This set of notes provides a summary of the particular needs among children with ASD in respect of the development of literacy skills. Reference is made to the common visual strengths and to possible difficulties in seeking to rely wholly or largely upon phonic strategies.
There is also reference to hyperlexia, which is commonly but not uniquely found among individuals with ASD, with a discussion of the characteristics of this condition and the needs in terms of classroom practice.
An introductory set of thoughts, concerning teaching strategies for children with autism and ASD, is provided by Falk-Ross et al (2004).
Their focus was upon children with Asperger Syndrome who have been identified in relatively large numbers over the last 10+ years, and of whom a significant percentage may be included within mainstream classes.
They describe this condition as a grouping of physical and behavioural characteristics which can present challenges for education, especially at primary school level when literacy teaching requires inferential levels of analysis …. something which will place the children concerned at a particular disadvantage.
There is a further complication in that the signs and symptoms of this condition may not be readily recognised for what they are, and the subtleties of the behavioural and learning idiosyncracies may not be appreciated.
The authors, accordingly, set out to examine how the Asperger children stand out in terms of language and literacy performance, and the style of intervention and classroom support that will best facilitate mainstream inclusion and achievement.
The emphases were upon routine provision for children in the middle and later stages of junior schooling, and upon issues that need particular attention such as sensory processing, pragmatic language, and parent-teacher communication.
It is noted that Asperger Syndrome first appeared in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1994 as a subcategory of pervasive developmental disorder, albeit with the recognition that there is wide variation among individuals all legitimately diagnosed in terms of intellectual capacities, sensory functioning, social skills, and motor skills.
It is also recognised that Asperger Syndrome may overlap, and/or be confounded, with other pervasive disorders such as obsessive-compulsive disorder, non-verbal learning disability, ADHD, Tourette Syndrome, high functioning autism, Rett Syndrome, hyperlexia, and pervasive disorder not otherwise specified.
The authors stress that, like autism, Asperger Syndrome involves impaired social interaction and communication, along with perseverative behaviour, and delayed or disordered language development.
However, individuals will vary in the severity or number of such symptoms, and the extent to which they experience additional problems. The example is given of apparently adequate language usage when this superficial appearance can conceal marked problems with understanding the significance of what they hear or of drawing inferences. There may also be a weakness in reading social situations such that behaviour appears inappropriate, further reducing interaction opportunities.
Teachers’ perceptions or expectations may be lowered by observed inattentiveness, or anxiety, or maladaptive behaviours which are misinterpreted as wilfulness or non-compliance when actually they are a matter of failing to understand what is expected.
Therefore, what is needed is a greater awareness of these differences coupled with a willingness in the mainstream sector to accommodate to them and provide support as required.
In particular, Falk-Ross et al discuss the risk of negative reactions to the common sensory over-sensitivity among children with Asperger Syndrome and ASD which may lead to some avoidance behaviours in the classroom, or at least to an interruption in task completion and an increase in distractibility.
Their prescription includes the generous use of visual cues and reminders of the routines and tasks to be completed, simple written copies of basic instructions for steps towards a given goal, and signals (planned and agreed in advance) by which to re-focus the pupil if attention is wandering.
Reference is also made to the use of “manipulatives” such as a squashy ball or “worry stones ” which can be played with and act as a diverter but not in such a way as to be disruptive. The advice of an occupational therapist or speech and language therapist would be valuable in reducing sensitivities, alongside any actions that can reduce ambient noise or over-brightness of lighting (including the use of overlays through which to read black on white print).
Further, the use of computer programmes can be helpful in providing a focus for attention and for ensuring that steps move on at the pace of the learner.
Meanwhile, the problems with interpreting spoken and non-verbal information and for recognising “social” messages need to be addressed, perhaps via direct teaching of pragmatic language skills using direct modelling of the component skills … with the example given of using card games as a means of establishing the routine of turn-taking.
Various other games, including board games, can provide the opportunity to establish a pattern of listening and of communication initiations and responses, while drawing attention to information emerging from body language, gestures, and facial expressions.
Specific concerns could be tackled by the use of Social Stories or by examining comic-strip conversations to highlight the various ways in which communications are made. The authors also recommend electing the children in question as reporters for a classroom news centre given the need to prepare the information and rehearse the presentation. Shared story telling or reading between teacher and child is a further means of providing a model of verbal interaction and listening.
The authors the discuss the significance of language routines in offering predictability and organisation to lessons, and in ensuring that instructions are understood and confusion avoided. Language and learning are seen as equally based upon social construction, which further underlines the potential disadvantages experienced by children with Asperger Syndrome or ASD which are characterised by socio-communicative problems.
Such difficulties may be readily observed when it comes to shared discussions, summarizing, and making comparisons; and the problems are likely to increase as the content becomes more abstract. Again, the use of visual organisers and prompts is advocated, along with an implication always to check understanding before moving on to the next step.
With regard to reading comprehension, the authors note that performance is most accurate when the focus is objective and factual, but problems may arise in terms of drawing implications or when the reader is confronted with idioms or multiple meanings, and when only limited use is made of surrounding context.
In addition, comprehension can be inhibited by a tendency towards distractibility and towards literalness, and by a common weakness in drawing from previous experience or from knowledge gained in a different context … with implications for working with the pupils in drawing attention to the significance of details, predicting what might happen next, and generally moving away from the immediate and literal.
Parents will be valuable partners in all this, particularly with regard to identifying possible sources of anxiety, ensuring consistency of handling (including how to manage any crisis), and agreeing on the amount and form of homework.
With regard to this latter point, reference is made to Myles and Southwick (1999) who hold that the immediate post-school period can be very difficult to manage because the child is likely to be tired and may need to unwind after what could be a challenging and potentially stressful time in the classroom.
Homework can be problematic anyway given the need to be clearly organised, to emphasis upon getting things written down, and the distractibility …. with implications for ensuring that, if homework is set (and some specialists argue that pupils with ASD should be spared the further challenge of homework), there is a routine for when and where it is to be done, prioritisation, and for ensuring a manageable schedule with breaks built in. (There is a further requirement for close school-home communication, and for setting homework which the parents would be able to do !)
Falk-Ross et al conclude by stressing again the Asperger and ASD core characteristics of narrow/concrete use of language, perseveration of behaviours (including verbal behaviour), awkward or limited social interactions with staff and peers, and the predisposition to sensory overload … with corresponding needs for decreasing sensory stimulation, differentiation of demands in terms of goals and processes, and direct teaching and modelling of social and communication skills.
Within all this is the major significance of early diagnosis and the establishment of accommodation to the weaknesses and individualistic styles, in order to reduce the threat of heightened anxiety and frustrations associated with misunderstanding and inappropriate expectations.
On the subject of reading teaching, Broun (2004) introduces her paper by recognising how the development of communicative and social skills are crucial for children with ASD but noting, too, that the acquisition of scholastic skills are just as important.
This author traces her emphasis upon a visual approach to the teaching of reading skills to the guidance produced by Oelwein (1995) who discussed the most effective strategies for use with children with Down Syndrome.
The link between this group of learners and those with ASD is the likely weakness in auditory and phonological skills and awareness, with the probability that there would be difficulties in seeking to teach reading via “traditional” and phonics-based approaches.
Broun describes the growing awareness of the typical visual style among ASD children, and her own study explored whether the approaches advocated by Oelwein would be effective for these children, many of whom were observed to be struggling with a phonic emphasis and who might be turned off literacy by materials which did not match their style.
Her initial experience of using such approaches with ASD children, albeit of varying styles and behaviours, indicated the probability of successful outcomes; and Broun proceeded to adopt the methodology more widely.
The Oelwein approach teaches to the strengths of the ASD child, focusing upon the visual preferences. There is a consistent pairing of the printed word with the spoken word to ensure a link between the visual and auditory components, with kinaesthetic cues available from the system of matching and selecting words presented in a range of formats and in completing sentences from those individual words.
There is a growing awareness that the ASD population generally do find it more efficient to learn to read by recognizing whole words; and this approach can produce fairly rapidly a sense of achievement and success which will be motivating for continuing efforts.
By contrast, it is argued that learning letter sounds and putting them together can be too abstract, and these phonemes are not readily seen as the building blocks for words. The children may, in any event, learn the sounds of the letters but still find it very hard to combine them into sequences in a fluent manner or to decode unfamiliar words, with the effect that comprehension and meaning are lost.
However, phonics are not ignored … it is just that they are not the starting point for the development of reading. When the learner has gained a sight vocabulary of up to 50 words, (s)he may then learn the letter –sound association by examining the components of selected and familiar words. One starts from a top-down approach, and “backward-chains” from the whole words to their component sounds.
Meanwhile, it is seen as important to ensure that the content of reading material is relevant to the child with his or her particular experiences. So, one would use elements of a language experience approach, using vocabulary which is meaningful. Thus, the names of familiar people, pets, favourite foods, toys, etc. are selected for the gradual development of a repertoire of known words which can be built into sentences for reading practice by the inclusion of joining words. The subsequent step is to develop vocabulary which is relevant to topics and subjects being taught.
The steps in the Oelwein approach can be summarized as “Acquisition” – learning to recognize words; “Fluency” – consistent accuracy in recognizing the words; “Transfer” – the words are recognized in different formats, or fonts, or contexts; and “Generalisation” where the words are recognized in any situation.
It is recommended that grids onto which to print words should be large, and that flashcards should also be large (around 2 by 5 inches) with the words written in black lower-case form of around 1 inch. A first step would involve matching a word to the given word, followed by selecting a given word on request, and the third step involves saying or signing the word on being shown a word and being asked “ What does it say ? ”
Oelwein also stresses the importance of putting words together to make coherent sentences, and, therefore, argues for the consistent inclusion into the daily reading routine of time for the use of the child’s known vocabulary to create sentences. This is followed by encouraging the child to combine or lengthen the sentences by use of building words like “because”, “and”, with”, etc..
Fluency and consolidation can be aided by the use of personal dictionaries or alphabetic scrapbooks.
The final bit of advice is for access to actual books as soon as practicable in order both to gain a sense of achievement and to widen experience, while demonstrating the purpose in, and pleasure to be gained from, reading. Initially, the books can be individually created, containing descriptions of the child, his/her likes and dislikes, and experiences …. ideally reinforced by photographs. One can then progress to actual printed books, with a simple text and clear font, albeit taking them page by page.
Comprehension can be stimulated by exercises to match words to the appropriate picture or object or person; and then match sentences in the same manner; with the child also encouraged to produce simple descriptive sentences to go with a picture.
Broun concludes by describing how many children, taught to read by these top-down and language-experience approaches, have shown a corresponding increase in their spoken vocabulary and in their consistent willingness to use spoken language in the form of whole sentences.
The work of O’Connor and Klein (2004) deals with those (older) pupils with ASD who may show adequate or better decoding skills and reading accuracy, but who show poor comprehension of the content.
They, too, suggest that there has been relatively little focus upon scholastic skills because the social or behavioural needs of children with autism have been seen as more critical. However, they also recognize the recent increase in the number of children diagnosed, including many with high functioning autism and Asperger Syndrome whose cognitive and language skills are less impaired and who are likely to be part of a mainstream class and to face the scholastic challenges appropriate to the age group.
It is noted by various authors (eg Happe 1997) that many of these high functioning pupils do show distinctive weaknesses in their reading … notably the disparity between good word reading and poor comprehension. In some cases, there has been reference to “hyperlexia” where reading accuracy is very good but there is virtually no understanding of what is read.
(This is not to say that all pupils with these difficulties are autistic; nor that all pupils at the higher end of the autistic spectrum will have a degree of hyperlexia. However, this pattern is relatively common among the ASD population.)
In their review of studies, O’Connor and Klein describe the frequent pattern of adequate decoding of new words or non-words, with the implication that phonetic strategies are unimpaired , along with an ability to deal with phonetically irregular words, suggesting adequate lexical skills as well. However, it is quite common for these pupils to show impaired or absent comprehension; and there is further evidence (Goldstein et al 1994) that the problems with comprehension become more marked over time, with adolescents showing even poorer skills than children, with the implication for greater disadvantage as there arises a greater demand for drawing inferences and looking beyond the immediate and obvious.
Meanwhile, there is evidence that single-word reading comprehension among the high functioning ASD pupils is largely intact, but that for longer linguistic units there will be increasing difficulty. Some syntactic skills might be present, such as the ability to complete cloze tasks with syntactically correct words, but the problems arise as the grammatical complexity and semantic complexity become greater.
There may also be problems in integrating information, such as information from a previously read passage with that from current reading.
The authors then refer to “anaphora” … the means of gaining coherence from a text, and the ability to make sense of what is being read by referring back to what has gone before. For example, anaphora may come into play when a pronoun like “he” or “she” appears in the text and it may be necessary to remind oneself to whom the pronoun refers. It is suggested that individuals with ASD, with their problems in managing attention, would find it hard to cope with these cues.
It is also noted that the children in question are likely to have problems in using prior knowledge to interpret the significance of text, and they may cope with factual recall questions directly concerned with their current reading, but be unable to deal with questions which call for the common sense application of general knowledge gleaned from previous reading. The individuals may possess the appropriate knowledge but do not apply it during their further reading.
The study completed by O’Connor and Klein themselves set out to investigate ways of supporting15 year old learners’ understanding of text at the level of sentence or above by using “ procedural facilitation ”.
This involves offering prompts by which to stimulate executive processes. For example, the learners could be set pre-reading questions with a view to drawing direct attention to prior knowledge and to prime the process of activating that existing knowledge. Alternatively, use could be made of anaphoric prompting in checking to whom or what pronouns refer…. encouraging the readers to pause and check that they are following the text accurately, and to look back as necessary to re-read what has gone before.
A third possibility is a cloze task which requires the reader to make predictions as they read, and implies the need to go back and re-read passages to consolidate their understanding.
To check understanding and comprehension, the readers might be asked to retell the story in their own words; to describe the main idea; to offer a good title; to make inferences via why and how questions; to answer who, what, when, and where questions; and to detect sentences which are incongruent or irrelevant to the main theme.
The results indicated that this procedural facilitation significantly enhance the readers’ comprehension of the texts. Analysis highlighted the particular value of anaphoric cues whose effect was felt by the majority of the sample, while the effects of the other two approaches were observable but not statistically significant.
Meanwhile, activation of previous knowledge was confirmed to have risks as much as benefits. Activating previous knowledge usually does improve recall and comprehension, but the current study indicated that, for some of the ASD sample, the cues could activate prior knowledge that was irrelevant or inaccurate, but that this information perseverated and got in the way of the current comprehension targets.
This latter problem is not unique to individuals with ASD, but the strong and idiosyncratic interests of this group could lead to a greater probability of conflict … and this very conflict may not be recognised given the pattern of non-monitoring of comprehension.
Self monitoring is confirmed as challenging for the ASD group, with no spontaneous readiness to verify understanding or repair comprehension … hence some observable benefits from the direct prompting via the anaphoric cues and cloze demands.
The authors conclude by recommending to teachers and parents the likely benefits of encouraging readers to check back over what they are reading. Computer based learning could be particularly valuable in highlighting anaphoric cues, with the reader expected to identify the referent of a pronoun, for example, before moving on. Such prompts could gradually be faded as the learner becomes used to a self-checking routine.
What matters, in any event, is an awareness of this comprehension weakness, and the corresponding need to intervene. The problems will not show spontaneous remission.
Finally, one would draw attention to the work of Murdick et al (2004) who also were concerned with hyperlexia, albeit not focusing simply upon the ASD population but concerned with that wider sample of readers who share the pattern of adequate decoding and poor comprehension.
Their concern is increased by the awareness that the resulting disadvantage in the classroom (which may not be readily identified) can be associated with social and behavioural problems.
These authors also note that the child with hyperlexia might be misdiagnosed … as having a language disorder, Asperger Syndrome, ADHD, hearing loss, or learning difficulty. In fact, one school of thought (Ray 1999) has it that hyperlexia should be included within the ASD category given the considerable sharing of characteristics between the two groups.
The term “hyperlexia” was first coined by Silberberg and Silberberg (1967) to describe those individuals with superior word recognition but delayed language abilities marked by poor understanding and comprehension of the written word. However, Murdick et al hold that this condition is not well understood, and note that it does not stand as an identifiable category of need according to the Individuals with Disabilities Education Act.
The American Hyperlexia Association does not offer a clear definition, but refers to three characteristics for the identification of hyperlexia … precocious reading ability, significant difficulties in understanding and using language, and problems with social skills. Given this, one can see how hyperlexia and ASD can be confused, or seen as showing considerable overlap.
The children in question often show spontaneous beginning of reading before the age of two years, and may be competent in reading accuracy by 5 years … perhaps showing reading skill in advance of spoken language skills.
However, these children may depend upon rote learning and develop an unorganised store of information which may not be readily available for use in context.
It is further argued that the children in question use language in ways that are differentiable from those observed in children without the hyperlexic condition. For example, it is reported that most of the children utter their first words during the second year but may lose these words before reaching two years and have to relearn them at a later stage.
The early learning is commonly marked by echolalia and learned in whole phrases rather than word by word.
Speech may present as repetitive and lacking in pragmatics, and, in this, can be similar to that observed among children with ASD.
Reference is then made to Kupperman et al (1995) who describe how the majority of children with hyperlexia show behaviours which can interfere with social interaction and social skill development. These behaviours may include non-compliance, ritualistic behaviour, and self stimulation, and are considered to work towards a sameness of routines with corresponding anxiety about change and transition …. again, similar to children with ASD.
It is the hypothesis of Kupperman et al that these social and behavioural issues reflect deficits in the ability accurately and rapidly to process and comprehend language.
With regard to intervention, Murdick et al review evidence and opinion with the recommendation that the children will require classroom support in terms of the classroom setting and nature/presentation of demands. Ideally the class should be small but providing a range of normally developing peers who can provide positive language models.
A clear structure and routine are required, with plentiful use of visual aids and prompts such as mind maps or simply highlighting the most salient parts of texts, along with adequate adult time by which to check the children’s understanding and their focus upon the task in hand. There may need for attention when the text in question contains idioms and figures of speech that may be confusing when treated literally; and for pre-teaching of certain vocabulary or deliberate introduction of background information as new concepts and data are introduced.
The authors conclude by referring to the complex patterns of strengths and weaknesses that are displayed by the children with hyperlexia, and their concern is that teachers or parents may be influenced by the superficial show of good reading and fail to appreciate the underlying weaknesses in understanding, with the corresponding risk of inappropriate demands and expectations leading to stress and deteriorating behaviour.
* * * * * * *
Broun L. 2004 Teaching students with autistic spectrum disorders to read. Teaching Exceptional Children 36(4) 36-40
Falk-Ross F., Iverson M., and Gilbert C. 2004 Teaching and learning approaches for children with Asperger Syndrome. Teaching Exceptional Children 36(4) 48-55
Goldstein G., Minshew N., and Siegel D. 1994 Age differences in academic achievement in high functioning autistic individuals. Journal of Clinical and Experimental Neuropsychology 16 671-680
Happe F. 1997 Central coherence and theory of mind in autism. British Journal of Developmental Psychology 15 1-12
Kupperman P., Bligh S., and Barouski K. 1995 Hyperlexia.
Murdick N., Gartin B., and Rao S. 2004 Teaching children with hyperlexia. Teaching Exceptional Children 36(4) 56-59
Myles B. and Southwick J. 1999 Asperger Syndrome and Difficult Moments. Shawnee Mission KS : Autism-Asperger Publishing Company.
O’Connor I. and Klein P. 2004 Exploration of strategies for facilitating the reading comprehension of high functioning students with ASD. Journal of Autism and Developmental Disorders 34(2) 115-127
Oelwein P. 1995 Teaching Reading to Children with Down Syndrome. Bethesda MD : Woodbine House Publishing.
© Mike Connor 2004.
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