Reading and Students with Autism

Autism is a complex disability with the hallmark features of impaired communication and socialization. Students with autism face unique challenges in learning to read that are related to these impairments. Yet with targeted interventions and accommodations in reading instruction and assessment, these students can become proficient readers. Understanding the characteristics of students with autism is an important step toward the development of effective instruction and appropriate assessment for these students.

This paper is intended to begin a discussion of the issues surrounding reading and students with autism; it is not intended to be a comprehensive research review. The paper provides: (1) an overview of the characteristics of students with autism, (2) a description of common approaches to reading instruction, and (3) assessment approaches and issues that surround the assessment of reading for students with autism.

The paper is one of several brief papers developed to contribute to the process of conducting research and developing accessible reading assessments for students with disabilities. Creating accessible reading assessments based on accepted definitions of reading and proficiencies of reading requires knowledge of the issues specific to each disability and how they affect reading and the assessment of reading. The information in these papers was obtained through a broad review of literature and Web sites of national agencies and organizations, along with input and feedback from professionals in the disability areas. Each paper is intended as a first step to facilitate discussions that include individuals who do not know the disability, in this case autism, and those who may know the disability but have not considered the interaction of the disability with reading or the assessment of reading through statewide testing.

Students with Autism

Children with autism demonstrate communication deficits that may involve a complete absence of spoken language, along with an atypical focus or intensity of interests and repetitive patterns of behavior. Deficits in the development of certain language skills may occur, particularly in the area of comprehension of higher-level more complex discourse, which in turn, can affect reading comprehension ability. Some students with autism demonstrate hyperlexia, a precocious ability to decode words with relatively little ability to comprehend the meaning of what is read. The presence of hyperlexia can complicate the assessment of reading ability in these students because their strong word reading skills can mask deficits in the ability to understand what they read.

Approximately 78,749 students 6-21 years of age in the United States received special education services for autism in the 2000-2001 school year, comprising about 1.4% of all students receiving special education services in U.S. schools (U.S. Department of Education, 2002). This percentage has nearly tripled during the past decade; students with autism comprised less than 0.5% of students receiving special education services in 1993-94 (U.S. Department of Education, 1995). Four times as many males as females exhibit autism.

It has been estimated that about 4,561 English language learners (ELLs) received special education services for autism in 2001-2002. Thus approximately 1.3% of school-age ELLs with disabilities were identified with autism (Zehler, Fleischman, Hopstock, Pendzick, & Stephenson, 2003). The challenge of learning English and having a disability adds another level of complexity to learning to read and demonstrating reading achievement (Mueller & Markowitz, 2004).

Although early reports suggested that close to half of children with autism never developed spoken language, current estimates, which reflect earlier diagnosis and intervention, suggest that 60-80% of children with autism do learn some spoken language (Rogers, 2006). Approximately 20% are considered “high functioning,” with IQ scores within the normal range and fluent spoken language (Tager-Flusberg, Paul, & Lord, 2005). This group includes children with Asperger syndrome (Klin, Volkmar, & Sparrow, 2000).

While autism is the most familiar label for these children, the condition actually comprises a spectrum of disability. Children who demonstrate all three of the cardinal diagnostic criteria for autism: severe deficits in social interaction, deficits in communication, and the presence of stereotypical and repetitive patterns of movements, activities, and interests – are given the diagnostic label of autism. The term “autism spectrum disorders,” however, refers to the complex group of related disorders that have similar autism-like characteristics: (1) Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) refers to a collection of features that look like autism but may not be as severe or extensive; (2) Rett syndrome, which primarily affects girls, is a genetic disorder characterized by speech and motor skills that regress with age, along with other neurological disorders; (3) Asperger syndrome refers to the existence of autistic characteristics but relatively intact language abilities, and (4) Childhood Disintegrative Disorder refers to a condition in which development appears normal for the first few years of life, but then regresses with the loss of speech and other skills until the characteristics of autism are evident. In addition to this range of syndromes on the autism spectrum, children with autism spectrum disorder can show a wide range of levels of cognitive function, from superior levels of intellectual ability, to abilities in the mentally retarded range.

Children with autism spectrum disorders generally have problems in three core areas, with varying degrees of intensity: socialization, communication, and restricted patterns of behaviors and interests (Ruble & Gallagher, 2004). This may lead to difficulty understanding social rules such as taking turns and sharing; problems with understanding and reading the emotions of others; difficulty taking the perspective of other people; and problems initiating and maintaining interactions and conversation with other people. Children with autism spectrum disorders have varying degrees of difficulty with inferring the thoughts or beliefs of others, a concept referred to as “theory of mind” (Barnhill, 2004). For higher functioning children, including those with Asperger syndrome, theory of mind deficits lead to difficulties explaining behavior, understanding emotions, predicting the behavior or emotional state of others, understanding the perspective of others, inferring the intentions of others, understanding how behavior affects how others think or feel, applying social conventions, and differentiating fact from fiction (Barnhill, 2004), even in the presence of relatively well-developed vocabulary and grammatical skills.

Instruction for Students with Autism Spectrum Disorders

Autism (which is often used as short for “autism spectrum disorders”) may manifest itself in a variety of ways in school. For example, higher functioning children with autism spectrum disorders often have uneven development of cognitive skills but have relative strengths in processing visual, including written, information. Thus these children may show relative strengths in responding to written material relative to their responses to speech. Even bright children with these disorders often have trouble responding to verbal information presented at a fast pace, difficulty understanding multi-step commands, inconsistent attention to and understanding of verbal information, and a need for their attention to be directed to verbal information, which may need to be repeated several times before it is processed. Problems are often compounded because students with autism typically have difficulty screening out distractions, completing activities independently, and initiating work activities. Likewise, transitions can be difficult for students with autism. Such students have difficulty stopping one activity and moving onto the next, difficulty being flexible, and difficultly shifting attention (Autism Society of America, 2005).

With respect to characteristics likely to impact reading directly, Barnhill (2004) noted that children with Asperger syndrome and other high functioning children with autism spectrum disorders “may lack higher level thinking and comprehension skills” despite their average or above intelligence and good rote memory skills. He goes on to state that, “Many can decode words well, and their impressive vocabularies may give the false impression that they understand everything they are saying or reading. Instead they may be parroting what they have heard or read, but not understand it fully” (p. 39).

Some common approaches recommended for teaching reading to students with autism can benefit all students. For example, Kluth and Darmody-Latham (2003) suggested that teachers focus on students’ interests in order to improve motivation. Providing reading material on children’s special interests (many students with autism develop circumscribed interests in idiosyncratic topics such as trains or weather) can help motivate children, but attempts should be made, as well, to expand interests to include more age- and socially-appropriate material to provide students with more information that can support connections with peers and progress in the school curriculum. Because the life experiences of children with autism may be limited, reading material should be relevant to a child’s own experiences can promote comprehension (Broun, 2004). In addition, however, specific interventions aimed at fostering reading comprehension that are used with other children with reading difficulty, including creating anticipatory sets, using graphic organizers, and practicing summarization, can be helpful for these students. Teachers should frequently check for comprehension given that these students, especially those with Asperger syndrome or hyperlexia, may be proficient decoders but may not understand what they have read.

Educators in the United States have also used reading interventions specially designed for students with autism, albeit with varying success. Research has demonstrated that a variety of approaches assist students with autism in communicating academic knowledge. Word processors, computers, and augmentative communication devices (such as touch screens or communication boards) are generally considered to be useful communication aids for some individuals with autism spectrum disorders. Likewise, visual organizers such as advance organizers, flow charts, concept maps or Venn diagrams help concretize literary information for students (Hetzroni & Tannous, 2004). Direct teaching of figurative language or words with multiple meanings may also promote better comprehension of literary material. Finally, students who have difficulty reading print may benefit from teacher read aloud activities (Kluth & Darmody-Latham, 2003). Little research has focused on approaches for ELLs with autism spectrum disorders.

Assessment of Students with Autism Spectrum Disorders

Students with autism may struggle on tests for a variety of reasons. Lord and McGee (2001), in discussing the participation of students with autism in screening assessments, noted a variety of provisions that need to be made. Among these was the need to attend to the student’s functional adjustment to the testing situation. The Committee on Educational Interventions for Children with Autism (Lord & McGee, 2001) indicated that the “results of specific assessments obtained in more highly structured situations must be viewed in the broader context of a child’s daily and more typical levels of functioning and response to real-life demands. The child’s adaptive behavior (i.e., capacities to translate skills into real world settings) is particularly important.” They also indicated that the “behavior of a child will vary depending on such aspects of the setting as novelty, degree of structure provided, and complexity of the environment…” In essence, these and the other recommendations indicate that assessments should consider the social and communicative difficulties that a student with autism may exhibit.

Without research to guide state or district achievement testing of reading, there are several considerations for students with autism to participate in assessments in their most advantageous environment, with each student’s social and communication challenges in mind. According to large-scale test accommodation literature, accommodations such as alternative settings, extended time, and computer formats (Thompson, Blount, & Thurlow, 2002) are among those that may be appropriate for students with autism. Few states have accommodation policies for ELLs with disabilities, and we know little about the accommodations typically used by ELLs with autism. It is likely that these students would benefit from individualized combinations of accommodations. Decision makers need to determine how to accommodate communication, behavioral, and academic concerns for reading tests.

Unique questions arise for some students in this population. For example, can students be given long breaks, even across multiple days, to accommodate their difficulty focusing on the test itself? Is there anything about the test design itself that can be adjusted –without changing the proficiency standards – to assess these students better in reading?

Summary

The intent of this brief paper is to highlight issues surrounding reading and students with autism spectrum disorders. While not a comprehensive review, it is intended to give enough of a sense of the characteristics of the students, general instructional approaches used with them, and assessment approaches and issues to generate discussion about the possible ways in which more accessible assessments can be designed for those students who are proficient readers given the fact that they are diagnosed with autism. This paper is part of the background for research on accessible reading assessments conducted by the Partnership for Accessible Reading Assessments (PARA), and for discussions among collaborators on the National Accessible Reading Assessment Projects (NARAP).

References

Autism Society of America (2005). Common characteristics of autism. Retrieved March 24, 2005 from the World Wide Web: http://www.autism-society.org/site/PageServer?pagename=autismcharacteristics.

Barnhill, G. P. (2004). Asperger syndrome: A guide for parents and educators. In A. Canter, L. Paige, M. Roth, I. Romero, & S. Carroll (Eds.), Helping children at home and school II: Handouts for families and educators. Bethesda, MD: National Association of School Psychologists.

Broun, L. T. (2004). Teaching students with autistic spectrum disorders to read: A visual approach. Teaching Exceptional Children, 36, 36-40.

Hetzroni, O. E., & Tannous, J. (2004). Effects of a computer-based intervention program on the communicative functions of children with autism. Journal of Autism and Developmental Disorders, 34, 95-113.

Klin, A., Volkmar, F., & Sparrow, S. (2000). Asperger syndrome. NY: Guilford Press.

Kluth, P., & Darmody-Latham, J. (2003). Beyond sight words: Literacy opportunities for students with autism. The Reading Teacher, 56(6), 532-535.

Lord, C., & McGee, J. P. (Eds.). (2001) Educating children with autism. Washington, D.C.: National Academy Press.

Muller, E., & Markowitz, J. (2004). Synthesis brief: English language learners with disabilities. Alexandria, VA: National Association of State Directors of Special Education Inc.

Rogers, S. (2006). Evidence-based intervention for language development in young children with autism. In T. Charman and W. Stone (Eds.), Social and communication development in autism spectrum disorders: Early identification, diagnosis, and intervention. NY: Guilford. In press.

Ruble, L., & Gallagher, T. (2004). Autism spectrum disorders: Primer for parents and educators. Bethesda, MD: National Association of School Psychologists. http://www.naspcenter.org/pdf/Autism204_blue.pdf

Tager-Flusberg, H., Paul, R., & Lord, C. (2005). Language and communication in autism. In F. Volkmar, R. Paul, A. Klin and D. Cohen (Eds.), Handbook of Autism and Pervasive Developmental Disorders – 3rd Ed. (pp. 335 – 364). NY: Wiley.

Thompson, S. J., Blount, A., Thurlow, M. (2002). A summary of research on the effects of test accommodations: 1999 through 2001 (Technical Report 34). Minneapolis, MN: University of Minnesota, National Center on Educational Outcomes.

U.S. Department of Education (1995). Seventeenth annual report to Congress on the implementation of the Individuals with Disabilities Education Act. Washington, DC: Author.

U.S. Department of Education. (2002). Twenty-fourth annual report to Congress on the implementation of the Individuals with Disabilities Education Act. Washington, DC: Author.

Zehler, A. M., Fleischman, H. L., Hopstock, P. J., Pendzick, M. L., & Stephenson, T. G. (2003). Descriptive study of services to LEP students and LEP students with disabilities (No. 4 Special topic report: Findings on special education LEP students). Arlington, VA: Development Associates, Inc.

Acknowledgments

This paper was developed through a collaborative effort of numerous members of the PARA staff. The contributors are listed here alphabetically: Kristin Eisenbraun, Christopher Johnstone, Sheryl Lazarus, Kristi Liu, Danielle Matchett, Ross Moen, Mari Quenemoen, Rachel Quenemoen, Sandra Thompson, and Martha Thurlow. In addition, we had the invaluable assistance of a member of the General Advisory Committee for the National Accessible Reading Assessment Projects (NARAP), Stan Dublinske, who is Senior Advisor for Planning of the American Speech-Language-Hearing Association, and several individuals working with him who provided detailed input, including suggestions for specific (and better) wording. These individuals included Diane Paul, Kathleen Whitmire, Silvia Diehl, and Rhea Paul. Input also was provided by another member of the General Advisory Committee for NARAP, Drew Albritten, who was Executive Director of the Council for Exceptional Children, and CEC member who he recommended provide input to us, Cynthia Pearl, University of Central Florida.

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