The Impact of Attention on Reading in Adolescents with Autism Spectrum Disorder

Background: Research suggests that attention plays an important role in the development of reading skills even after controlling for other known predictors of reading such as general cognitive functioning (IQ; e.g., Rabiner & Coie, 2000) and receptive language skills (e.g., Cain & Bignell, 2013). Most research examining the relationship between attention and reading has been conducted with either typically developing (TD) children (e.g., Dally, 2006; Rabiner & Coie, 2000), or with individuals with Attention-Deficit Hyperactivity Disorder (ADHD) and/or reading disorders (e.g., Kibby et al., 2014; Stern & Shalev, 2013). Less research has been conducted with students with Autism Spectrum Disorder (ASD). The few studies that have examined the relationship between attention and reading in ASD samples suggest that word reading skills are associated with sustained attention (May et. al, 2013; Mayes and Calhoun, 2007). For TD populations, sustained attention has been more strongly associated with reading comprehension skills (e.g., Arrington et al., 2014).

Objectives: The aim of the present study was to examine the relationship between sustained attention and two specific reading abilities; word reading skills and reading comprehension. In addition, we examined if sustained attention adds to the prediction of word reading and reading comprehension above and beyond two other known predictors of reading; IQ and receptive language skills.

Methods: The study included 22 adolescents (M_age = 14.3 years old) recruited from a school providing services to students with special education needs presenting with a primary diagnosis of ASD. Most participants had below average general cognitive functioning (M_FSIQ= 62.3, SD= 22), as defined by the full-scale IQ of the WASI-II (Wechsler, 2011). Attention was measured using the d’ score of the Conners’ Continuous Performance Test 3rd Edition (CPT 3; Conners, 2014), a computerized attention task. Reading performance was assessed on the Word Reading and Reading Comprehension subtests of the Wechsler Individual Achievement Test-Third Edition (WIAT-III; Wechsler, 2009). Receptive language skills were assessed on the Listening Comprehension subtest of the WIAT-III.

Results: Word Reading scores were not significantly correlated with any predictors (FSIQ, listening comprehension performance, attention). Reading Comprehension scores were correlated with FSIQ (r= .43, p<.05), attention (r=-.76[1], p<.01), and listening comprehension (r=.70, p<.01). A multiple regression analysis was conducted with Reading Comprehension as the outcome measure and the three predictors as the independent variables. The predictors explained 72.8% of the variance in reading comprehension (R² =.73, F(3,16)=14.28, p<.01). Listening comprehension (β = .44, p<.05) and attention (β = .44, p<.05) were significant predictors of reading comprehension in the regression but FSIQ was not.

[1] On the CPT-3, a greater score indicates a poorer performance.

Conclusions: Our results suggest that for adolescents with ASD and lower than average cognitive functioning, sustained attention and receptive language skills both play a significant role in reading comprehension. A better understanding of the cognitive factors influencing reading achievement could have a number of implications regarding how reading difficulties in students with ASD can be remediated, such as targeting attention to remediate reading difficulties in students who do not respond to traditional reading interventions.