Paula J. Clarke

Efficacy of a reading and language intervention for children with Down syndrome: a randomized controlled trial

Background This study evaluates the effects of a language and literacy intervention for children with Down syndrome. Methods Teaching assistants (TAs) were trained to deliver a reading and language intervention to children in individual daily 40-min sessions. We used a waiting list control design, in which half the sample received the intervention immediately, whereas the remaining children received the treatment after a 20-week delay. Fifty-seven children with Down syndrome in mainstream primary schools in two UK locations (Yorkshire and Hampshire) were randomly allocated to intervention (40 weeks of intervention) and waiting control (20 weeks of intervention) groups. Assessments were conducted at three time points: pre-intervention, after 20 weeks of intervention, and after 40 weeks of intervention. Results After 20 weeks of intervention, the intervention group showed significantly greater progress than the waiting control group on measures of single word reading, letter-sound knowledge, phoneme blending and taught expressive vocabulary. Effects did not transfer to other skills (nonword reading, spelling, standardised expressive and receptive vocabulary, expressive information and grammar). After 40 weeks of intervention, the intervention group remained numerically ahead of the control group on most key outcome measures; but these differences were not significant. Children who were younger, attended more intervention sessions, and had better initial receptive language skills made greater progress during the course of the intervention. Conclusions A TA-delivered intervention produced improvements in the reading and language skills of children with Down syndrome. Gains were largest in skills directly taught with little evidence of generalization to skills not directly taught in the intervention.

Accessing and selecting word meaning in autism spectrum disorder.

BACKGROUND Comprehension difficulties are commonly reported in autism spectrum disorder (ASD) but the causes of these difficulties are poorly understood. This study investigates how children with ASD access and select meanings of ambiguous words to test four hypotheses regarding the nature of their comprehension difficulties: semantic deficit, weak central coherence, reduced top-down control and inhibition deficit. METHODS The cross-modal semantic priming paradigm was used. Children heard homonym primes in isolation or as final words in sentences biased towards the subordinate meaning and then named picture targets depicting dominant or subordinate associates of homonyms. RESULTS When homonyms were presented in isolation, children with ASD and controls showed priming for dominant and subordinate pictures at 250ms ISI. At 1,000ms ISI, the controls showed dominant (but not subordinate) priming whilst the ASD group did not show any priming. When homonyms were presented in subordinate sentence contexts, both groups only showed priming for context-appropriate (subordinate) meanings at 250ms ISI, suggesting that context has an early influence on meaning selection. At 1,000ms ISI the controls showed context-appropriate (but not inappropriate) priming whereas the ASD group showed both appropriate and inappropriate priming. CONCLUSIONS Children with ASD showed intact access to semantic information early in the time course of processing; however, they showed impairments in the selection of semantic representations later in processing. These findings suggest that a difficulty with initiating top-down strategies to modulate online semantic processing may compromise language comprehension in ASD. Implications for intervention are discussed.

Accessing, Integrating, and Inhibiting Word Meaning in Poor Comprehenders

This study examined three processes crucial to reading comprehension (semantic access, integration, and inhibition) to identify causes of comprehension impairment. Poor comprehenders were compared to chronological-age controls and vocabulary-age (VA) controls. When listening to homonym primes (“bank”) versus unrelated primes, controls were faster to name pictures related to dominant (money) and subordinate (river) meanings at 250 ms interstimulus interval (ISI) but only showed dominant priming at 1,000 ms ISI, whereas poor comprehenders only showed dominant priming. When listening to subordinately biased sentences ending in homonyms (“John fished from the bank”) versus control sentences, all groups showed priming when naming subordinate (appropriate) pictures at 250 ms ISI: VA controls and poor comprehenders also showed priming when naming dominant (inappropriate) pictures. At 1,000 ms ISI, controls showed appropriate priming, whereas poor comprehenders only showed inappropriate priming. These findings suggest that poor comprehenders have difficulties accessing subordinate word meanings, which can manifest as a failure to inhibit irrelevant information.

Recollection in adolescents with Autism Spectrum Disorder.

INTRODUCTION Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder primarily affecting social interaction and communication. Recently, there has been interest in whether people with ASD also show memory deficits as a result of abnormal brain development. However, at least in adolescents with ASD, the recollection component of episodic memory has rarely been explored. This paper is an evaluation of recollection in three different experiments in adolescents with ASD, using both objective (source discrimination) and subjective methods (Remember-Know judgments). METHODS Three experiments were designed to measure different aspects of contextual information: sensory/perceptual information (Experiment 1), temporal information (Experiment 2) and spatial information (Experiment 3). To measure objective and subjective recollection, for all three experiments, all participants were presented with information to learn in a specific context. At the recognition stage, they were asked whether they remembered the information or just knew the information was there (R/K response, subjective method). To assess the quality of these subjective judgments, participants justified their Remember responses using the contextual information. After the recognition task, to assess source memory (objective measure), all items presented at encoding were represented and participants have to recall the source for all these items. RESULTS All three experiments showed that adolescents with ASD could correctly recall source information. However, in the first experiment adolescents with ASD gave significantly fewer Remember responses than controls. CONCLUSIONS These findings point to a specific and subtle recollection impairment in adolescents with ASD, at least when subjective methods are used. We discuss how these might relate to differences in the self and to the brain abnormalities in ASD.

Reading comprehension impairments in Autism Spectrum Disorders

Les enfants porteurs d’un Trouble du spectre autistique (TSA) presentent, pour la plupart, des difficultes de comprehension avec un niveau de lecture relativement correct. Ces etudes sont peu nombreuses et rares sont celles qui ont examine les competences de base necessaires a l’apprentissage de la lecture (e.g. le decodage phonologique) chez ces enfants. Dans cette etude, 49 enfants porteurs d’un TSA et 49 enfants tout-venant de meme âge sont evalues en lecture (mots, textes, comprehension), en decodage phonologique (lecture de pseudomots) et en vocabulaire. La lecture de mots et celle de textes (exactitude) sont de niveau similaire dans les deux groupes. En revanche, la comprehension en lecture et les connaissances du vocabulaire sont plus faibles chez les TSA. Environ 31% des TSA presentent un ecart entre la comprehension et la lecture de mots (compares a 10% chez les enfants tout-venant). Lorsque les deux groupes sont apparies en lecture de mots, les enfants porteurs d’un TSA presentent malgre tout un faible niveau de decodage phonologique. Alors que le decodage phonologique represente un predicteur significatif du niveau de comprehension en lecture chez les TSA, ce n’est pas le cas pour le groupe d’enfants tout-venant. L’ensemble de ces donnees suggere que le niveau de lecture ‘apparent’ des enfants porteurs d’un TSA masque des difficultes basiques dans le decodage phonologique. Ces difficultes associees a celles observees en comprehension orale limite le developpement de la comprehension en lecture chez les enfants porteurs d’un TSA.

The poor comprehender profile: Understanding and supporting individuals who have difficulties extracting meaning from text

Publisher Summary This chapter illustrates the components of reading comprehension and how they can fractionate in reading disorders. The focus has been on providing a picture of current understanding of the poor comprehender profile, as well as introducing the issues and key questions pertinent to this field. It is recognized that the simple view is useful in distinguishing the dyslexic and poor comprehender profiles and capturing the basic skills fundamental to successful reading. The simple view, however, fails to explain the complexities in reading comprehension, and to do this, alternative models, such as the construction-integration model need to be considered.

Reading Intervention for Poor Readers at the Transition to Secondary School

ABSTRACT This study evaluated two 20-week reading interventions for pupils entering secondary school with reading difficulties. The interventions were delivered by trained teaching assistants (three 35-min sessions per week). 287 pupils (ages 11–13) from 27 schools were randomly allocated to three groups: reading intervention (targeting word recognition and decoding skills), reading intervention plus comprehension, or a waiting list control group. Neither intervention produced statistically significant gains in word reading but the reading intervention plus comprehension intervention produced significant gains in reading comprehension (d = 0.29) and vocabulary (d = 0.34). Further evaluations of methods to improve word reading in this population are needed.