Adam’s Case Study: Literacy in Autism

Literacy in autism is not well understood. When we meet a preshooler with autism, most of us have no idea how to help that child learn to read and comprehend.

Adam is currently in grade three in a public school. If you were to meet him in the hallway, you would recognize that he has autism.

  • He would most likely remain silent if you talked to him.
  • He tends to use a whispered voice.
  • He might glance at you and then dart away.
  • There would probably be an assistant with him in the hallway, to prompt him and keep him safe.

If you were to follow Adam into his classroom, your impression of him would change dramatically.

  • Adam can comprehend books at grade level and keep up with the curriculum.
  • He can write with a pencil and excels at using a computer.
  • He spells better than most of the students in his class.

How did a little boy with autism develop such excellent literacy skills? Why has Adam been successful in keeping up with his peers in spite of the profound sensory processing difficulties that are part of his autism? Adam’s parents have faithfully used Fast ForWord software with him at home for the past four years.

Click on the link to jump forward in this post.

Literacy in Autism during the Preschool Years

Literacy in Autism in Kindergarten

Literacy in Autism in Grade One

Literacy in Autism in Grade Two

Literacy in Autism in Grade Three

Literacy in Autism during the Preschool Years

Adam’s First Program: Fast ForWord Reading Readiness

When Adam was a preschooler, his parents contacted me. I’m a private speech-language pathologist. I introduced him to Fast ForWord Reading Readiness. This was installed on his home computer so he could use it every day at home.

Adam learned to use a mouse, match shapes and colours and match upper and lower case letters. He then learned to listen and click and drag shapes like “large red circle” or “small green square.”

Weekly Progress Reports Provided Proof of Improvement

The Fast ForWord software programs have a backend for administrators. Clinicians can change settings, view the usage data and create progress reports. I emailed Adam’s parents a progress report every week.

The following graph shows some long flat spots. Fast ForWord software is adaptive. It does not move up if the student is making mistakes. It will repeat at the current level.

When Adam became more accurate, the Fast ForWord Reading Readiness program moved up. The stagger-step pattern in the data was evidence that the software was working. It was proof that Adam was learning to listen and respond accurately. The burst of progress after a long flat spot was very encouraging for Adam’s parents.

autism case study following directions

Why did Adam Start to Improve?

One of the features of autism is the inconsistent sensory attentiveness. Sometimes it is too high and at other times it is too low. The intense repetition that Fast ForWord provides through discrete trial training has the power to break through the sensory barriers.

In short, I think Adam became better at following directions because Fast ForWord software provided the intensity he needed. (This was our first success. I knew there was still a lot of work ahead.)

Literacy in Autism in Kindergarten

Continuing in the Fast ForWord Readiness Program

Adam didn’t have the listening skills expected for kindergarten. Phonemic awareness refers to the skill of distinguishing the difference between speech sounds. The only change in the following words is a change in the vowel. The vowel is a phoneme. This tiny change in sound alters the meaning of the word.

Only one tiny phoneme is changing but the meaning is changing dramatically: hut, heat, hit, hat, hoot, hot, hate.

A phoneme can also be added to a word to change the meaning. For example, plural S is a phoneme: hat, hats.

To understand language, children must be able to discriminate between phonemes quickly and accurately. In the following graph, you can see that Adam started to have success with phonemic awareness after Day 50 in the Reading Readiness programs. His parents didn’t give up.

autism case study phonemic awareness

Adam’s Second Program: Fast ForWord Language

Adam eventually finished his first program, so I started him on the Fast ForWord Language program. (I didn’t feel very confident that he would be able to handle it because he was still very inattentive.)

Auditory Word Recognition

It was Adam’s first exposure to the patented stretched speech signal in the Fast ForWord programs. The games did not have any text. (We were thrilled when Adam started listening to words carefully.) For example, he could hear the contrast between “breathe” and “breeze” and find the right picture.

This was the beginning of true listening comprehension, not supported with printed words. (I think the slowed speech signal was exactly was he needed, because he had success right from the beginning.)

autism case study auditory word recognition

Following Complex Directions

Adam’s ability to follow directions stayed at the same level for a long time. For example, he could understand a short message like “Touch the green circle.” This success was seen in daily life too. He was happy to comply with requests like, “Get your shoes. Find your pencil.”

Despite lots of effort, Adam could not understand more complex instructions like, “Put the green circle beside the red square.” Long instructions were too much for him. His 12-month license expired before he could finish all the games in the Fast ForWord Language program.

autism case study complex directions

Adam’s First Reading Assessment

Here is Adam’s result on the Diagnostic Online Reading Assessment, done in May of his kindergarten year. You can see that his spelling was almost at the grade 2 level. In contrast, he had a lot of trouble with the phonemic awareness subtest.

autism case study reading assessment in kindergarten

Savant Skill: Spelling that was Better than Expected

Some children with autism love the alphabet and become fixated on it. Some of them develop skills that are far in advance of what would be considered normal. This is referred to as a  savant skill. Adam’s terrific spelling, contrasted with his poor performance on tasks that tested his phonemic awareness, was highly unusual.

In the general population, it is very rare to see above average spelling skills in a child with poor listening and poor language comprehension. When I see this type of profile, I know that the student is relying heavily on visual memory.

(At this point, I was impressed with Adam’s memory. It was sobering to realize how intelligent he was.)

Literacy in Autism in Grade One

Adam’s Third Program: Fast ForWord Reading One

Adam loved the alphabet, so I started him on Fast ForWord Reading One. The games use vocabulary from the Dolch word lists for the primary grades. The speech signal is at a normal rate. Once Adam got rolling on the spelling game, he improved at a steady rate, requiring very little repetition.

autism case study spelling

Hyperlexia: Reading Words without Understanding Them

Like so many children with autism, Adam was hyperlexic. This means he could decode words well beyond his comprehension level. Semantics – the meaning of words – is explicitly taught in Fast ForWord Reading One by asking children to sort words into categories. For example:

  • Things you wear
  • Things you eat
  • Types of vehicles

The next graph shows the agony. (I’m always stunned when I see data like this.) What teacher or parent would provide this many repetitions? Fast ForWord software is calmly persistent.

Adam stayed in the Fast ForWord Reading One program for 191 sessions, taxing the ability of the software to graph his progress.

autism case study vocabulary

Adam’s Fourth Program: Second Attempt at Fast ForWord Language

Adam’s parents agreed with me that we had to keep working on his listening comprehension. It is the foundation for reading comprehension. He needed the ability to comprehend full sentences, not just single words and short phrases.

They were willing to start at the beginning of Fast ForWord Language again. My company had a site license by this time, so there was less financial risk if it didn’t work.

This time Adam was much more successful! All the comprehension games improved nicely. The only game that presented ongoing difficulty was Sky Gym, which uses high and low tones rather than speech sounds. (I’ve seen this problem in other children with autism so I wasn’t surprised that it was Adam’s nemesis.)

autism case study language

Literacy in Autism in Grade Two

Adam’s Fifth Program: Fast ForWord Reading Two

After Adam finished Fast ForWord Reading One and Fast ForWord Language, he was ready for the Fast ForWord Reading Two program.

Hyperlexia: Spelling is Easy; Comprehension is Hard

The data in the following graph gives you a picture of Adam’s hyperlexia. The three games that reached 100% early were devoid of any comprehension demands (i.e. Bear Bags, Fish Frenzy, Magic Bird).

The three games that required language comprehension improved more slowly, but he made it to 100% in every game. This would not have been possible without the patient supervision provided by his parents day after day.

autism case study reading 2 Adam’s Second Reading Assessment

I re-administered the Diagnostic Online Reading Test in March of Adam’s grade two year. He scored at the expected levels in all areas. (I was so proud of him.)

autism case study reading assessment 2

Comprehension Improved by Three Grade Levels

The following chart compares Adam’s results from kindergarten and grade two. The abbreviations match the sections in the bar graph above. For example, HFW is high frequency words.

During this two year period, Adam’s literacy skills evened out. The foundational skills that he was missing became much stronger.  He finally scored in the good range for phonemic awareness. The most impressive outcome was that his comprehension improved by three grade levels.
autism case study improvement

Literacy in Autism in Grade Three

Adam’s Sixth Program: Fast ForWord Language to Reading

Adam is currently working on his sixth and seventh programs. The Fast ForWord Language to Reading program is helping Adam with memory, attention, processing speed and sequencing.

Adam’s struggles with comprehension are not over. The Cosmic Reader game gives you a picture of how much repetition is needed for Adam to make gains in comprehension.

autism case study language reading

Adam’s Seventh Program: Fast ForWord Reading Three

The Fast ForWord Reading Three program spans several grades. It is not equivalent to a grade 3 curriculum. (I have often used it with high school students.)

  • The Chicken Dog game is a spelling game. It is not surprising that Adam reached 100% in this game first.
  • The games Canine Crew and Scrap Cat both show a stagger-step pattern. This is proof that the software is providing exactly what Adam needs.

autism case study reading 3

It is rare for Adam to have immediate success. He benefits enormously from intensive repetition. This is how he has acquired such strong literacy skills despite the profound sensory processing difficulties that are part of his autism.

If you have questions, please send me an email or book a phone call to discuss your concerns.

About the Author Neuroplan

Online speech language therapy and literacy apps. We offer treatment programs for people who struggle with Dyslexia, Learning Disabilities, ADD/ADHD, Autism, Auditory Processing, Acquired Brain Injury, Stuttering and English Literacy.

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