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

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.

Self-Regulation and Academic Learning in Preschoolers with Autism Spectrum Disorder: Links to School Engagement and Levels of Autism Characteristics

Children with autism spectrum disorder often demonstrate self-regulation challenges and academic difficulties. Although self-regulation has been well documented as an important factor for academic achievement in neurotypical children, little is known about how it is related to academic learning in autistic children, especially during preschool, a critical developmental period for both emergent academic skills and self-regulatory abilities. It is also unclear whether school engagement or autism characteristics influence the relation between self-regulation and academic learning in autistic children during preschool. Thirty-two autistic preschoolers participated in this study. Direct measures and parent reports were used to measure three dimensions of self-regulation, including executive function, effortful control, and emotion regulation. Classroom-based data from multiple academic programs were used to reflect their average rates of achieving new literacy and mathematics learning goals. Teachers reported the participants' levels of school engagement, and their autism characteristics were measured directly. Emotion regulation was significantly linked to the rate of meeting literacy learning goals in autistic preschoolers, whereas multiple executive function skills, including inhibitory and attentional control and working memory, were associated with their mathematics learning rate. Emotion regulation demonstrated a stronger association with literacy learning when autistic children were more engaged in classroom activities. Levels of autism characteristics did not mediate or moderate the association between self-regulation and academic learning. Future interventions and teaching should consider fostering self-regulation and facilitating school engagement for autistic preschoolers besides targeting their learning performance on specific academic content to promote their current and future academic success.

The Comprehension of Grammatical Structures in a Pediatric Population with ASD and Epilepsy: A Comparative Study

Autism Spectrum Disorder (ASD) and epilepsy represent a comorbidity that negatively influences the proper development of linguistic competencies, particularly in receptive language, in the pediatric population. This group displays impairments in the auditory comprehension of both simple and complex grammatical structures, significantly limiting their performance in language-related activities, hampering their integration into social contexts, and affecting their quality of life. The main objective of this study was to assess auditory comprehension of grammatical structures in individuals with ASD and epilepsy and compare the results among the three groups. A non-experimental cross-sectional study was designed, including a total of 170 participants aged between 7 and 9 years, divided into three groups: a group with ASD, a group with epilepsy, and a comorbid group with both ASD and epilepsy (ASDEP). The comprehension of grammatical structures was assessed using the CEG and CELF-5 instruments. Statistical analyses included MANOVA and ANOVA to compare scores between groups to verify associations between study variables. The results indicate that the group with ASD and epilepsy performed worse compared to the ASD and epilepsy-only groups, respectively. Additionally, a significant and directly proportional association was observed among all variables within the measures of grammatical structure comprehension. The neurological damage caused by epilepsy in the pediatric population with ASD leads to difficulties in understanding oral language. This level of functioning significantly limits the linguistic performance of these children, negatively impacting their quality of life and the development of core language skills.

Impaired social concept processing in persons with autistic-like traits

Situated models suggest that social concepts are grounded in interpersonal experience. However, few studies have tested this notion experimentally, and none has targeted individuals with reduced social interaction. Here, we assessed comprehension of text-level social and non-social concepts in persons with and without autistic-like traits. Participants read a social and a non-social text and answered questionnaires targeting social and non-social concepts, respectively. We compared behavioral outcomes, gauged their contribution to subject-level classification, and examined their association with validated measures of autism. Persons with autistic-like traits showed selective deficits in grasping text-level social concepts, even adjusting for intelligence, memory, and vocabulary. Also, social concept comprehension was the only variable that significantly classified between groups. Finally, social concept outcomes correlated negatively with measures of autism, including social interaction. Our results suggest that reduced interpersonal experience selectively compromises text-level social concept processing, offering empirical constraints for situated models of social semantics.

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.

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.

The effects of working memory training in children revealed by behavioral responses and ERP

BACKGROUND

Recent studies have examined the effect of computerized cognitive training on working memory (WM), but the behavioral and neural effects were uncertain. Also, few studies have explored WM training effects on children using event-related potentials. The purpose of our study was to investigate the effects of WM training in children, including the effects on behavioral performance and neurophysiological outcomes.

METHODS

Forty-four healthy children (mean age = 7.76 years, SD = 0.57 years, 18 females) were assigned to the training and control groups. Over 20 training sessions, the training group participated in the computation-span and spatial N-back tasks, whereas the control group joined in normal class activities. They all completed the pre- and post-test evaluation of WM tasks (digit span backwards task and N-back task).

RESULTS

The results showed that WM training led to improved performance in the digit span backwards task and 2-back task of post-test evaluation, shortened P3a and P3b latencies in nontarget trials during the spatial 1-back task, shortened P3a latency in target and nontarget trials, as well as increased P3b amplitude and shortened P3b latency in target trials during the spatial 2-back task.

CONCLUSIONS

These results suggested that WM training might enhance children's behavioral performance on WM tasks and brought about neurophysiological changes. This study gives insights into the potential of WM training effects on children's behavioral performance and neurophysiological outcomes.

Reading and Writing Skills in Adolescents With Autism Spectrum Disorder Without Intellectual Disability

The purpose of this study is to extend the knowledge about academic achievement in individuals with autism spectrum disorder (ASD). To this end, first, we analyzed differences in a wide range of reading and writing skills in adolescents with ASD without intellectual disability (ASD-WID) and adolescents with typical development (TD). Second, these two groups were compared on academic outcomes in core subjects and indicators of successful transition to secondary school. Third, the potential contribution of literacy skills to academic outcomes was examined in the two groups. Participants were 56 adolescents between 12 and 14 years old, 30 with ASD-WID and 26 with TD. Results showed no significant differences between the two groups on measures of reading fluency or literal and inferential comprehension. However, the performance of the group with ASD was significantly lower on reading comprehension processes that assess cognitive flexibility. Regarding their written expression skills, significant differences were observed between the group with ASD and the group with TD on most of the indicators analyzed as: productivity, lexical diversity, and overall coherence (resolution component). In addition, findings showed that the deficits in reading and writing observed in the adolescents with ASD significantly affected their academic achievement, which was lower than that of their peers with TD and below what would be expected based on their intellectual capacity. Moreover, their families' perceptions of the transition to high school reflected worse adjustment and lower self-esteem, confidence, and motivation.

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.

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.

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.

Memory enhancements from active control of learning in children with autism spectrum disorder

LAY ABSTRACT

Research with adults and typically developing children has shown that being able to actively control their learning experience, that is, to decide what to learn, when, and at what pace, can boost learning in a variety of contexts. In particular, previous research has shown a robust advantage of active control for episodic memory as compared with conditions lacking this control. In this article, we explore the potential of active control to improve learning of 6- to 12-year-old children diagnosed with autism spectrum disorder. We presented them with a simple memory game on a touchscreen tablet, in which children were asked to recall as many of the presented objects as possible. For half of the objects, children could decide the order and pacing of study (active condition); for the other half, they passively observed the study decisions of a previous participant (yoked condition). We found that recognition memory was more accurate when children could actively control the order, pace, and frequency of the study experience, even after a week-long delay. We discuss how teachers and educators might promote active learning approaches in educational and pedagogical applications to support inclusive learning.

Pivotal response treatment: A study into the relationship between therapist characteristics and fidelity of implementation

In this study, we investigated the relationship between fidelity of pivotal response treatment implementation and therapist characteristics, such as therapist personality, therapist–child relationship, therapist attitude toward evidence-based practices, and therapist experience. We also explored whether child age and autism symptom severity were related to pivotal response treatment fidelity. Participants were 41 level III certified pivotal response treatment therapists who recorded three 10-min pivotal response treatment sessions and completed four questionnaires to measure therapist characteristics. Results indicated that therapists’ attitude toward evidence-based practices, specifically openness to innovation, and therapists’ experience with pivotal response treatment significantly predicted fidelity of pivotal response treatment implementation. Cross-validation methods largely confirmed these findings. Therapist personality, therapist–child relationship, and child characteristics were not significantly related to pivotal response treatment fidelity. Implications for clinical practice and directions for future research are discussed.

What Can Eye Movements Tell Us about Subtle Cognitive Processing Differences in Autism?

Autism spectrum disorder (ASD) is neurodevelopmental condition principally characterised by impairments in social interaction and communication, and repetitive behaviours and interests. This article reviews the eye movement studies designed to investigate the underlying sampling or processing differences that might account for the principal characteristics of autism. Following a brief summary of a previous review chapter by one of the authors of the current paper, a detailed review of eye movement studies investigating various aspects of processing in autism over the last decade will be presented. The literature will be organised into sections covering different cognitive components, including language and social communication and interaction studies. The aim of the review will be to show how eye movement studies provide a very useful on-line processing measure, allowing us to account for observed differences in behavioural data (accuracy and reaction times). The subtle processing differences that eye movement data reveal in both language and social processing have the potential to impact in the everyday communication domain in autism.

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.