Evidence-Based Reading Intervention Practices for Students with ASD

Reading proficiency is a skill that is necessary to function in society. Yet, low reading scores during the school years continue to be a persistent trend in the U.S. The Annie E. Casey Foundation (2014) reports that 66% of U.S. students are not reading proficiently and are not prepared for future success. The No Child Left Behind Act of 2001 and The Individual with Disabilities Education Act (IDEA) of 2004 mandate high academic standard opportunities and evidence-based practice (EBP) instruction for all student – including students with autism spectrum disorders (ASD). Students with ASD are increasingly being incorporated in general education classrooms where there is a strong emphasis on reading proficiency (Lanter & Watson, 2008). Reading instruction has been given relatively little focus in EBP analysis with regard to students with ASD (Spector 2011). The research is evolving and shows that there are proven methods of reading interventions for students with ASD. This paper will explore the evidence-based practices for reading intervention (sight word and reading comprehension instruction) in students with ASD.

The reading profile of students with ASD is heterogeneous (Nation, Clarke, Wright, & Williams, 2006). It is the general consensus that students with ASD are great readers because of their ability to decode due to their unique rote abilities. Caution should be taken with this generalization because of the varying degrees of cognitive and linguistic skills seen in students with ASD and because word reading does not always indicate that meaning is being stemmed from the printed text. When students’ decoding skills far exceed their reading comprehension skills, they are described as having hyperlexia. These students have a compulsive preoccupation with reading and an early onset of precocious word reading skill that is unparalleled to their reading comprehension (Lanter & Watson, 2008). Children with hyperlexia are often diagnosed with ASD or may present with characteristics of ASD (Nation, 1999). On the other hand, decoding words can also be challenging to students with ASD. Nation et al., (2006) found that decoding impairment was more prevalent in students with ASD than in the general population.

Historically, students with ASD are disqualified from reading programs because of erroneous beliefs that they cannot cognitively access the curriculum. Today, federal laws mandate schools to use EBP to teach reading to all students. Evidence-based reading interventions assist students with ASD to become proficient readers. The current best evidence, research-proven reading instruction for students with ASD, that should guide clinical and academic practice, are sight word instruction and reading comprehension intervention.

Sight Word Instruction

Sight word instruction is beneficial for students with ASD (Spector 2010). It is useful in fostering a sense of accomplishment and motivation in learning to read (Broun 2004 as cited in Spector 2010). It is a more accessible starting point intervention than phonics-based approaches for students with ASD who have challenges with abstract, auditory-based concepts (Broun & Oelwein, 2007 as cited in Spector 2010). Reading programs usually incorporate sight word instruction for high utility words that are not decodable. Sight word instruction benefits students with ASD because its mastery enables them to execute functional tasks such as reading grocery lists, menu items, directions, recipes, and environmental signs (Browder & Xin, 1998 as cited in Spector 2010).

Spector (2010) examined the evidence on sight word instruction as a means of teaching student with ASD to read printed words. The results showed the following as research-proven reading instruction for students with ASD: Visual supports – Students were required to match food logos, environmental signs, grocery aisle signs, and spoken words to printed words (i.e. Dolch words). Massed trials – students responded to each sight word in succession during flash card drills. Differential positive reinforcement – students were presented with sight word stimuli and were required to read each word. They were given feedback on correct and incorrect responses. They received praise, tokens, and/or food for corrected errors. Systematic prompting – students were given defined prompts when presented with sight word stimuli. Overall, students with ASD, even those with no prior reading instruction and limited oral language, learned to identify printed words. Sight word instruction is an evidence-based practice to teach students with ASD.

Reading Comprehension Intervention

The challenges that students with ASD have with reading comprehension can be explained by three theoretical frameworks (Gately, 2008 as cited in El Zein, Solis, Vaughn, & McCulley, 2014). One is the theory of Weak Central Coherence (WCC). It explains that students with ASD present with challenges in identifying main ideas and summarizing. The Theory of Mind (ToM) framework states that students with ASD often do not comprehend the emotion/internal states of characters in reading passages and thus are challenged with predicting character actions (Carnahan & Williamson, 2010, Colle, Baron-Cohen, Wheelwright, & Van der Lely, 2008, and Williamson, Carnahan, & Jacobs, 2009 as cited in El Zein et al., 2014). The third framework is the Executive Dysfunction Theory (EDF). It explains that students with ASD may have unique frontal lobe activity that is manifested by challenges with planning, flexibility, and self-monitoring (Pennington, et al., 1997 as cited in El Zein et al. 2014). These challenges lead to reading comprehension deficits because in order to accurately and appropriately obtain meaning from reading passages, readers are required to be flexible in adapting to changes in printed text. Reading comprehension, for students with ASD, is achieved when they appropriately summarize information, retrieve and apply prior knowledge, understand social cues and character emotions, and make inferences from printed text. These are high-level reading skills and students with ASD struggle with skilled reading because of their challenges with interpretive language.

Evidence-based practice for reading comprehension intervention, for students with ASD, is increasingly becoming necessary as they are now being included in general education classrooms. El Zein et al. (2014) synthesized reading comprehension intervention studies that were conducted on students with ASD. The outcome identified interventions that increase reading comprehension. The following are effective reading comprehension interventions for students with ASD: Direct Instruction (DI) program, Corrective Reading Thinking Basic: Comprehension Level A – featured use of scripts, choral student responses, cuing student responses, correction of errors, modeling and independent practice. Peer tutoring with typically developing peers – typically developing peers provided 1:1 tutoring sessions followed by 10 minutes of free play activities with tutees. Tutors provided task directions, modeling, and prompting. Class-wide peer tutoring (CWPT) with typically developing peers – it featured reading in pairs, feedback from peers for oral reading, 3 minutes of reading comprehension questions (WH questions) by tutors, and error correction. Cooperative Learning Groups (CLG) with typically developing peers – featured teacher-directed reading instruction, peer tutoring on vocabulary words, WH question practice, and factual information game based on the story. Story Map – student read a passage, then used a graphic organizer Story Map as a visual map of literal story elements (characters, place, time, beginning, middle, and end). Reciprocal questioning and scaffolding instruction using SCORE curriculum – featured students with ASD and typically developing peers taking turns reading a story out loud and asking questions. Scaffolding instruction featured modeling, verbal prompting, and corrective feedback and taught question generation and response. SCORE curriculum features five social skills: share ideas, compliment others, offer encouragement or help, recommend changes nicely, and exercise self-control. Overall, explicit instruction, student grouping practices, graphic organizers, and strategy instruction are effective interventions for increasing reading comprehension in students with ASD.

The current best evidence reading intervention for students with ASD, that should guide clinical and academic practice, are sight word and reading comprehension intervention.

 

Tamara Sterling, M.S. CCC-SLP, TSSLD is a Speech-Language Pathologist in New York. She has eight years of experience working with children and adults with articulation, stuttering, language, and autism spectrum disorders. She is an ASHA Mentor and a recent recipient of v award. For more information, please email sterling.tamara20@gmail.com.

References

Annie E. Casey Foundation. (2014, January 28). Low reading scores show majority of U.S. children not prepared for future success. [Web log comment]. Retrieved from http://www.aecf.org/blog/low-reading-scores-show-majority-of-us-children-not-prepared-for-future-s/

 

El Zein, F., Solis, M., Vaughn, S., & McCulley L. (2014). Reading comprehension intervention for students with autism spectrum disorders: A synthesis of research. Journal of Autism and Developmental Disorders, 44, 1303-1322.

 

Individuals with Disabilities Education Improvement Act of 2004. Pub. L. No. 108-446, 118 Stat. 2647 (2004).

 

Lanter, E., & Watson, L.R. (2008). Promoting literacy in students with ASD: The basics for the SLP. Language, Speech, and Hearing Services in Schools, 39, 33-43.

 

Nation, K., (1999). Reading skills in hyperlexia: A developmental perspective. Psychological Bulletin, 124, 228-355.

 

Nation, K., Clarke, P., Wright, B., & Williams, C. (2006). Patterns of reading ability in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 36, 911-919.

 

No Child Left Behind Act of 2001, Pub. L. No. 107-110, 115 Stat. 1425 (2002).

 

Spector, J.E. (2011). Sight word instruction for students with autism: An evaluation of the evidence base. Journal of Autism and Developmental Disorders, 41, 1411-1422.

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