How Do Children with Autism Spectrum Disorder Understand What They Read?

Background: Extracting information from written material is a pillar of academic success. For most children with ASD, making sense of what they read – reading comprehension – is a noted area of challenge. To support these children’s academic progress, we must understand the component skills contributing to their reading comprehension. Research suggests that children with ASD draw on two broad skills: word reading, the ability to identify words, and oral language, used to attach meaning to these words. Children with ASD tend to have advanced word reading abilities relative to their levels of reading comprehension, which when marked is referred to as hyperlexia. This raises questions about the relative importance of each component skill in the reading comprehension of children with ASD.

Objectives: This study seeks to improve our understanding of the mechanisms by which children with ASD understand what they read. Specifically, this study asks, what are the relations between reading comprehension and (a) word reading, (b) oral language, and (c) component skills of oral language for children with ASD?

Methods: In this systematic literature review, we searched four major databases, using autis*, child*, reading, literacy, and academic achievement as search terms. Studies were selected that included both reading comprehension and word reading measures from school-aged, monolingual English-speaking children with ASD. A meta-analysis was then conducted using 27 studies with data from 1018 children.

Results: Descriptive Statistics. These studies reported a wide range of word reading and reading comprehension abilities. Average standard scores for word reading ranged from 82.29-109.05, and for reading comprehension from 74.3-107.59. Consistent with a hyperlexic profile, in all but one study, the average word reading score was greater than that for reading comprehension, with the mean difference ranging from -4.84 to 29.9.

Results: Meta-analysis. Similar mean correlations were found between reading comprehension and (a) word reading (M r=0.685 [0.574-0.771], n=27 studies), and (b) oral language (M r=0.653 [0.579-0.716], n=24). Among the components of oral language skills, relations were also similar between reading comprehension and (a) vocabulary (M r=0.709 [0.563-0.811], n=9), and (b) sentence-level abilities (M r=0.701 [0.580-0.791], n=5).

Conclusions: Our results demonstrate that word reading and oral language are essential to reading comprehension for children with ASD. This finding may seem surprising given the noted hyperlexic profile of some children with ASD, which at its extreme suggests word reading in the absence of understanding. However, many assertions about reading comprehension are based on group comparisons between children with and without ASD. In our view, oral language has been over-emphasized in understanding reading comprehension because children with ASD often show more marked difference in this area. By looking within samples of children with ASD, and not only in relation to children with typical development, this study reveals key insights as to the relation between both component skills, word reading and oral language, and reading comprehension for these children. In sum, this study provides a necessary foundation for further studies of the mechanisms that underlie reading comprehension for children with ASD.