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Difficulties with Reading and narration in children with autism

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​​​​​​​Children with autism may be good at reading a text one word at a time, but simultaneously have problems understanding and retelling the content of what they read. Research now shows the importance, for these children, of extensive language assessment and follow-up over time.

Children with autism have difficulties in communication and social interaction, and many also have delayed language development. At the same time, the language ability of children with autism is known to vary widely, from not speaking at all to having a well-developed language for their age.

“It’s usually a deviant language development that parents worry about first,” says Emilia Carlsson, PhD at Sahlgrenska Academy, University of Gothenburg, and a licensed and registered speech and language pathologist at the Gillberg Neuropsychiatry Centre in Gothenburg.

For her thesis, she studied language ability in children with autism. She started with a large group, identified through screening at child health centres, who had already been diagnosed by two and a half years of age. Of these, 85 children were followed up by speech and language pathologists at age seven or eight. In parallel, a control group of more than 100 children without autism were recruited at preschool and compulsory school.

Risk of overestimation

About half of the children with autism proved to find reading difficult, while roughly a third were able to read well. Some children with autism were adept at single-word reading but had difficulty in understanding the text, which might result in others overestimating their reading ability.

The results also showed that the children with autism found narration difficult. Their retellings were shorter and less complex, compared not only with their peers but also with younger children without autism who were otherwise at the same language level.

The ability to retell a story proved to be linked to both language proficiency and visual, and nonverbal ability. The latter was tested by asking the children to arrange pictures in the right order to create a logical sequence of events.

Long-term follow-up important

Carlsson’s research showed an association between early language ability and subsequent reading skills. Children with autism who could read well at age eight had already shown superior linguistic ability at age three, while the older children who had problems with reading had experienced more severe early language difficulties as well.

Undergoing comprehensive language assessment and also being followed up by speech and language pathologists over time may therefore be described as key elements in the care and nurture of children with autism.

“More knowledge of how reading and narrative skills are linked to other aspects of language proficiency is important so that the right support and intervention can be provided for these children,” Carlsson says.

Title: Aspects of Communication, Language and Literacy in Autism: Child Abilities and Parent Perspective