ASA's 37th National Conference on Autism Spectrum Disorders (July 13-15, 2006)

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Saturday, July 15, 2006: 10:00 AM-11:15 AM
550 A-B
#1763- Hyperlexia and Autism: How Theory of Mind Relates to Reading Comprehension.
This presentation seeks to answer several questions about the nature of hyperlexia, reading compression, and autism. Current research and definitions of hyperlexia and its occurrence within the autism population will be reviewed. Cognitive profiles of both hyperlexic and autistic students demonstrate impairments in the ability to answer reading comprehension questions. This deficit may be explained by the Theory of Mind hypothesis. Tips and suggestions for how best to target social and reading comprehension in students with autism will be reviewed.

Presenter:Dawn A. Holman, PhD, Autism Spectrum Consultants, Inc, Clinical Director - Dawn Holman received her Doctorate in Educational Psychology. She earned a Dissertation of Merit award for research on hyperlexia and reading comprehension. She worked with Dr. Lovaas at UCLA’s Clinic for Behavioral Treatment of Children. She has worked extensively as an ABA therapist and supervisor. She provides training for staff across the US and England. Dr. Holman is a licensed Marriage and Family Therapist. She sits on the Board of Directors of the San Diego chapter of the ASA. She has spoken at numerous conferences, including the Southern California Autism Society’s annual conference, and educator training for the Elija Foundation.
I. Learning Objectives: Autism research has focused on cognitive profiles and behavioral manifestations of the disorder. There is a paucity of research on the literacy skills of students on the spectrum, despite the fact that there is a subgroup of children who display precocious decoding abilities, with poor comprehension known as hyperlexia. The purpose of this presentation is to: - Provide an overview of hyperlexia and its relationship to autism spectrum disorders, from a research review and from clinical knowledge. - Provide an overview of cognitive deficits in autism that may cause difficulty in the area of reading comprehension (such as theory of Mind) - Review recent research that examines the specific relationship between autism spectrum disorders, hyperlexia and deficits in reading comprehension skills. - Provide intervention strategies and tips that can be utilized within both clinical (Applied Behavioral Analysis) and educational (classroom) settings.

II. Content of Presentation: The presentation will provide updated information on the current definitions, incidence rates and possible treatments for hyperlexia, as well as attempt to explain its relationship to autism. In addition, the presentation will make the case for a link between the documented deficits in Theory of Mind in the high functioning autism and Asperger's Syndrome population, to reported deficits in reading comprehension for even the most able autistic students.

To begin, hyperlexia will be reviewed. Not all autistic children are hyperlexic, but developmental disturbances, especially in the area of language and socialization, are always present in hyperlexia. Hyperlexic children characteristically display advanced decoding or phonological skills with regards to the conversion procedure of the printed word to the oral articulated word. They are known as “precocious readers”, and have been documented mainly on a case-study basis, and are often treated as autistic savants. The definition of hyperlexia is variable, with most researchers defining it as a precocious knowledge of decoding single words without the corresponding level of ability in the comprehension of words and texts. Many autistic children show this same pattern, with an ability to decode, but a seeming inability to comprehend.

The neuropsychological profiles of autistic children will be reviewed. In general, these students tend to show impairments in complex memory, language, and reasoning domains, with relatively intact performance in the areas of attention, simple memory, simple language, and visual-spatial domains (Minshew, Goldstein & Siegel, 1997). Cognitive profiles typically reflect lower composite scores on the verbal component of intelligence tests such as the Wechsler Intelligence Scales for Children (Wechsler, 1974; 1991). In addition, the research regarding deficits in Theory of Mind will be summarized. Very few research studies have looked at anything related to reading comprehension within the autism population. Thus the importance of language and cognitive development as it relates to literacy will be made.

The presentation will stress that there is a need for a more specific definition of hyperlexia as it occurs within the autistic population and a better understanding of the ramifications of the disorder as it applies to academic performance, especially in the literacy domain. Without an understanding of the cognitive processes and functions that are intact and those that are impaired, educators will have great difficulty designing appropriate Individual Education Plans for such students.

In order to understand a variety of reading texts, such as fiction, the reader must have an adequate understanding of other people. Therefore, the deficits in Theory of Mind in the autism population may parallel deficits in reading comprehension, when the tasks involve making inferences, motive interpretation, and predictions about people and intentions, etc. A recent research study conducted by the presenter (Holman, Rueda, Manis and Yaden, 2003) will be reviewed. In it, three groups of children were tested on both standardized and non-standardized reading assessments. High functioning, non-mentally retarded autistic children, with and without hyperlexia, were compared to normal readers at grades 3, 4 and 5. In addition, measures of social inferential comprehension were tested, both in oral and written formats, in order to assess the hypothesis that deficits in Theory of Mind in autistic children are comparable to deficits in inferential reading comprehension of fictional text. Results from the study indicated that students with hyperlexia outperformed students with autism on all measures, both reading and non-reading, such that hyperlexia could be considered a general advantage over autism. Implications for future research and a variety of classroom and resource-room friendly interventions will be offered.

III. Contributions to Best Practices and advances in field of autism: The rise in autism incidence nationwide necessitates research into both the cause, and potential treatments for the disorder. Educationally, there is a paucity of research and treatment of literacy development in children with autism in particular. The purpose of this presentation will be to clarify and expand upon research in the area of reading skills in autistic children, with and without hyperlexia. The audience will be able to learn how to identify patterns of reading skills that are intact and impaired within the autism population. This is important for a number of reasons, including clarifying the definition of hyperlexia, increasing awareness of the strengths and weaknesses of students with autism when it comes to decoding text, from the simple words to the entire concept of reading comprehension, and global comprehension in general.

While great progress has been made, both clinically and educationally with behavioral treatment for autism, the focus has rarely been on identifying patterns of strengths and weaknesses that can be utilized to teach literacy to children with on the spectrum. Understanding what may be an underlying general deficit, such as a deficit in Theory of Mind, or social inferential understanding, may help guide interventions in more than one area. Intervention implications for both individual education plans (IEP's) for Special Education and effective academic mainstreaming within the least restrictive, often the regular education classrooms, as mandated by Public-Law-142, will likely result from a better understanding of both the cognitive and the reading processes that are in effect in autistic students (National Research Council, 2001).

The presentation will provide information regarding the developmental pattern of reading and comprehension skills that exist in autistic children in general, and can lead to instructional progress for educators and parents working with this population. Current Best Practices indicate the use of Applied Behavioral Analysis, which could be useful in the teaching of the necessary underlying understanding of social and inferential comprehension. Specific strategies for teaching emotions, inferences and cause and effect, will be reviewed. In addition, ideas for improving reading comprehension in the student with autism will be presented, in the hopes that this will allow for greater efficacy within both the classroom and clinical settings.

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