Early Reading Comprehension Intervention for Preschoolers with Autism Spectrum Disorder and Hyperlexia

Abstract

Children with autism spectrum disorder (ASD) and hyperlexia (HPL) have both advanced word reading skills and a reading comprehension disorder, alongside impaired oral language. We developed a unique, parent-supported, tablet-based intervention aiming to improve oral and reading comprehension at the word-, phrase- and sentence-level, for preschoolers with ASD and hyperlexia (ASD + HPL). English-speaking preschoolers (N = 30) with ASD + HPL (N = 8), ASD without HPL (N = 7) and typical development (N = 15) underwent a 6-week no-intervention period followed by a 6-week intervention period. Findings revealed a significant increase in reading comprehension scores for the group with ASD + HPL as compared to the TD group (p = .023). Gains were also found for receptive but not expressive language for all groups. Implications for early intervention for preschoolers with ASD + HPL are discussed.

Appendix

Figures 

Fig. 6

Examples of verbs, adjectives, pronouns, concepts, phrases and sentences used in the intervention

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Fig. 7

Successful or Unsuccessful Acquisition of a Target Word in 2/3 Trials in a Learning Opportunity: Three Possible Avenues. Note: Acquisition of an oral or written word is determined when a child chooses the correct image for the corresponding auditory and/or written word combination on the first attempt of at least two of the three trials in a learning opportunity. Although a child has 3 attempts within one trial to correctly choose the corresponding image, only the first attempt counts towards determination of acquisition. That is, each target word will be presented in three novel pairings or learning opportunities. If a child has been exposed to three novel trials for a target word and has not met the criteria for 2/3 correct selection on the first attempt of a trial, the unacquired target word remains in a general bank of vocabulary to be targeted for receptive language acquisition (up to two more learning opportunities or 6 more trials); after which the word will no longer be presented. Therefore, there are a total possibility of 9 trials per word dependent on performance. Progression from the Oral Language to the Reading Comprehension phase occurs automatically when the Oral Language phase has been confirmed for an individual target word. The process for the Reading Comprehension phase is identical, without the auditory support. It is important to note that a child can be working at both phases simultaneously for different words. That is, words at the Oral Language phase and the Reading Comprehension phase are integrated, depending on performance. Once a word has been acquired in the Oral Language phase, it will be presented immediately in the Reading Comprehension phase, interspersed (every second word) with an Oral Language trial, to maximize written word exposure, as reading comprehension is the goal of the application.

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Fig. 8

Movement from single word to phrase to sentence level. Note: Introduction of verbs and adjectives is based on acquisition of 25 nouns. Progression from Word level to Phrase level is dependent on acquisition of 25 nouns, plus 25 verbs and 25 adjectives, which is in agreement with typical language development (Brown, 1973). Progression from Phrase to Sentence level is dependent on 80% acquisition in each category (noun, verb, adjective, concept, pronouns) for a total of approximately 260 words. The same content used at the word-level, e.g., dog is incorporated at the phrase-level, e.g., dog runs, and at the sentence-level, e.g., The dog runs fast, as the child acquires verbs and adjectives, adverbs and pronouns. Similarly, once a phrase or sentence has been established at the Oral Language phase, using the same criteria, the phrase is practiced at the Reading Comprehension phase. As with the Oral Language and Reading Comprehension phases, a child may work at a number of different levels simultaneously, dependent on acquisition rates, as the transition from a word to a phrase is seamless. Movement from Phrase Level to Sentence Level occurs when the child has acquired 80% of words in all categories.

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