Reading Instruction for Children with Autism Spectrum Disorders: A Systematic Review and Quality Analysis

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.

Exploring the Effects of Literacy Instruction for Children With Cerebral Palsy: A Systematic Review

PURPOSE

Some children with cerebral palsy (CP) have difficulty acquiring conventional reading and writing skills. This systematic review explores the different types of literacy instruction and their effects on the reading and writing skills of children with CP.

METHOD

Relevant studies published between 2000 and 2020 were identified using electronic databases and terms related to CP and literacy. Data on participant characteristics, instruction characteristics, and instruction outcomes were extracted. A standardized measure of effect size was used to quantify reported treatment effects.

RESULTS

The systematic search identified 2,970 potentially relevant studies, of which 24 met inclusion criteria. These studies included 66 children with CP aged 5-18 years. One of the included studies utilized a group research design, whereas the remaining used single-subject designs. Studies investigated literacy instruction methods designed to teach phonics, sight-word recognition, reading fluency, reading comprehension, spelling, or written expression skills, or multicomponent instruction (instruction methods encompassing three or more of these skills). Most instruction methods were associated with gains in reading and writing skills with medium to large effects; however, our analysis of methodological rigor suggests that these findings need to be interpreted with caution.

CONCLUSIONS

We propose that literacy instruction utilizing evidence-based principles can be effective for children with CP, provided instruction is accessible and allows children to demonstrate and receive feedback on their skills; however, further research is greatly needed. Clinical implications and priorities for future research are discussed.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21357558.

Effects of adapted Letter-Sound correspondence instruction with older learners with complex communication needs and autism spectrum disorder

Individuals who use augmentative and alternative communication (AAC) are often excluded from learning literacy skills that use phonological approaches due to challenges with verbal production of speech sounds. This study was conducted to evaluate the effectiveness of systematic literacy instruction with materials modified to teach letter-sound correspondences (LSC) to pre-adolescent and adolescents with autism spectrum disorders (ASD) with minimal or no speech who use AAC. A single subject design across three letter-sound sets was used, with three individuals with ASD. A total of 12 LSC were targeted in the intervention. During the intervention, the participants were instructed using model, guided, and independent practice trials using low-tech letter tiles followed by two extension activities: letter sorting and initial letter-sound picture books. A functional relationship was established between the LSC intervention and the percent of correct responses on the LSC assessment probes. Very large and large effects sizes were calculated for all participants across the three LSC sets. The study adds to the very limited research base related to phonics instruction for older learners (ages 9 to 18) with ASD, demonstrating that LSC progress can still be made at an older age with systematic instruction.

Behavioral and neurobiological evidence for the effects of reading interventions on autistic children: A systematic review

This study systematically reviewed the literature on reading interventions for autistic children. Peer-reviewed articles that reported behavioral and/or neurobiological effects of reading intervention were identified in five online databases. After screening, 15 studies met the inclusion criteria for this review. These studies focus on interventions targeted towards improving specific reading skills: comprehension, vocabulary, fluency, and phonological awareness. Studied interventions included interactive and shared reading, visualization strategies, vocabulary and main idea instruction, video modeling, and interventions supported by tablet-based technology. Overall, the studies identified in this review reported improvements to each of the targeted reading skills and changes to neural activation and connectivity. In addition, changes at the brain level were associated with improvements in reading. Specifically, frontal, temporal, and occipital regions associated with visual and language processing showed increased activation and functional connectivity following intervention. This review provides important insights into the landscape of reading intervention studies in autism and into the neurobiological underpinnings of reading skills and how interventions affect those processes.

A trial of online ABRACADABRA literacy instruction with supplementary parent-led shared book reading for children with autism

BACKGROUND/AIMS

The COVID-19 pandemic has highlighted the need for accessible support for children with developmental disabilities. This study explored online literacy instruction with supplementary parent-led shared book reading (SBR) for children with autism.

METHODS

Twenty-one children with autism (5-12 years) completed a battery of assessments (T1) before being assigned to ability matched Instruction (n = 10) and Control groups (n = 11). Instruction group participants completed 16 h of ABRACADABRA instruction working with a researcher 1:1 online and SBR activities at home with a parent over 8 weeks. All participants were reassessed after the instruction period (T2) and parents of children in the Instruction group were interviewed regarding their views and experiences.

RESULTS

Quantitative analyses showed no significant improvements in reading for Instruction group children relative to Control group children. However, each child successfully participated in 16 online instruction sessions and qualitative data revealed that parents were generally positive about the program, with some observing improvements in their child's literacy skills and reading confidence.

CONCLUSIONS AND IMPLICATIONS

While it appears children with autism can participate in online literacy instruction, sixteen hours of online ABRACADABRA instruction with parent-led SBR may not be effective in improving their reading skills. Further research is required to explore whether more intensive and/or extended online instruction may be feasible and effective, and to improve uptake of parent-led book reading activities at home.

Autismus: Ein Überblick über Lernvoraussetzungen und Fördermaßnahmen

Zusammenfassung. Autistische Schülerinnen und Schüler besitzen häufig geringere schulische Kompetenzen als nicht-autistische Schülerinnen und Schüler. Zugleich bestehen große Unterschiede in den schulischen Kompetenzen zwischen autistischen Schülerinnen und Schülern. Nicht selten weisen sie schulische Kompetenzen auf, die niedriger sind, als es aufgrund ihrer kognitiven Fähigkeiten zu erwarten wäre. Um zu verstehen, welche Faktoren das Lernen autistischer Schülerinnen und Schüler beeinflussen, wird in diesem Artikel ein Überblick über die Lernvoraussetzungen autistischer Schülerinnen und Schüler gegeben. Der Überblick zeigt, dass es autistischen Schülerinnen und Schülern schwerfallen kann, Vorwissen abzurufen und in Lernsituationen aktiv anzuwenden, Lernprozesse aufgrund von Einschränkungen in den exekutiven Funktionen angemessen zu steuern, verbale und visuelle Informationen im Arbeitsgedächtnis zu verarbeiten, kognitive und metakognitive Lernstrategien spontan anzuwenden, sich mit Lerninhalten auseinanderzusetzen, die nicht ihren eigenen Interessen entsprechen, und lernabträgliche Emotionen mittels geeigneter Strategien zu regulieren. Um autistische Schülerinnen und Schüler im Lernen zu unterstützen, werden Fördermaßnahmen zu den einzelnen Lernvoraussetzungen vorgestellt. Implikationen für Forschung und Praxis werden diskutiert.

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

AIM

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

METHOD

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

RESULTS

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

CONCLUSION

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

Literacy instruction for autistic children who speak languages other than English

LAY ABSTRACT

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

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

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

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.

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.

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.