Characterization and prediction of early reading abilities in children on the autism spectrum

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.

Spatial Language and Cognition in Autistic Preschoolers

PURPOSE

ASD is associated with relative strengths in the visuospatial domain but varying abilities in the linguistic domain. Previous studies suggest parallels between spatial language and spatial cognition in older autistic individuals, but no research to date has examined this relationship in young autistic children. Therefore, the purpose of the present study was to investigate the connection between children's spatial language production and nonverbal spatial cognition over time. We also examined two potential predictors of spatial language observed in previous literature, ASD symptom severity and parent spatial language input.

METHODS

In past work investigating spatial language in NT children of the same age, parent-child interactions have been a primary context for study. Therefore, in the present study, we analyzed transcripts of dyadic naturalistic play interactions between autistic children and their parents over three visits from age 30 to 66 months and administered standardized cognitive and ASD diagnostic assessments at each visit.

RESULTS

Spatial language production was related to nonverbal spatial cognition even when accounting for overall language production, though the strength of that relationship decreased over time. Parent spatial input (but not ASD severity) significantly predicted children's spatial language production over and above the effect of overall language production.

CONCLUSION

Spatial language is associated with spatial cognition in young autistic children and appears to reflect the interaction of overall linguistic skills and nonverbal spatial cognitive ability regardless of autism severity. Parent-mediated interventions may be a promising context for increasing spatial language in autistic preschoolers.

The Contribution of Perceptual Reasoning Skills to Phonological Awareness for School Age Autistic Children

This study aimed to investigate the phonological awareness (PA) skills of school age autistic children (age range = 6-12) in two parts: (1) comparing their performance on a PA task to non-autistic children with groups matched on chronological age, verbal and non-verbal cognitive skills, and (2) exploring the role of cognitive skills and autism characteristics on PA skills. Results revealed that the groups did not differ in their PA skills (study 1) and that perceptual reasoning skills are associated with the PA skills of autistic participants (study 2). Results highlight the role of non-verbal cognitive skills in literacy development for autistic children and suggest that their perceptual reasoning abilities likely contribute a great deal when learning to read.

Dynamic insights into research trends and trajectories in early reading: an analytical exploration via dynamic topic modeling

Introduction

Early reading has gained significant attention in the academic community. With the increasing volume of literature on this subject, it has become crucial to assess the current research landscape and identify emerging trends.

Methods

This study utilized the dynamic topic model to analyze a corpus of 1,638 articles obtained from the Web of Science Core Collection to furnish a lucid understanding of the prevailing research and forecast possible future directions.

Results

Our in-depth assessment discerned 11 cardinal topics, among which notable ones were interventions' impacts on early reading competencies; foundational elements of early reading: phonological awareness, letters, and, spelling; and early literacy proficiencies in children with autism spectrum disorder. Although most topics have received consistent research attention, there has been a marked increase in some topics' popularity, such as foundational elements of early reading and early literary proficiencies in children with autism spectrum disorder. Conversely, other topics exhibited a downturn.

Discussion

This analytical endeavor has yielded indispensable insights for scholars, decision-makers, and field practitioners, steering them toward pivotal research interrogatives, focal interest zones, and prospective research avenues. As per our extensive survey, this paper is a pioneering holistic purview of the seminal areas of early reading that highlights expected scholarly directions.

Adapting Curricula for Children With Language Comprehension Deficits

PURPOSE

We will describe how a multisite research team adapted a language-focused curriculum to be used in a scale-up project. Specifically, we identified underlying principles to modify a Tier 1 whole-classroom language comprehension-focused curriculum to be used as a Tier 2 small-group curriculum with children identified as at risk for low language comprehension, including children with developmental language disorder (DLD).

METHOD

We discuss how researchers used the following five guiding principles to adapt a curriculum for children at risk for low language comprehension, including children with DLD: (a) increased and ongoing professional development, (b) simplification of language input, (c) increased scaffolding, (d) attention to distributed practice, and (e) materials to support diversity and inclusion.

RESULTS

We used these guiding principles to modify a popular language-based curriculum used in schools across the country.

CONCLUSION

This clinical focus article showcases how guiding principles and frameworks for adaptation, within implementation science, can serve as a guidepost for speech-language pathologists and other educators who are adapting or scaling up a curriculum or intervention that was not designed for their target population.

Childhood Academic Performance: A Potential Marker of Genetic Liability to Autism

Autism spectrum disorder (ASD), a heritable neurodevelopmental disorder, confers genetic liability that is often expressed among relatives through subclinical, genetically-meaningful traits, or endophenotypes. For instance, relative to controls, parents of individuals with ASD differ in language-related skills, with differences emerging in childhood. To examine ASD-related endophenotypes, this study investigated developmental academic profiles among clinically unaffected siblings of individuals with ASD (n = 29). Lower performance in language-related skills among siblings mirrored previously-reported patterns among parents, which were also associated with greater subclinical ASD-related traits in themselves and their parents, and with greater symptom severity in their sibling with ASD. Findings demonstrated specific phenotypes, derived from standardized academic testing, that may represent childhood indicators of genetic liability to ASD in first-degree relatives.

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.

A randomized controlled trial into the effects of probiotics on electroencephalography in preschoolers with autism

LAY ABSTRACT

This study investigates the effects of a probiotic on preschoolers' brain electrical activity with autism spectrum disorder. Autism is a disorder with an increasing prevalence characterized by an enormous individual, family, and social cost. Although the etiology of autism spectrum disorder is unknown, an interaction between genetic and environmental factors is implicated, converging in altered brain synaptogenesis and, therefore, connectivity. Besides deepening the knowledge on the resting brain electrical activity that characterizes this disorder, this study allows analyzing the positive central effects of a 6-month therapy with a probiotic through a randomized, double-blind placebo-controlled study and the correlations between electroencephalography activity and biochemical and clinical parameters. In subjects treated with probiotics, we observed a decrease of power in frontopolar regions in beta and gamma bands, and increased coherence in the same bands together with a shift in frontal asymmetry, which suggests a modification toward a typical brain activity. Electroencephalography measures were significantly correlated with clinical and biochemical measures. These findings support the importance of further investigations on probiotics' benefits in autism spectrum disorder to better elucidate mechanistic links between probiotics supplementation and changes in brain activity.

Reading Behaviors through Patterns of Finger-Tracking in Italian Children with Autism Spectrum Disorder

The paper proposes an ecological and portable protocol for the large-scale collection of reading data in high-functioning autism spectrum disorder (ASD) children based on recording the finger movements of a subject reading a text displayed on a tablet touchscreen. By capitalizing on recent evidence that movements of a finger that points to a scene or text during visual exploration or reading may approximate eye fixations, we focus on recognition of written content and function words, pace of reading, and accuracy in reading comprehension. The analysis showed significant differences between typically developing and ASD children, with the latter group exhibiting greater variation in levels of reading ability, slower developmental pace in reading speed, less accurate comprehension, greater dependency on word length and word frequency, less significant prediction-based processing, as well as a monotonous, steady reading pace with reduced attention to weak punctuation. Finger-tracking patterns provides evidence that ASD readers may fail to integrate single word processing into major syntactic structures and lends support to the hypothesis of an impaired use of contextual information to predict upcoming stimuli, suggesting that difficulties in perception may arise as difficulties in prediction.

"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.

Naturalistic parent-child reading frequency and language development in toddlers with and without autism

BACKGROUND AND AIMS

The efficacy of parent-child reading for supporting language development has been well-established in the neurotypical (NT) literature. For children with autism spectrum disorder, (ASD) who may be at risk for delays in language development, prior research has shown promise for shared book-reading interventions. Yet there has been limited research on naturalistic parent-child reading with autistic children to date. The present study aimed to fill this missing link in the current literature.

METHODS

Fifty-seven autistic toddlers participated at two developmental time points: Time 1 (Mage = 30.4 months) and Time 2 (Mage = 43.8 months). An NT control group (N = 31) was matched on age to a subset of the ASD group (N = 33). We assessed group differences in parent-child reading frequency between age-matched NT and autistic groups. Using a one-year follow-up design, we evaluated the relationship between parent-child reading and autistic children's language development.

RESULTS

Cross-group comparisons revealed that parents of age-matched NT children reported significantly more frequent weekly parent-child reading than parents of autistic toddlers. After a one-year follow-up with the autistic group, within-group analyses revealed that greater frequency of parent-child reading (controlling for maternal education, books in the home, and autism symptom severity) was associated with larger growth in autistic toddlers' receptive and expressive language skills.

CONCLUSIONS AND IMPLICATIONS

These findings have important clinical implications as they emphasize the potential of parent-child reading for supporting autistic children's language development. Findings demonstrate that frequency of parent-child reading is associated with language development over one year. Findings also demonstrate that parents of autistic children engage in less frequent parent-child reading than parents of age-matched NT peers, suggesting these parents may face more barriers to implementing parent-child reading than parents of NT children.

The co-occurrence of neurodevelopmental problems in dyslexia

The primary aim of this study was to explore the overlaps between dyslexia and a range of neurodevelopmental disorders and problems (NDPs), specifically symptoms of attention-deficit/hyperactivity disorder, autism spectrum disorder, atypical sensory perception and developmental coordination disorder. Capitalizing on a population-based sample of twins, secondary aims included estimating the heritability of dyslexia and reporting on the measurement characteristics of the scale used to assess dyslexia. A telephone interview regarding symptoms of dyslexia and other NDPs was conducted with parents of 1,688 nine-year-old twins. The prevalence and the heritability of dyslexia were estimated at 8 and 52%, respectively. The boy: girl ratio was 1.5:1. Results revealed that there was more than an eight-fold increase in (diagnostic proxy) NDPs prevalence in the dyslexia group as compared to typical readers. Quantitatively measured symptoms of inattention, oral language problems and atypical sensory perception significantly predicted dyslexia status in a multivariate analysis. By contrast, ASD-related inflexibility was inversely associated with dyslexia in the multivariate model. In sum, dyslexia often overlaps with other NDPs. The current study provides new knowledge supporting the position to move beyond isolated diagnostic categories into behavioural profiles of co-occurring problems when trying to understand the pattern of strengths and needs in individuals with dyslexia.

Model Teachers or Model Students? A Comparison of Video Modelling Interventions for Improving Reading Fluency and Comprehension in Children with Autism

Video modelling (VM) interventions have been used to improve the fluency of individuals with learning disabilities and reading difficulties; this study aimed to replicate these findings with autism spectrum disorder (ASD) students. Four children with ASD (aged between 8 and 15) experienced two VM interventions, across 10 sessions, during an alternating treatments design: VM using a teacher model, and feedforward video self-modelling (FFVSM) where the student acted as the model. For two participants, FFVSM was found to be an effective intervention but overall, results for both interventions were inconsistent with previous research. Talking Mats Interviews were used to include these individuals within the social validation process of behavioural research.

School-entry language skills as predictors of concurrent and future academic, social, and adaptive skills in kindergarteners with ASD

OBJECTIVE

This study compared language profiles of children with autism spectrum disorder (ASD) and typically developing (TD) children at kindergarten-entry and investigated whether kindergarten-entry language scores were predictive of concurrent and future academic achievement, peer interactions, and adaptive skills in children with ASD.

METHOD

Participants included 97 children (62 children with ASD; 35 TD children) assessed at kindergarten-entry and -exit. Language abilities were assessed using the Children's Communication Checklist-2 (CCC-2). Children with ASD and TD children's language scores were compared at baseline, and the ASD group was followed longitudinally. Regression analyses were performed to compare language scores between ASD and TD groups and to predict concurrent and future functional skills from kindergarten-entry language scores for children with ASD.

RESULTS

Children with ASD demonstrated significantly more impairments across all scales of the CCC-2 at kindergarten-entry compared to TD children. Within the ASD group, kindergarten-entry pragmatic language significantly predicted concurrent math and reading achievement. Both syntactic/semantic and pragmatic domains significantly predicted kindergarten-exit reading performance; pragmatics significantly predicted kindergarten-exit math performance. Pragmatics also predicted concurrent and kindergarten-exit peer play. Syntax/semantics significantly predicted concurrent adaptive communication skills, whereas pragmatics significantly predicted concurrent adaptive daily living and socialization skills, as well as kindergarten-exit socialization skills.

CONCLUSIONS

School-entry language abilities can serve as a valuable predictor of functional outcomes across the kindergarten year for cognitively-able children with ASD. Results highlight the need to target early language abilities to maximize academic, social, and adaptive skills.

Augmentative and Alternative Communication Supports for Language and Literacy in Preschool: Considerations for Down Syndrome and Autism Spectrum Disorder

Children with Down syndrome and children with autism spectrum disorder have a range of speech abilities during preschool that impacts access to both language and literacy instruction. It is the responsibility of the speech-language pathologist to advocate for and provide intervention using augmentative and alternative communication (AAC) through individualized assessment. This article provides a review of the literature supporting the use of AAC during preschool for both language and literacy development in children with Down syndrome and children with autism spectrum disorder who have limited speech. A small scale exploratory report is discussed to highlight differences in early literacy skills found in children in each group. Implications for AAC intervention during preschool to support both language and literacy 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.

Early Word Reading of Preschoolers with ASD, Both With and Without Hyperlexia, Compared to Typically Developing Preschoolers

A portion of children with Autism Spectrum Disorder (ASD) exhibit a strength in early word reading referred to as hyperlexia (HPL), yet it remains unclear what mechanisms underlie this strength. Typically developing children (TD) acquire phonological awareness, alphabet knowledge and language skills as precursors to word reading. We compared these skills across English-speaking preschoolers with ASD, both with and without hyperlexia, and TD preschoolers. Findings indicated that the group with both ASD and HPL (ASD + HPL) exhibited advanced word reading and letter naming skills as compared to the other two groups, but did not demonstrate commensurate phonological awareness, letter-sound correspondence, or language skills. Findings support an alternative, non-phonological approach to early word reading in preschoolers with ASD and hyperlexia.

Children with ASD and Communication Regression: Examining Pre-Loss Skills and Later Language Outcomes Through the Preschool Years

This study investigated receptive and expressive language outcomes in children with autism spectrum disorder (ASD) with and without a history of language/communication regression, employing three progressively less stringent definitions of regression. Data were derived from a large, longitudinal sample of children with ASD in which regression was assessed at approximately 30 months. Results indicated poorer receptive language and larger discrepancies between receptive and expressive language in the regression group than the group without regression at 44 months but not 66 months. Number of words used before loss predicted receptive language at 44 months. Overall, results suggest that a regression profile in ASD is associated with modest and transient impacts on language outcomes that are no longer discernable at school entry.

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.

Brief Report: Associations Between Autism Characteristics, Written and Spoken Communication Skills, and Social Interaction Skills in Preschool-Age Children on the Autism Spectrum

We used parent-report data from a prospective longitudinal study to better understand the early strengths in written skills often observed in preschoolers on the spectrum. Consistent with previous research, children demonstrated relative strengths in standardized written communication compared to spoken communication scores on the VABS-II. We found no significant links between children's performance on the written communication subdomain and their autism characteristics or the Social Interaction Deviance Composite score on the CCC-2. Our results emphasize the need for further research into the early strengths in written skills of preschoolers on the spectrum. From a clinical viewpoint, we highlight the need for a comprehensive emergent literacy assessment in this group of children who are at high risk of persistent literacy difficulties.

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.

Emergent Literacy Assessment in Children With Autism Spectrum Disorder Who Have Limited Verbal Communication Skills: A Tutorial

Purpose Children with autism spectrum disorder (ASD) are at increased risk of experiencing difficulties with the development of literacy, including the emergent literacy skills recognized to underpin conventional literacy success. Comprehensive assessment is essential. Characteristics of ASD can make assessment challenging, and this can be compounded when children are unable to demonstrate their skills using spoken language. The purpose of this clinical tutorial is to outline the process of emergent literacy assessment for children with ASD who have limited verbal communication skills. A case example of a 5-year-old boy is presented. Method Pertinent literature is reviewed around the literacy profiles of children with ASD, the subgroup of children with ASD who have limited verbal communication skills, key components of emergent literacy, and previous research examining the emergent literacy abilities of children with ASD. The case report is described in depth and emphasizes the key factors to consider when designing an assessment battery and protocol. Results The case example information is interpreted, and its application is discussed. Key outcomes are highlighted including a greater understanding of the child's literacy strengths and needs and the implications for individualized instruction. Conclusion The clinical tutorial highlights the need for a comprehensive, well-planned assessment approach that involves all members of the educational team, and that is considerate to the needs of the individual child and responsive to their communication needs.

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.

No Differences in Code-Related Emergent Literacy Skills in Well-Matched 4-Year-Old Children With and Without ASD

This study used data from a prospective community-based sample and compared the code-related emergent literacy skills (phonological awareness and letter knowledge) of 4-year-old children with ASD (n = 36) to their peers without ASD (n = 36), matched for age, gender, socio-economic status, language ability, and nonverbal cognition. We also compared groups on parent-reported home literacy measures, including the amount of time their child enjoyed being read to. There were no significant group differences in emergent literacy, indicating that an ASD diagnosis was not related to children's emergent literacy performance. We found no group differences in parent-reported home literacy experiences. This highlights the need for careful consideration of factors beyond ASD traits that may influence literacy outcomes in this population.

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.

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.

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’.

Reading Comprehension in Children With and Without ASD: The Role of Word Reading, Oral Language, and Working Memory

Word reading and oral language predict reading comprehension, which is generally poor, in individuals with autism spectrum disorder (ASD). However, working memory (WM), despite documented weaknesses, has not been thoroughly investigated as a predictor of reading comprehension in ASD. This study examined the role of three parallel WM N-back tasks using abstract shapes, familiar objects, and written words in children (8-14 years) with ASD (n = 19) and their typically developing peers (n = 24). All three types of WM were significant predictors of reading comprehension when considered alone. However, these relationships were rendered non-significant with the addition of age, word reading, vocabulary, and group entered into the models. Oral vocabulary emerged as the strongest predictor of reading comprehension.

Reading in Children With Fragile X Syndrome: Phonological Awareness and Feasibility of Intervention

Individuals with fragile X syndrome (FXS) present with significant deficits in reading skills, but scant research exists to understand the characteristics of the reading delays or best practices for reading instruction with this population. Study 1 examined the relationship between phonological awareness and reading skills in individuals with FXS. Study 2 evaluated the feasibility of a web-based reading intervention, which incorporated phonological awareness and phonics instruction but was originally developed for mainstream students, for children with FXS. Results suggest that phonological awareness and reading skills are correlated in this population, and that instruction targeting phonological awareness and phonics should not be ruled out for individuals with FXS. Further studies are needed to examine their potential effects.

A Preliminary Investigation of Parent-reported Fiction versus Non-fiction Book Preferences of School-Age Children with Autism Spectrum Disorder

BACKGROUND & AIMS

Anecdotal evidence suggests that individuals with autism spectrum disorder (ASD) prefer non-fiction books over fiction books. The current study was the first to investigate parent-reports of children with ASD's fiction and non-fiction book preferences and whether these relate to individual differences in social communication, oral language, and/or reading abilities.

METHOD

Children (ages 8-14 years, M = 10.89, SD = 1.17) with ASD diagnoses (n = 19) and typically developing (TD) peers (n = 21) participated. Children completed standardized measures of social communication, oral language, and reading abilities. Parents reported children's current favorite book, and from these responses, we coded children's fiction versus non-fiction book preferences.

MAIN CONTRIBUTION

Contrary to anecdotal evidence, children with ASD preferred fiction similar to their TD peers. Fiction versus non-fiction book preference was significantly related to social communication abilities across both groups. Children's oral language and reading abilities were related, as expected, but the evidence for a relationship between social communication and reading comprehension was mixed.

CONCLUSIONS

This study provides preliminary evidence supporting the association of social communication in fiction versus non-fiction book preference, which may be related to children's comprehension and support the theoretical role of social communication knowledge in narrative/fiction.

IMPLICATIONS

It should not be assumed that all children with ASD prefer expository/non-fiction or do not read narrative/fiction. Children who prefer non-fiction may need additional social communication knowledge support to improve their understanding of narrative fiction.

Morpho-Orthographic Processing in Children with Autism Spectrum Disorder: The Case of Hebrew Orthography

OBJECTIVE

Most studies on word reading in children with autism spectrum disorder (ASD) focus on graphemic-phonemic decoding and the direct orthographic route. To extend the scope, we investigated morpho-orthographic identification beyond graphemic-phonemic abilities.

PATIENTS AND METHODS

The original study included 31 sixth-grade children with ASD and comparison groups of typically developing (TD) children: 23 age-matched children, 15 third-graders, and 17 second-graders. The groups were compared regarding reading of morphologically based Hebrew pointed pseudowords to examine graphemic-phonemic decoding, and unpointed pseudowords to test morpho-orthographic identification. To better focus on morpho-orthographic identification processes, we eventually included only children with a minimum threshold of ≥65% correct in reading pointed pseudowords, thereby excluding 11 children with ASD, 1 TD age-matched child, and 1 TD third-grader.

RESULTS

About half of the children with ASD eventually included were as accurate as the TD second-graders in reading unpointed pseudowords, and slow in reading both pointed and unpointed pseudowords. The other half were as accurate as their typical peers in reading unpointed pseudowords, but slightly slower.

CONCLUSION

The results highlight the difficulties many Hebrew-reading children with ASD experience in using morpho-orthographic processes beyond their difficulties in using graphemic-phonemic processes, demonstrating effortful (slow) reading. While this study can be considered a pilot investigation, further studies are needed.

The Home Literacy Environment of Preschool-Age Children with Autism or Down Syndrome

AIMS

This exploratory study investigated if there were differences in the home literacy environment of preschool children on the autism spectrum and preschool children with Down syndrome to determine if the home literacy environment may potentially be associated with strengths or weaknesses in children's social communication skills.

METHODS

A total of 111 parents of preschoolers with identified disabilities completed a home literacy questionnaire.

RESULTS

Results indicated that both groups of parents started reading to their children at an early age and owned at least 25 children's books. However, parents of children with Down syndrome read to their child more often, reported higher child interest in reading, and more frequently played rhyming games with their child. No group differences were found in teaching of letter names, although parents of children with autism reported a higher frequency of pointing out signs/words in the environment and reported their children knew more letter names. Group differences were also found in the relationship between parent behaviours, child interest, and children's print-related skills.

CONCLUSION

This study highlights the influence both parent behaviours and child interest may have on shared book reading practices of parents with their preschool children with disabilities.

Brief Report: Ages of Language Milestones as Predictors of Developmental Trajectories in Young Children with Autism Spectrum Disorder

Recognizing early risk markers in young children with autism spectrum disorder (ASD) is critical for timely diagnosis and intervention. The purpose of this study was to extend previous findings regarding language milestones to a longitudinal design, in which ages of expressive language milestones (i.e., first words, first phrases) could serve as predictors of developmental trajectories in a heterogeneous sample of young children with ASD (N = 98; age at first assessment: M = 32 months, SD = 5). Age of first words predicted trajectories of expressive language and adaptive skills; number of words predicted each outcome examined. Because these aspects of early language show promise as potential indicators of later functional outcomes, future research on developmental processes as they relate to individual differences will be particularly informative.

The Oral Narrative Comprehension and Production Abilities of Verbal Preschoolers on the Autism Spectrum

Purpose

This study described the oral narrative comprehension and production skills of verbal preschool-age children on the autism spectrum and investigated correlations between oral narrative ability and norm-referenced language test performance.

Method

Twenty-nine preschool-age children (aged 4;0–5;9 years;months) with autism, who obtained an age-equivalent score of at least 36 months on the expressive communication subscale of the Vineland Adaptive Behavior Scales–Second Edition (Sparrow, Cicchetti, & Balla, 2005), participated. Children listened to an unfamiliar fictional narrative and answered comprehension questions afterward. After listening to the narrative a second time, children were asked to retell the narrative without picture support. Narratives were transcribed and analyzed for length, semantic diversity, grammatical complexity and accuracy, intelligibility, inclusion of critical events, and narrative stage.

Results

All children participated in the comprehension task, and 19 children produced an analyzable narrative retell. Compared with published data on typically developing children, significant difficulties were observed in narrative comprehension, intelligibility, and grammatical accuracy. Most of the children told descriptive or action sequences, with only 1 child producing an abbreviated episode. Significant positive correlations were found (a) between performance on the Peabody Picture Vocabulary Test–Fourth Edition (Dunn & Dunn, 2007) and semantic diversity and narrative comprehension and (b) between parent-reported receptive communication competence (Vineland Adaptive Behavior Scales–Second Edition) and narrative comprehension.

Conclusions

This study provides preliminary evidence of specific difficulties in oral narrative comprehension and production skills in verbal preschoolers on the autism spectrum.

Effects of Emergent Literacy Interventions for Preschoolers With Autism Spectrum Disorder

Combining data from a series of three planned, consecutive independent randomized controlled trials (RCTs), the present study investigates two literacy interventions for preschool children with autism spectrum disorder (ASD). For the first cohort, children were randomized to interactive book reading treatment (IBR)or a business-as-usual (BAU) control condition; in Cohort 2, children were randomized to phonological awareness treatment (PA)or BAU; in Cohort 3, children were randomized to IBR or PA. Both treatments were implemented weekly in the classroom from November to May. Combined across cohorts, data from n =47 IBR, n =42 PA, and n =44 BAU students from 57 classrooms in 8 districts were available for analysis. Model results showed that IBR had significantly greater pretest-posttest gains than the sample mean on expressive vocabulary and listening comprehension (d*=0.29 and 0.30), whereas PA had significantly greater phonological awareness gains (d*=0.39).

Reading comprehension of ambiguous sentences by school-age children with autism spectrum disorder

Weak central coherence (processing details over gist), poor oral language abilities, poor suppression, semantic interference, and poor comprehension monitoring have all been implicated to affect reading comprehension in individuals with autism spectrum disorder (ASD). This study viewed the contributions of different supporting skills as a collective set of skills necessary for context integration-a multi-component view-to examine individual differences in reading comprehension in school-age children (8-14 years) with ASD (n = 23) and typically developing control peers (n = 23). Participants completed a written ambiguous sentence comprehension task in which participants had to integrate context to determine the correct homonym meaning via picture selection. Both comprehension products (i.e., offline representations after reading) and processes (i.e., online processing during reading) were evaluated. Results indicated that children with ASD, similar to their TD peers, integrated the context to access the correct homonym meanings while reading. However, after reading the sentences, when participants were asked to select the meanings, both groups experienced semantic interference between the two meanings. This semantic interference hindered the children with ASD's sentence representation to a greater degree than their peers. Individual differences in age/development, word recognition, vocabulary breadth (i.e., number of words in the lexicon), and vocabulary depth (i.e., knowledge of the homonym meanings) contributed to sentence comprehension in both children with ASD and their peers. Together, this evidence supports a multi-component view, and that helping children with ASD develop vocabulary depth may have cascading effects on their reading comprehension. Autism Res 2017, 10: 2002-2022. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

LAY SUMMARY

Like their peers, children with ASD were able to integrate context, or link words while reading sentences with ambiguous words (words with two meanings). After reading the sentences, both groups found it hard to pick the correct meaning of the ambiguous sentence and this decision was more difficult for the participants with ASD. Older children, children with better word reading abilities, and children with higher vocabularies were better at understanding ambiguous sentences. Helping children with ASD to develop richer vocabularies could be important for improving their reading comprehension.

From word reading to multisentence comprehension: Improvements in brain activity in children with autism after reading intervention

Background

Children with ASD show a unique reading profile characterized by decoding abilities equivalent to verbal abilities, but with lower comprehension skills. Neuroimaging studies have found recruitment of regions primarily associated with visual processing (e.g., fusiform gyrus and medial parietal cortex), but reduced activation in frontal and temporal regions, when reading in adults with ASD. The purpose of this study was to assess neural changes associated with an intense reading intervention program in children with ASD using three fMRI tasks of reading.

Methods

25 children with ASD were randomly assigned to a treatment (ASD-EXP) or waitlist group (ASD-WLC). Children participated in a reading intervention program (4-hour sessions per day, 5 days a week for 10 weeks). We utilized three tasks: word, sentence, and multisentence processing, each with differential demands of reading comprehension. fMRI data were acquired at each of two scanning sessions 10-weeks apart.

Results

Across tasks, post-intervention results revealed that the ASD-EXP group showed greater activation in bilateral precentral gyrus and the postcentral gyrus, visual processing regions (e.g., occipital cortex, fusiform gyrus), and frontal regions. In the word task, left thalamus and the right angular gyrus (AG) activation was unique to the ASD-EXP group post-intervention. Sentence tasks showed differential activation of core language areas (e.g., IFG, IPL) post-intervention.

Conclusions

Our results provide evidence for differential recruitment of brain regions based on task demands in children with ASD, and support the potential of targeted interventions to alter brain activation in response to positive gains in treatment. Children with ASD have a different reading profile from other reading disorders that needs to be specifically targeted in interventions.

A Discrepancy in Comprehension and Production in Early Language Development in ASD: Is it Clinically Relevant?

This study examined the extent to which a discrepant comprehension-production profile (i.e., relatively more delayed comprehension than production) is characteristic of the early language phenotype in autism spectrum disorders (ASD) and tracked the developmental progression of the profile. Our findings indicated that a discrepant comprehension-production profile distinguished toddlers (30 months) with ASD from late talkers without ASD (91% sensitivity, 100% specificity) in groups that were comparable on expressive language, age, and socioeconomic status. Longitudinal data for children with ASD revealed that the discrepant profile steadily decreased from 30 to 44 months until there was no significant comprehension-production difference at 66 months. In conclusion, results suggest that lower comprehension than production may be an age-specific marker of toddlers with ASD.