Language, Speech and Hearing Services in Schools : Literacy in Autism—Across the Spectrum (janvier 2021)

Numéros spéciaux

1. Westerveld MF, Paynter J. Introduction to the Forum : Literacy in Autism-Across the Spectrum. Lang Speech Hear Serv Sch ;2021 (Jan 19) ;52(1):149-152.

Purpose The purpose of this article is to introduce the LSHSS Forum : Literacy in Autism-Across the Spectrum. The articles in this forum provide an overview of the current evidence related to literacy in autism spectrum disorder (ASD) from preschool to adolescence and highlight the high literacy needs of this population. Method This introduction provides an overview of some of the reasons why children with ASD are at risk of persistent literacy difficulties and a summary of the six articles included in this forum. Conclusion More research is clearly needed to better understand which factors contribute to the high literacy needs in this population. For now, based on the best available evidence, the authors in this forum provide clear clinical implications that should be highly useful for speech-language pathologists and other professionals involved in literacy assessment and intervention for children and adolescents on the autism spectrum.

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2. Fleury VP, Whalon K, Gilmore C, Wang X, Marks R. Building Comprehension Skills of Young Children With Autism One Storybook at a Time. Lang Speech Hear Serv Sch ;2021 (Jan 19) ;52(1):153-164.

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.

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3. Clendon S, Paynter J, Walker S, Bowen R, Westerveld MF. Emergent Literacy Assessment in Children With Autism Spectrum Disorder Who Have Limited Verbal Communication Skills : A Tutorial. Lang Speech Hear Serv Sch ;2021 (Jan 19) ;52(1):165-180.

Purpose Children with autism spectrum disorder (ASD) are at increased risk of experiencing difficulties with the development of literacy, including the emergent literacy skills recognized to underpin conventional literacy success. Comprehensive assessment is essential. Characteristics of ASD can make assessment challenging, and this can be compounded when children are unable to demonstrate their skills using spoken language. The purpose of this clinical tutorial is to outline the process of emergent literacy assessment for children with ASD who have limited verbal communication skills. A case example of a 5-year-old boy is presented. Method Pertinent literature is reviewed around the literacy profiles of children with ASD, the subgroup of children with ASD who have limited verbal communication skills, key components of emergent literacy, and previous research examining the emergent literacy abilities of children with ASD. The case report is described in depth and emphasizes the key factors to consider when designing an assessment battery and protocol. Results The case example information is interpreted, and its application is discussed. Key outcomes are highlighted including a greater understanding of the child’s literacy strengths and needs and the implications for individualized instruction. Conclusion The clinical tutorial highlights the need for a comprehensive, well-planned assessment approach that involves all members of the educational team, and that is considerate to the needs of the individual child and responsive to their communication needs.

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4. Davidson MM. Reading Comprehension in School-Age Children With Autism Spectrum Disorder : Examining the Many Components That May Contribute. Lang Speech Hear Serv Sch ;2021 (Jan 19) ;52(1):181-196.

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.

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5. Dynia JM, Solari EJ. Print Knowledge in Children With Autism Spectrum Disorder : Do Child and Family Variables Play a Role ?. Lang Speech Hear Serv Sch ;2021 (Jan 19) ;52(1):197-208.

Purpose This study aimed to examine the print knowledge of children with autism spectrum disorder (ASD) in comparison to children who have developmental language disorder (DLD) and typically developing (TD) children as well as examine the child and family predictors of print knowledge. Method A total of 629 preschool children, including 33 children with ASD, 93 children with DLD, and 503 TD children, were the focus of the current study. Teachers completed direct assessments with the children in the fall and spring of the academic year on print knowledge using the Phonological Awareness Literacy Screener. Results Analyses of covariance were used to compare the print knowledge skills (uppercase and lowercase letter identification, print and word awareness, name writing) in the fall and spring for each of the three groups. The groups were significantly different for the Print and Word Awareness and Name Writing subtests in both the fall and spring. A Tukey’s honestly significant difference further indicated that, for these subtests, the children with ASD had significantly lower scores than both the children with DLD and TD children. When examining the child and family predictors of residualized gain in print knowledge for the children with ASD, the only significant predictor for any outcome was fall scores. When examining the predictors for the full sample, fall scores, age, ASD status, and mothers’ education level were significant predictors of print and word awareness and name writing scores. Conclusions None of the child and family characteristics seemed to be related to residualized gain in print knowledge for children with ASD. However, when examining predictors of residualized gain in print knowledge for the full sample, ASD status was related to lower scores for both print and word awareness and name writing.

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6. McIntyre NS, Tomaszewski B, Hume KA, Odom SL. Stability of Literacy Profiles of Adolescents With Autism Spectrum Disorder and Associations With Stakeholder Perceptions of Appropriate High School Support Needs. Lang Speech Hear Serv Sch ;2021 (Jan 19) ;52(1):209-224.

Purpose For many individuals with autism spectrum disorder (ASD), postsecondary outcomes are poor. This may be due to insufficient academic supports, particularly with regard to literacy skills, during high school. More information is needed about skill profiles so that we can better differentiate support for students with varying social, communication, cognitive, and academic proficiency levels. This study was designed to (a) identify unique literacy profiles of high school students with ASD, (b) assess profile stability over time, (c) identify predictors of profile membership, and (d) analyze stakeholder reports of required school support intensity. Method Participants were a diverse sample of high school students with ASD, 14-21 years old (N = 544), their parents, and their teachers who participated in a randomized controlled trial of a comprehensive treatment model for high school students with ASD. Standardized measures were administered to assess nonverbal IQ, autism symptomatology, language/adaptive communication, reading comprehension, academic knowledge, and parent/teacher report of school support needs intensity. Latent transition analysis was conducted to examine sample heterogeneity and to explore the stability of the profiles. Associations between profiles and reports of support intensity were examined. Results Four literacy profiles were identified that were stable over 2 years : Emergent Literacy/Comprehensive Support, Low Literacy/Intensive Support, Average Literacy/Moderate Support, and Average Literacy/Limited Support. Parent and teacher reports of school support intensity generally aligned with the profiles. Conclusions These analyses provide insight into the diverse literacy and support needs in ASD. Implications for practice and the role of speech-language pathologists in assessment and intervention are discussed. Supplemental Material https://doi.org/10.23641/asha.13495119.

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7. Arciuli J, Bailey B. The Promise of Comprehensive Early Reading Instruction for Children With Autism and Recommendations for Future Directions. Lang Speech Hear Serv Sch ;2021 (Jan 19) ;52(1):225-238.

Purpose Children with autism have an increased likelihood of reading difficulties. The reasons for this are numerous and varied, but many children with autism can learn to read when they are provided with evidence-based early reading instruction. Method Here, we provide an overview of some of the factors that impact early reading development for children with autism and a rationale for the provision of comprehensive early reading instruction consistent with the recommendations of the National Reading Panel (NRP). We discuss research on NRP instruction for children with autism, including some of our own empirical studies. We also discuss some areas of research that were not emphasized by the NRP but that we view as important. We offer recommendations that extend beyond NRP guidelines in order to advance knowledge and improve practice. Conclusions Comprehensive early reading instruction holds great promise for children with autism, but there are gaps in our understanding that need to be addressed. These include the most effective method(s) for tailoring reading instruction to the needs of the individual while optimizing delivery to small groups of children, supporting skills and making other accommodations not outlined by the NRP, and consideration of bilingualism and of reading instruction in languages other than English, among other issues. While our focus in this review article is early reading instruction for children with autism who use oral language, we acknowledge that there is a major gap in the literature concerning reading instruction for those who do not use oral language. We hope that this review article will be helpful to clinicians, educators, and researchers alike, as well as children with autism and their families, friends, and support networks.

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8. Brien A, Hutchins TL, Westby C. Autobiographical Memory in Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, Hearing Loss, and Childhood Trauma : Implications for Social Communication Intervention. Lang Speech Hear Serv Sch ;2021 (Jan 19) ;52(1):239-259.

Purpose Speech-language pathologists (SLPs) work with a variety of populations at risk for poor autobiographical and episodic memory. The purpose of this tutorial is to describe autobiographical memory and how it is affected in children with autism spectrum disorder, attention-deficit/hyperactivity disorder, hearing loss, and childhood trauma, as well as provide clinicians with practical strategies for supporting autobiographical memory in each of these clinical populations. Method This tutorial reviews the literature on (a) autobiographical and episodic memory in typical development ; (b) its relation to theory of mind, personal narrative skills, and executive functions ; (c) elaborative reminiscing in typical development ; (d) how autobiographical memory is impaired in children with autism spectrum disorder, attention-deficit/hyperactivity disorder, hearing loss, and childhood trauma ; and (e) strategies for supporting autobiographical memory in each clinical population. Conclusions When adequately prepared, SLPs are uniquely situated to address autobiographical and episodic memory in their work with children, families, and related professionals. This is a long-overdue focus of such great clinical import that justifies its inclusion in the traditional training and preparation of SLPs. Adapting elaborative reminiscing strategies for use with various clinical populations is promising for facilitating healthy EM development and related cognitive functions.

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9. Neave-DiToro D, Fuse A, Bergen M. Knowledge and Awareness of Ear Protection Devices for Sound Sensitivity by Individuals With Autism Spectrum Disorders. Lang Speech Hear Serv Sch ;2021 (Jan 19) ;52(1):409-425.

Purpose Sensitivity to sounds and atypical reactions to sensory input by individuals with autism spectrum disorder (ASD) have been reported in the literature. In response to this sensitivity, some individuals use ear protection devices (EPDs) such as noise-canceling headphones, earplugs, or earmuffs to attenuate the perceived unpleasant sounds. Given the communication deficits often noted in this population and the essential role of hearing in speech and language development, the impact of wearing EPDs to attenuate sound needs to be explored. The purpose of this study was to obtain information from various stakeholders regarding their opinions about use of EPDs in individuals with ASD and perceived benefits and possible concerns of EPD use. Method A survey was constructed to assess the opinions of speech-language pathologists, audiologists, teachers, and graduate students about EPDs among individuals with ASD. A total of 255 professionals and graduate students completed the survey. Results The vast majority of respondents indicated a level of awareness of EPDs within this population. Regarding observed use of such devices, the majority of participants (66%) reported observing individuals with ASD using EPDs. The most commonly used devices observed were headphones (91%), followed by earmuffs (44%) and earplugs (33%). Respondents who had experience recommending and/or using EPDs with individuals with ASD were asked to report on major reasons why the devices were used and the perceived benefits and possible negative effects. Conclusions There appears to be uncertainty among various stakeholders of the benefits and possible negative effects of EPD use by individuals with ASD. Additionally, there is a dearth of research in this area, and the necessity for specific guidelines for recommending and monitoring EPD use is indicated.

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10. Boyle S, McNaughton D, Light J, Babb S, Chapin SE. The Effects of Shared e-Book Reading With Dynamic Text and Speech Output on the Single-Word Reading Skills of Young Children With Developmental Disabilities. Lang Speech Hear Serv Sch ;2021 (Jan 19) ;52(1):426-435.

Purpose This study investigated the use of a new software feature, namely, dynamic text with speech output, on the acquisition of single-word reading skills by six children with developmental disabilities during shared e-book reading experiences with six typically developing peers. Method A single-subject, multiple-probe design across participants was used to evaluate the effects of the software intervention. Six children with developmental delays were the primary focus for intervention, while six children with typical development participated as peer partners in intervention activities. e-Books were created with the new software feature, in which a child selects a picture from the e-book and the written word is presented dynamically and then spoken out. These e-books were then used in shared reading activities with dyads including a child with a disability and a peer with typical development. Participants engaged in the shared reading activity for an average of 13 sessions over a 6-week time period, an average of 65 min of intervention for each dyad. Results Participants with disabilities acquired an average of 73% of the words to which they were exposed, a gain of 4.3 words above the baseline average of 1.7 correct responses. The average effect size (Tau-U) was .94, evidence of a very large effect. Conclusion The results provide evidence that the use of e-books with the dynamic text and speech output feature during inclusive shared reading activities can be an effective and socially valid method to develop the single-word reading skills of young children with developmental disabilities.

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