Reading in Autism Spectrum Disorders: A Literature Review

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

PURPOSE

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

RESEARCH STRATEGIES

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

SELECTION CRITERIA

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

DATA ANALYSIS

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

RESULTS

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

CONCLUSION

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

Importance of Desensitization for Autistic Children in Dental Practice

OBJECTIVES

Dental treatment in special needs patients, including children with autism, can be accomplished by reducing the behaviors that can reduce fear, as it has been demonstrated in other studies. The present study aims to examine the influence of the latency time elapsing between desensitization and the real dental situation on facilitating the access of children with autism to dental treatment.

STUDY DESIGN

Nineteen patients with autism, who were aged 3-14 years and attended the Special Education Center in Madrid but were living with their parents at home, were selected for the study. All children in the sample were subjected to a desensitization process before attending the real dental office. Two study groups were established: the latency period between the last desensitization and the real situation was one day for the first group and seven days for the second group. An experimental study was conducted to assess the child's cooperation in the dental chair; the dental examination was divided into several steps and the highest step reached by each child was recorded.

RESULTS

There is a statistical difference in the number of steps reached between the children who received the information just before the examination date and the children who experienced a longer latency period between receiving the information and experiencing the examination.

CONCLUSIONS

We would like to emphasize the importance of providing information in advance when dealing with autistic children; this information should be as close as possible to the real situation. Additionally, we would like to stress the importance of inter-cooperation between parents, educators, and pediatric dentists in order to guarantee adequate oro-dental care for autistic children. Further studies with larger sample sizes and a control group are recommended.

Evoking the N400 Event-related Potential (ERP) Component Using a Publicly Available Novel Set of Sentences with Semantically Incongruent or Congruent Eggplants (Endings)

During speech comprehension, the ongoing context of a sentence is used to predict sentence outcome by limiting subsequent word likelihood. Neurophysiologically, violations of context-dependent predictions result in amplitude modulations of the N400 event-related potential (ERP) component. While N400 is widely used to measure semantic processing and integration, no publicly-available auditory stimulus set is available to standardize approaches across the field. Here, we developed an auditory stimulus set of 442 sentences that utilized the semantic anomaly paradigm, provided cloze probability for all stimuli, and was developed for both children and adults. With 20 neurotypical adults, we validated that this set elicits robust N400′s, as well as two additional semantically-related ERP components: the recognition potential (~250 ms) and the late positivity component (~600 ms). This stimulus set (https://doi.org/10.5061/dryad.9ghx3ffkg) and the 20 high-density (128-channel) electrophysiological datasets (https://doi.org/10.5061/dryad.6wwpzgmx4) are made publicly available to promote data sharing and reuse. Future studies that use this stimulus set to investigate sentential semantic comprehension in both control and clinical populations may benefit from the increased comparability and reproducibility within this field of research.

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.

Recognizing Psychiatric Comorbidity With Reading Disorders

Reading disorder (RD), a specific learning disorder (SLD) of reading that includes impairment in word reading, reading fluency, and/or reading comprehension, is common in the general population but often is not comprehensively understood or assessed in mental health settings. In education settings, comorbid mental and associated disorders may be inadequately integrated into intervention plans. Assessment and intervention for RD may be delayed or absent in children with frequently co-occurring mental disorders not fully responding to treatment in both school and mental health settings. To address this oversight, this review summarizes current knowledge regarding RDs and common comorbid or co-occurring disorders that are important for mental health and school settings. We chose to highlight RD because it is the most common SLD, and connections to other often comorbid disorders have been more thoroughly described in the literature. Much of the literature we describe is on decoding-based RD (or developmental dyslexia) as it is the most common form of RD. In addition to risk for academic struggle and social, emotional, and behavioral problems, those with RD often show early evidence of combined or intertwined Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition childhood disorders. These include attention deficit hyperactivity disorder, anxiety and depression, disruptive, impulse-control, and conduct disorders, autism spectrum disorders, and other SLDs. The present review highlights issues and areas of controversy within these comorbidities, as well as directions for future research. An interdisciplinary, integrated approach between mental health professionals and educators can lead to comprehensive and targeted treatments encompassing both academic and mental health interventions. Such targeted treatments may contribute to improved educational and health-related outcomes in vulnerable youth. While there is a growing research literature on this association, more studies are needed of when to intervene and of the early and long-term benefits of comprehensive intervention.