The Impact of a Visualizing and Verbalizing Intervention on Language Ability in Children with Autism Spectrum Disorders

Background:  Deficits in language comprehension have been widely reported in children with autism spectrum disorders (ASD). Such deficits generally range from lack of functional speech to difficulties in comprehension and discourse processing (Tager-Flusberg et al., 2005). Deficits in language result in variable reading profiles in individuals with ASD, the most common being that of poor comprehension despite adequate decoding skills (Nation et al., 2006). Improving reading comprehension in children with ASD is a challenging task. The Visualizing and Verbalizing for Language (V/V) Intervention program (Bell, 1991; Torgeson et al., 1999) targets visual imagery skills of children with language disabilities to help them improve both oral and reading comprehension.  

Objectives:  The goal of the present study was to investigate the impact of a 10-week intensive V/V language intervention on reading and language abilities in high-functioning children with ASD. 

Methods:  Children (ages 8-13 years) with ASD were randomly assigned to an Intervention group (n = 23) or Wait-List Control group (n = 18). Additionally, children with typical development (n= 26) were recruited as a control group.  Children in the Intervention group received the V/V training, a one-on-one intervention that lasted 10 weeks (total = 200 hours of direct instruction). All children with ASD were tested on a variety of neuropsychological measures at baseline and at 10 weeks.

Results:  (1) At baseline, the Intervention group had significantly lower scores than the control group on their reading comprehension (t(47)=-6.24, p=.000) on the Gray Oral Reading Test-4 (GORT-4), receptive vocabulary (t(47)=-2.43, p=.02) on the Peabody Picture Vocabulary Test-4 (PPVT-4), expressive vocabulary (t(47)=-1.97, p=.05) on the Expressive Vocabulary Test-2 (EVT-2), and oral comprehension (t(46)=-2.63, p=.01) on the Oral Directions subtest of the Detroit Tests of Learning Aptitude-2 (DTLA-2); (2) After 10 weeks, the Intervention group did not differ from the control group on their scores on the PPVT-4, EVT-2, or DTLA-2. The Wait-List Control group did not show this pattern of results at pre- or post-testing; and (3) The Intervention group significantly improved their reading comprehension scores on the GORT-4 following intervention (F(1,21)=15.06, p=.001, partial eta squared=.418).

Conclusions:  The language intervention in this study was designed to use nonverbal sensory input to develop oral and written language comprehension, establish vocabulary, and develop higher order thinking skills. Our findings revealed that following intervention, children with ASD improved their receptive and expressive vocabulary, as well as oral comprehension to the level of typically developing control children. The intervention group also showed an improvement in their comprehension from first session to the second. Overall, our findings suggest that the V/V program appears helpful in improving vocabulary and oral comprehension abilities in children with ASD. More research, with larger samples, is needed to further establish the effectiveness of this program on reading comprehension abilities in children with ASD.