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Westerveld PUB6044
Westerveld PUB6044
Westerveld PUB6044
A high percentage of children with Autism Spectrum Disorder (ASD) show elevated challenges in learning to read. We
investigated longitudinal predictors of reading skills in 41 children diagnosed with ASD. All children completed measures
of precursor literacy skills at the age of 4–5 years, including phonological awareness, letter sound knowledge, rapid auto-
matic naming, name writing, and phonological memory (digit span), along with measures of word- and passage-level
reading skills in their first year of formal schooling. Nonverbal cognition and letter sound knowledge accounted for
53.4% of the variance in regular single word reading at school age, with letter sound knowledge a significant individual
predictor. Overall, 18 children showed reading ability scores in the average range on a standardized test of passage-level
reading ability, whereas 23 children performed below expectations. These groups differed significantly on all precursor lit-
eracy measures (at ages 4–5), except autism symptoms based on parent report. Group membership was significantly pre-
dicted by preschool receptive vocabulary, name writing, and rapid automatic naming, with high sensitivity and
specificity. These results are discussed in reference to the literature describing early literacy predictors for typically devel-
oping children, highlighting key areas for future intervention and support. Autism Res 2018, 11: 1332–1344. © 2018
International Society for Autism Research, Wiley Periodicals, Inc.
Lay summary: Children with autism are at increased risk of persistent reading difficulties. We examined whether pre-
school reading-related skills linked to later reading ability. Performance on the following three tasks administered at pre-
school predicted children who showed early reading success versus below expectations in their first year of school:
vocabulary, name writing, and rapid naming of familiar objects and shapes. These results can inform future
interventions.
From the Griffith Institute for Educational Research, Griffith University, Brisbane, Queenland, Australia (M.F.W.); Cooperative Research Centre for Living
with Autism, Brisbane, Queenland, Australia (M.F.W., J.P., K.O.L., D.T.); Menzies Health Institute Queensland, Gold Coast, Queensland, Australia (M.F.W., J.P., D.T.);
Received October 17, 2017; accepted for publication June 10, 2018
Address for correspondence and reprints: Marleen Westerveld, School of Allied Health Sciences, Griffith University, Griffith Health Centre G40 2.70,
Queensland, 4222, m.westerveld@griffith.edu.au
Published online 26 August 2018 in Wiley Online Library (wileyonlinelibrary.com)
DOI: 10.1002/aur.1999
© 2018 International Society for Autism Research, Wiley Periodicals, Inc.
The current study builds on previous research by evaluat- Participants included 41 children (35 male, 6 female)
ing the links between preschool precursor literacy skills whose parents agreed to follow-up from the initial cohort
and reading accuracy abilities in a group of children with of 57 (72%). Those who declined participation reported
ASD who were in their first year of schooling. It extends change of location out of state (n = 3), being unavailable
previous research in several ways. First, it used a for assessment (n = 3), or challenges in child behaviors
more comprehensive battery of emergent literacy tasks perceived to limit capacity to complete a test session
to include the five main predictors of early reading (n = 2). Parents of two children did not provide reasons
Measures
Table 1. Participant Characteristics at Time 1 (Preschool)
and Time 2 (Year 1) Time 1. Measures collected at Time 1 as part of our ini-
n Mean Range SD tial study [Westerveld et al., 2017] are summarized below.
For further details on measures please refer to Westerveld
Time 1 et al. [2017]. For participant performance, please see
Gender (M/F) 35/6
Age (months) 41 57.6 49–70 5.7
Table 1.
DevtQuotient 41 78.1 44–119 20.6 Autism symptoms: The SCQ [Rutter et al., 2003] was
PPVT-SSa 41 78 64–127 16.1 completed by the primary caregiver, and the total raw
SCQ 41 15.8 5–32 6.0 score was used as a measure of autism symptoms
LSK 41 8.6 0–25 8.9 (max 40).
PA 41 6.3 0–10 4.2
Name writing 41 3.6 0–7 2.5
Receptive vocabulary: The PPVT-4 [Dunn & Dunn,
RAN-SS* 41 88.1 55–136 25.2 2007] was used to assess receptive vocabulary. SSs were
Digits 41 89.0 28–139 25.2 calculated and used for analysis.
Nonverbal cognition: The visual reception and fine
Time 2 motor subtests of the MSEL [Mullen, 1995] were adminis-
Gender (M/F) 35/6
Age (months) 41 73.4 66–81 4.5
tered. A DQ was calculated by dividing the child’s average
Months of schooling 41 9.2 4–12 2.0 age-equivalent score across these two subtests by the
CELF-P2 CLS* 38 75.6 45–122 20.5 child’s age [see Bishop, Guthrie, Coffing, & Lord, 2011].
Phonological awareness: The beginning sound aware-
Note. PPVT, Peabody Picture Vocabulary Test; SCQ, Social Communica-
ness subtest from the Phonological Awareness Literacy
tion Questionnaire; LSK, Letter sound knowledge; PA, phonological aware-
ness, RAN, rapid automatic naming; CELF-P2 CLS, Clinical Evaluation of
Screening for Preschoolers (PALS-PreK) [Invernizzi, Sulli-
Language Fundamentals—Preschool 2nd Edition, Core Language Score. van, Meier, & Swank, 2004] was administered. This test
a
SSs (scores between 85 and 115 are WNL). has been specifically designed for 4-year-old children and
SCQ – 0.02 0.03 −0.07 −0.05 0.02 −0.17 0.02 0.05 −0.01
PPVT 0.72** 0.30 0.45** 0.49** 0.40* 0.60** 0.45** 0.51**
DevtQuotient – 0.32* 0.20 0.48** 0.38* 0.55** 0.45** 0.50**
LSK – 0.63** 0.47** 0.57** 0.45** 0.71** 0.73**
PA – 0.38* 0.34* 0.38* 0.53** 0.49**
Name writing – 0.30 0.57** 0.50** 0.56**
RAN – 0.29 0.53** 0.54**
Digits – 0.41** 0.45**
RWReading – 0.92**
YARCbeg –
Note. SCQ, Social Communication Questionnaire; PPVT, Peabody Picture Vocabulary Test; LSK, letter sound knowledge; PA, phonological awareness;
NW, name writing; RAN, rapid automatic naming; Digits, digit span; RWreading, regular word reading; YARCbeg, beginner passage ability score on the York
Assessment of Reading for Comprehension.
*P < 0.05 level.
**P < 0.01 level.
including DQ and LSK was statistically significant, nonsignificant terms (P > 0.10) removed using backward
F (2, 36) = 22.80, P < 0.001, adjusted R2 = 0.534, account- conditional elimination. Only three of the variables
ing for 53.4% of the variance in single word reading remained significant, PPVT-SS, Name writing, and RAN.
ability. Variables in this model included DQ (β = 0.24, The nonsignificant predictors were removed, and the
t = 2.00, P = 0.053) and LSK (β = 0.64, t = 5.40, P < 0.001). logistic analysis was rerun entering PPVT-SS, Name writ-
The addition of LSK to DQ resulted in a statistically sig- ing, and RAN. Table 5 shows the results of the final
nificant increase of 35.5% (adjusted R2) of the variance in model. Note that the log likelihood changed from
single word reading, F(1, 36) = 29.21, P < 0.001. 16.41 at Step 1 to 17.76 at Step 5 and that the Hosmer
and Lemeshow goodness of fit test was nonsignificant
Prediction of Group Membership (P = 0.73), indicating the model is not a poor fit. The
model was statistically significant, χ2(3) =38.79, P < .001.
To answer research question two, we investigated pre-
school group differences in nonverbal cognition, vocabu-
lary, and precursor literacy skills. As reported in the data Table 4. Group Comparisons of Average (n = 17) Versus
screening section, one case was removed for analysis Below Average Readers (n = 23) on Preschool Measures
based on the studentized residual, leaving 40 cases for Below
this part of the analysis. Children who scored within the Average average
normal range (SS > 85) on the YARC reading accuracy readers readers
(passage reading ability) were considered average readers Mean (SD) Mean (SD) Cohen’s
(n = 17), whereas children who scored below SS85 or who Variable range range t P d
could not complete the beginner passage (n = 2) were SCQ 16.6 (6.4) 15.5 (5.8) .601 0.551 0.18
categorized as “below average” readers (total n = 23). We 7–32 5–28
conducted independent t tests (with Bonferroni adjust- DQ 89.1 (16.6) 68.7 (18.5) 3.618 0.001 1.16
ment for multiple comparisons) and adjustment for het- 65–119 44 - 108
erogeneity of variance when needed (LSK, PA, and RAN). PPVT-SS 99.4 (13.7) 80.1 (10.0) 5.142 <0.001 1.61
76–124 64–102
As shown in Table 4, the average readers performed LSK 15.1 (9.0) 3.7 (5.2) 4.700 <0.001 1.55
significantly better on all tasks compared to the below 0–25 0–20
average readers. There were no group differences in PA 9.1 (2.1) 4.2 (4.0) 4.749 <0.001 1.53
autism severity (SCQ; P = 0.551), nor age at follow up 0–10 0–10
(P = 0.379), or time spent at school (P = 0.932). NW 5.1 (2.1) 2.3 (2.1) 4.148 <0.001 1.33
1–7 1–7
To answer research question three, a binomial logistic RAN-SS 104.7 (18.1) 75.7 (18.6) 4.920 <0.001 1.58
regression was performed to determine if we could pre- 64–136 55–119
dict reading group membership in Year 1 using preschool Digits 103.3 (22.4) 77.3 (22.4) 3.715 0.001 1.16
variables (PPVT-SS, DQ, LSK, PA, Name writing, RAN, 62–139 28–120
and Digit span). We did not include SCQ, based on the
Note. SCQ, Social Communication Questionnaire; DQ, developmental
results of the independent t tests. Consistent with the quotient; PPVT, Peabody Picture Vocabulary Test; LSK, letter sound knowl-
exploratory nature of our analysis, all variables of interest edge; PA, phonological awareness; NW, name writing; RAN, rapid auto-
were initially entered into the logistic model and matic naming; Digits, digit span, ability score; SS, standard score.
Note. PPVT, Peabody Picture Vocabulary Test; NW, name writing; RAN, rapid automatic naming; SS, standard score.
The model explained 80.8% (Nagelkerke R2) of the vari- subsequent analyses. At this early stage of formal school-
ance in reading group membership and correctly classi- ing, we also found strong correlations between regular
fied 92.5% of cases. Furthermore, sensitivity of the model single word reading and beginner passage reading, indi-
(how well the model predicted which children would end cating both tasks tapped into a similar skill (i.e., the abil-
up in the average reader group) was high (94.1%), and so ity to read single words). We found wide variability across
was specificity (how well the model predicted which chil- both reading measures, ranging from 0 to maximum in
dren would end up as below average readers) at 91.3%. single word reading and from very low to average range
in beginner passage-reading ability relative to their age
and stage of schooling. Finally, a subset of children
Discussion showed performance within normal limits on the stan-
dardized test of passage-reading ability, however approxi-
The present study investigated the preschool predictors mately half showed significant challenges, with
of reading ability in a group of children with ASD who 20 children unable to complete the standardized passage
were in their first year of schooling. The findings of our reading task. This finding is in line with results found in
initial study [Westerveld et al., 2017] indicated early previous research, showing wide variation in perfor-
strengths in print-related emergent literacy skills in a mance in reading ability in school-age children with
group of verbal preschoolers with ASD, including alpha- ASD, as well as up to 50% displaying challenges [e.-
bet knowledge and PA, but noted wide variability in per- g., Arciuli et al., 2013; Nation et al., 2006].
formance consistent with previous investigations Our first research question asked which preschool vari-
[e.g., Lanter, Watson, Erickson, & Freeman, 2012]. The ables including nonverbal cognition, vocabulary, and
current study tracked this cohort of children, who partici- precursor literacy skills predicted word reading ability
pated in a battery of reading tasks when they had com- during the first year of formal schooling. We found non-
pleted between 4 and 12 months of formal education. verbal cognition predicted a significant proportion of the
We were able to predict 53.4% of the variance in regular variance (17.9%) in regular single word reading ability.
single-word reading ability when entering nonverbal cog- These results are consistent with results from previous
nition at Step 1, and adding preschool LSK at Step 2. Our studies confirming the important correlations between
results further revealed that approximately 50% of this nonverbal cognition and reading ability in both typically
group of participants showed difficulties in reading on a developing children and in children with ASD [Catts,
standardized test of passage reading ability. Finally, group Herrera, Nielsen, & Bridges, 2015; Davidson & Ellis Weis-
membership (average vs. below average readers on pas- mer, 2014; Lanter et al., 2012; Nation & Snowling,
sage reading ability at the end of their first year of school- 2004]. Our results further showed that LSK was the only
ing) could be predicted with 92.5% accuracy based on significant independent predictor, once nonverbal cogni-
preschool performance in vocabulary, name writing, and tion was entered into the model. Together, nonverbal
RAN. These results advance our understanding of the cognition and preschool LSK accounted for 53.4% of the
early reading pathways of a group of children with ASD variance in regular word reading ability at the end of the
who were initially assessed prior to school entry. first year of schooling. Closer inspection of children’s per-
The group of children participated in two tasks of read- formance on the precursor literacy skills (Table 3) shows
ing ability: single word reading and passage reading. moderate correlations between LSK, PA, RAN, and digit
Although we measured single word reading across non- span, which may explain why some of these skills did
words, irregular words, and regular words, significant not emerge as significant in our model. However, the
floor effects were found for nonword reading, with strength of these correlations are very similar to those
19 children unable to obtain a score on this task. Based found in studies of typically developing children [Catts
on strong correlations between regular and irregular word et al., 2015], and confirm the importance of LSK during
reading ability scores, we selected regular word reading as the preschool years in explaining variance in early read-
our outcome measure for word reading ability in ing outcomes [Fricke et al., 2016; National Early Literacy