autism spectrum disorder (ASD), postsecondary outcomes are poor. This may be due to insufficient academic supports, particularly with regard to literacy skills, during high school. More information is needed about skill profiles so that we can better differentiate support for students with varying social, communication, cognitive, and academic proficiency levels. This study was designed to (a) identify unique literacy profiles of high school students with ASD, (b) assess profile stability over time, (c) identify predictors of profile membership, and (d) analyze stakeholder reports of required school support intensity. Method Participants were a diverse sample of high school students with ASD, 14-21 years old (N = 544), their parents, and their teachers who participated in a randomized controlled trial of a comprehensive treatment model for high school students with ASD. Standardized measures were administered to assess nonverbal IQ, autism symptomatology, language/adaptive communication, reading comprehension, academic knowledge, and parent/teacher report of school support needs intensity. Latent transition analysis was conducted to examine sample heterogeneity and to explore the stability of the profiles. Associations between profiles and reports of support intensity were examined. Results Four literacy profiles were identified that were stable over 2 years: Emergent Literacy/Comprehensive Support, Low Literacy/Intensive Support, Average Literacy/Moderate Support, and Average Literacy/Limited Support. Parent and teacher reports of school support intensity generally aligned with the profiles. Conclusions These analyses provide insight into the diverse literacy and support needs in ASD. Implications for practice and the role of speech-language pathologists in assessment and intervention are discussed. Supplemental Material https://doi.org/10.23641/asha.13495119.

Print Knowledge in Children With Autism Spectrum Disorder: Do Child and Family Variables Play a Role?

Purpose

This study aimed to examine the print knowledge of children with autism spectrum disorder (ASD) in comparison to children who have developmental language disorder (DLD) and typically developing (TD) children as well as examine the child and family predictors of print knowledge.

Method

A total of 629 preschool children, including 33 children with ASD, 93 children with DLD, and 503 TD children, were the focus of the current study. Teachers completed direct assessments with the children in the fall and spring of the academic year on print knowledge using the Phonological Awareness Literacy Screener.

Results

Analyses of covariance were used to compare the print knowledge skills (uppercase and lowercase letter identification, print and word awareness, name writing) in the fall and spring for each of the three groups. The groups were significantly different for the Print and Word Awareness and Name Writing subtests in both the fall and spring. A Tukey's honestly significant difference further indicated that, for these subtests, the children with ASD had significantly lower scores than both the children with DLD and TD children. When examining the child and family predictors of residualized gain in print knowledge for the children with ASD, the only significant predictor for any outcome was fall scores. When examining the predictors for the full sample, fall scores, age, ASD status, and mothers' education level were significant predictors of print and word awareness and name writing scores.

Conclusions

None of the child and family characteristics seemed to be related to residualized gain in print knowledge for children with ASD. However, when examining predictors of residualized gain in print knowledge for the full sample, ASD status was related to lower scores for both print and word awareness and name writing.

Reading Comprehension in School-Age Children With Autism Spectrum Disorder: Examining the Many Components That May Contribute

Purpose

Reading comprehension is consistently poor in many school-age children with autism spectrum disorder (ASD). The purpose of this tutorial is to provide an overview from a multicomponent view on the many predictors that may contribute to reading comprehension difficulties in ASD.

Method

This tutorial reviews current literature on profiles and predictors of reading comprehension in ASD. The review is situated from a multicomponent theoretical view based on the “direct and indirect effects of reading” model that builds on the familiar “simple view of reading.” Each component, including word reading, listening comprehension, morphosyntax, vocabulary, working memory, comprehension monitoring, inferencing, and theory of mind, is separately reviewed, with consideration of the current evidence for their contribution to reading comprehension in ASD. At the end of each section, key takeaways are provided. To conclude, a summary with general clinical implications, case examples, and recommendations for future research across all components is offered.

Conclusions

Reading comprehension in ASD may be affected by any one or several components in any given individual. Speech-language pathologists have expertise and play a critical role in assessing and intervening on these components. The age and language status (language impaired or not) of a child are emerging as important factors for what to assess and consider for intervention. However, more research is needed that intentionally examines language status, evaluates reading comprehension at targeted ages or narrower age ranges, and/or examines language and reading development longitudinally.

Introduction to the Forum: Literacy in Autism-Across the Spectrum

Purpose The purpose of this article is to introduce the LSHSS Forum: Literacy in Autism-Across the Spectrum. The articles in this forum provide an overview of the current evidence related to literacy in autism spectrum disorder (ASD) from preschool to adolescence and highlight the high literacy needs of this population. Method This introduction provides an overview of some of the reasons why children with ASD are at risk of persistent literacy difficulties and a summary of the six articles included in this forum. Conclusion More research is clearly needed to better understand which factors contribute to the high literacy needs in this population. For now, based on the best available evidence, the authors in this forum provide clear clinical implications that should be highly useful for speech-language pathologists and other professionals involved in literacy assessment and intervention for children and adolescents on the autism spectrum.

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.

Reading Goals and Executive Function in Autism: An Eye-Tracking Study

The sources of reading comprehension difficulties in people with autism spectrum disorder (ASD) are still open to discussion. We explored their ability to adapt reading strategies to different reading goals using eye-tracking technology. A group of participants with ASD, and intelligence-, receptive oral language- and reading skills-matched control peers, read three stories under three different reading goals conditions: read for entertainment; read for study; and read fast and search information for a previously presented question. Each text required participants to answer comprehension questions. The ASD group was less accurate in question answering. The control group was faster in reading questions, displayed more fixations on the text, and reported to be more confident in question answering during reading for study compared to reading for entertainment. These differences between reading goals were not observed in the ASD group. The control group adopted and was aware of using different reading strategies according to different reading goals. In contrast, the ASD group did not change their reading behavior and strategies between entertainment and study reading goal condition, showing less of a tendency to adopt deep-level processing strategies when necessary. Planning, as measured by Tower of Hanoi, was the only executive task that predicted individual differences in text reading time across conditions. Participants with better planning ability were also able to adapt their reading behavior to different reading instructions. Difficulties in adjusting the reading behavior according to the task, evaluating own performance and planning may be partly involved in reading comprehension problems in ASD. LAY ABSTRACT: The control group read questions faster, reported to be more confident in question answering during reading for study compared to reading for entertainment, and were aware of using different reading strategies according to different reading goals. In contrast, the autistic group did not change their reading behavior and strategies according to the reading goal. Difficulties in adjusting the reading behavior according to the task, in evaluating own performance and in planning may be partly involved in reading comprehension problems in autism. Autism Res 2021, 14: 1007-1024. © 2020 International Society for Autism Research, Wiley Periodicals, LLC.

Functional Communication Profiles of Children and Youth with Autism: A Roadmap to Therapeutic and Educational Interventions

BACKGROUND

Autism spectrum disorder (ASD) entails varied developmental pathways along the entire lifespan, demanding early and ongoing diverse and responsive interventions to children's needs. This study examined in situ education and development attained by children and youth with ASD in a school with a therapeutic and educational curriculum.

OBJECTIVES

(1) Construct individual communication profiles in educational and developmental aspects. (2) Examine for associations between variables. (3) Demonstrate the clinical and educational utility of including cognitive-linguistic integrative variables. (4) Showcase how the profiles guide interventions tailored to students' individual needs.

METHODS

Functional communication profiles (FCPs) of 21 students, aged 5.0-16.8 years, mostly from bilingual middle-high socioeconomic status families, were constructed with input from their educational and therapeutic staff. Students' performance was examined with an array of instruments and tasks, including person and clock drawings, false belief, and bouba-kiki metaphor screens. Qualitative and quantitative analyses were performed to uncover associations, weaknesses, and strengths.

RESULTS

The profiles revealed associations between cognitive, linguistic, social, and educational abilities, indicating that some abilities from different domains tend to co-occur.

CONCLUSIONS

Including cognitive linguistic integrative variables was a novelty that revealed additional aspects of the children's abilities. Staff feedback confirmed the utility of FCPs in providing "a roadmap" to needed individual and common curriculum adjustments.

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.

Brief Report: A Randomized Controlled Trial of the Effects of RECALL (Reading to Engage Children with Autism in Language and Learning) for Preschoolers with Autism Spectrum Disorder

This study investigated the effects of a parent-implemented dialogic reading approach-Reading to Engage Children with Autism in Language and Learning (RECALL)-on the engagement in reading and inference-making ability for preschoolers with autism spectrum disorder (ASD). Thirty-one preschoolers (mean age = 5.90 years, SD = 0.69; 26 boys, 5 girls) were randomly assigned to a treatment or control group. Six weeks of RECALL significantly enhanced story comprehension, emotion knowledge, and reading engagement among preschoolers in the treatment group. This might be the first randomized controlled trial testing the effects of RECALL on children with ASD. Our findings suggest that additional instructional support such as the application of a prompting hierarchy during dialogic reading might help children with ASD reap greater benefits from shared book reading.

The Relationships Among Autism Spectrum Disorder Traits, Loneliness, and Social Networking Service Use in College Students

This study aimed to explore the relationships among autism spectrum disorder (ASD) traits, loneliness, and social networking services (SNS) use. We created a questionnaire to evaluate manners during LINE use, which included five factors: "low literacy," "inactive use," "low responsiveness," "lack of consideration," and "low group activity." Structural equation modeling revealed that difficulties in attention switching and low communication skills were associated with low literacy, low social skills were associated with inactive use, and low literacy and inactive use were associated with loneliness. We suggested that SNS use plays a role in maintaining and enhancing friendships, whereas college students with higher ASD traits tend to use inappropriate manners for SNS, which is associated with loneliness.

Central coherence in adults with a high-functioning autism spectrum disorder. In a search for a non-self-reporting screening tool

BACKGROUND

Autism spectrum disorder in adults, especially high-functioning ones, is often difficult to differentiate from other mental disorders. Therefore, many adults with ASD are misdiagnosed, and their social difficulties are not adequately addressed. Moreover, frequent comorbid issues make diagnosis a challenging prospect. Most of the available screening and diagnostic tools rely on self-reporting, which can be a biased method. Weak Central Coherence is one of the main cognitive theories of ASD. According to research, individuals with ASD are slower in comparison to typically developed control on the uptake of context. The study goal was to see if the central coherence tasks could be used as a reliable screening marker that differentiates between high-functioning ASD and typically developed controls.

METHOD

Thirty males with ASD (as in DSM-5) and 30 demographically matched controls were investigated with Central Coherence Inferences Tests. Tests' scores and reaction times needed to complete the tasks in both groups were compared.

RESULTS

High-functioning participants with ASD achieved a similar score in central coherence tests as the typically developed control group, but they needed significantly more time to solve them. The ROC analysis for both central coherence tests revealed AUC values of 0.73 in differentiating ASD from typically developed controls.

CONCLUSIONS

The results are discussed in reference to the clinical application of central coherence as a possible screening marker. Further research directions are proposed in terms of differential diagnosis of adults with ASD.

A Preliminary Study of Writing Skills in Adolescents with Autism Across Persuasive, Expository, and Narrative Genres

Writing is often difficult for individuals with autism spectrum disorder (ASD), yet relatively little literature exists that profiles specific strengths and needs within this area. This preliminary investigation compares the written language skills of adolescents with ASD without intellectual disability (n = 14) to typically developing (TD) adolescents (n = 12). Writing samples from persuasive, expository, and narrative genres were elicited. Variables of sample length, writing productivity, syntax, lexical diversity, and macrostructure were analyzed. In the persuasive and expository genres, the ASD group scored significantly lower than the TD group on sample length and some aspects of macrostructure. The ASD group scored higher than the TD group on lexical diversity in the persuasive genre. Other comparisons yielded large effect sizes but were not statistically significant.

Growth in narrative retelling and inference abilities and relations with reading comprehension in children and adolescents with autism spectrum disorder

BACKGROUND AND AIMS

Extant research indicates that children and adolescents with autism spectrum disorder (ASD) without an intellectual disability (ID) often experience difficulty comprehending written texts that is unexpected in comparison with their cognitive abilities. This study investigated the development of two key skills, narrative and inference abilities, that support higher level text comprehension and their relation to lexical-semantic knowledge, ASD symptomatology, and age. Three questions were addressed: 1.) What was the nature of narrative and inference skill development over time? 2.) What was the relation between narrative or inference development and lexical-semantic knowledge, ASD symptomatology, and age? 3.) Did initial narrative and inferencing skills, and the development of these skills, predict reading comprehension outcomes? Methods: Data from 81 children and adolescents with ASD without ID (FIQ ≥ 75) between the ages of 8-16-years-old at timepoint 1 were collected at 15-month intervals across three timepoints. ASD symptomatology was assessed with the ADOS-2. Standardized narrative retelling, inference, reading comprehension, lexical-semantic knowledge and cognitive assessments were administered. Latent growth curve models were conducted to examine narrative and inference skill development, and conditional growth models were fit to examine the relation between growth trajectories and covariates (lexical-semantic knowledge, ASD symptomatology, age) as well as with the reading comprehension distal outcome.

RESULTS

Narrative retelling skills followed a linear trajectory of growth and were a relative strength in this sample, while inference skills were well below average and declined over time relative to age-normed standard scores. Lexical-semantic knowledge explained significant heterogeneity in initial narrative and inference skills, whereas ASD symptomatology was only related to initial narrative retelling abilities and age was only related to initial inference abilities. Timepoint 3 reading comprehension skill (in the below average range) was significantly explained by initial narrative retelling and inference abilities.

CONCLUSIONS

The results of this study indicate that narrative retelling and inference skills are important for successful reading comprehension for individuals with ASD without ID and that lexical-semantic knowledge underpins these skills. Furthermore, the observation that ASD symptom severity was associated with narrative retelling skills is consistent with the hypothesis that problems in narrative reading skills are associated with the autism phenotype. Finally, inference skill was a particular challenge for individuals in this sample, although age was positively associated with better performance on the assessment.Implications: These findings suggest that narrative and inference skills, in addition to lexical-semantic knowledge, are important to target beginning in elementary grades to improve reading comprehension outcomes for children and adolescents with ASD without ID.

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.

Neural correlates of association strength and categorical relatedness in youths with autism spectrum disorder

Impaired language and communication are commonly observed in youths with autism spectrum disorders (ASDs). However, the organization of semantic knowledge in youths with ASD remains unclear compared to typically developing (TD) youths. The present study addresses this issue by using functional magnetic resonance imaging (fMRI) to examine the distinction between association strength and categorical relatedness of semantic knowledge. A sample of 31 male youths with ASD (mean age = 12.1 years, SD = 1.2) and 38 TD youths (mean age = 11.9 years, SD = 1.0) was recruited with matched age, gender, and handedness. Participants decided if two visually presented Chinese characters were semantically related during fMRI scanning. For weaker association strength, the ASD group showed greater left cuneus activation, which was positively correlated with the picture completion for visual perception, whereas the TD group showed greater middle temporal gyrus and inferior frontal gyrus activation. For higher categorical relatedness, the TD group showed greater activation than the ASD group in the occipitotemporal cortex and left precuneus, which was positively correlated with the similarities for concept formulation. Findings imply that the ASD group may use lower-level visual information for both association strength and categorical relatedness. The TD group showed higher-level controlled processes of more elaborate semantic representations for association strength and more elaborate features of categorical knowledge for semantic selection and integration. Autism Res 2019, 12: 1484-1494. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Individuals with autism spectrum disorder (ASD) often present language/communication impairments. Exploring the difference of semantic processing between youths with ASD and typically developing (TD) youths is crucial for understanding the organization of semantic knowledge. We found different neural substrates of semantic knowledge between these two groups. ASD youths may rely more on lower-level visual information during semantic judgments, whereas TD youths showed higher-level controlled processes of more elaborate semantic representations for selection and integration of words, phrases, and sentences.

Processing Speed is Impaired in Adults with Autism Spectrum Disorder, and Relates to Social Communication Abilities

Autism spectrum disorder (ASD) is characterized by a variety of social and non-social behavioral deficits. One potential mechanism that could unify this diverse profile of behaviors is slower processing speed. Seventy-six high-functioning adults with ASD were compared to 64 matched controls on standardized measures of processing speed. Participants with ASD were significantly slower on all measures, and on the composite score from the three tests (d's > .65). ASD participants with slower processing speeds scored higher on the ADOS Communication and Reciprocal Social Interaction scale (r = .34). These findings provide evidence of slower processing speeds in adults with ASD, and that this may be contributing to impairments in social communication skills. Interventions that improve processing speed might improve social communication abilities in ASD.

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.

The Effects of a Shared Reading Intervention on Narrative Story Comprehension and Task Engagement of Students with Autism Spectrum Disorder

The purpose of this study was to investigate the effects of a shared reading intervention on narrative story comprehension and task engagement of students with autism spectrum disorder (ASD). A single-case multiple baseline design was used, and three elementary-aged students with ASD participated in this study. The shared reading intervention included before, during, and after reading strategies (i.e., topic anticipation, dynamic reading, story retelling). Results of this study indicated that all participants demonstrated noticeable improvements in reading comprehension. Despite the longer duration of intervention sessions as compared to baseline sessions, participants showed similar or better task engagement with intervention. Improved reading outcomes were maintained at follow up for all participants. Implications for practical implementation and future research were discussed.

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.

Abnormal cortical activation during silent reading in adolescents with autism spectrum disorder

OBJECTIVE

Autism spectrum disorder (ASD) is a developmental disorder characterized by communication deficits and social difficulties, and individuals with ASD frequently exhibit varied levels of language abilities. However, the neurophysiological mechanisms underlying their language deficits remain unclear. To gain insight into the neurophysiological mechanisms of receptive language deficits, we assessed cortical activation patterns in adolescents with ASD during silent word-reading.

METHODS

We used magnetoencephalography to measure cortical activation during a silent word-reading task in 14 adolescent boys with high-functioning ASD and 17 adolescent boys with typical development (TD).

RESULTS

Compared with participants with TD, those with ASD exhibited significantly decreased cortical activation in the left middle temporal gyrus, left temporoparietal junction, bilateral superior temporal gyrus, left posterior insula, and right occipitotemporal gyrus, and increased activation in the right anterior insula. Participants with ASD also exhibited a lack of left-lateralization in the central sulcus and abnormal right-lateralization in the anterior insula area. Furthermore, in participants with ASD, we found that abnormal activation of the right central sulcus correlated significantly with lower visual word comprehension scores, and that decreased activation of the right anterior insula correlated significantly with the severity of social interaction difficulties.

CONCLUSION

Our findings suggest that atypical cortical activation and lateralization in the temporal-frontal area, which is associated with higher-order language processing functions, such as semantic analysis, may play a crucial role in visual word comprehension and social interaction difficulties in adolescents with ASD.

Efficacy of ABRACADABRA literacy instruction in a school setting for children with autism spectrum disorders

BACKGROUND

There is evidence indicating that instruction using ABRACADABRA (ABRA) - a free web application designed to promote literacy development - may benefit children with autism spectrum disorders (ASD) when administered on an individualized basis in children's homes.

AIMS

Here, we investigated the efficacy of ABRA instruction administered in small groups of children with ASD within a school setting.

METHODS AND PROCEDURES

Children were aged 5.83-8.42 years (n = 23). Some children were assigned to an instruction group and received a minimum of 20 h of ABRA instruction over 9 weeks (n = 11). The other children comprised an age- and ability-matched control group (n = 12) and received business as usual literacy instruction. Outcome measures included word-level accuracy, passage-level accuracy, and passage-level comprehension, all assessed using standardized tests that were independent of ABRA.

OUTCOMES AND RESULTS

ANOVAs comparing pre- versus post-instruction raw scores showed statistically significant improvements in word- and passage-level reading accuracy for the instruction group relative to the control group, with large effect sizes. Gains in reading comprehension for the instruction group were not statistically significant and, in a posthoc correlational analysis, appeared to be related to children's socialisation skills (r = .62).

CONCLUSIONS AND IMPLICATIONS

Literacy instruction using ABRA is associated with improvement in reading accuracy for children with ASD when administered in small groups within a school setting. Children with ASD may require additional supports to make gains in reading comprehension when literacy instruction using ABRA is delivered in groups.

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.

Current profiles and early predictors of reading skills in school-age children with autism spectrum disorders: A longitudinal, retrospective population study

This study explores current reading profiles and concurrent and early predictors of reading in children with autism spectrum disorder. Before the age of 3 years, the study cohort underwent a neurodevelopmental assessment following identification in a population-based autism screening. At age 8 years, reading, language and cognition were assessed. Approximately half of the sample ( n = 25) were ‘poor readers’ at age 8 years, meaning that they scored below the normal range on tests of single word reading and reading comprehension. And 18 were ‘skilled readers’ performing above cut-offs. The final subgroup ( n = 10) presented with a ‘hyperlexic/poor comprehenders’ profile of normal word reading, but poor reading comprehension. The ‘poor readers’ scored low on all assessments, as well as showing more severe autistic behaviours than ‘skilled readers’. Group differences between ‘skilled readers’ and ‘hyperlexics/poor comprehenders’ were more subtle: these subgroups did not differ on autistic severity, phonological processing or non-verbal intelligence quotient, but the ‘hyperlexics/poor comprehenders’ scored significantly lower on tests of oral language. When data from age 3 were considered, no differences were seen between the subgroups in social skills, autistic severity or intelligence quotient. Importantly, however, it was possible to identify oral language weaknesses in those that 5 years later presented as ‘poor readers’ or ‘hyperlexics’.