autism and essay writing

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Front Psychol

Reading and Writing Skills in Adolescents With Autism Spectrum Disorder Without Intellectual Disability

Inmaculada baixauli.

1 Occupational Sciences, Speech Language Therapy, Developmental and Educational Psychology Department, Catholic University of Valencia, Campus Capacitas, Valencia, Spain

Belen Rosello

2 Developmental and Educational Psychology, University of Valencia, Valencia, Spain

Carmen Berenguer

Montserrat téllez de meneses.

3 Neuropediatrics Section, Hospital la Fe de Valencia, Valencia, Spain

Ana Miranda

Associated data.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

The purpose of this study is to extend the knowledge about academic achievement in individuals with autism spectrum disorder (ASD). To this end, first, we analyzed differences in a wide range of reading and writing skills in adolescents with ASD without intellectual disability (ASD-WID) and adolescents with typical development (TD). Second, these two groups were compared on academic outcomes in core subjects and indicators of successful transition to secondary school. Third, the potential contribution of literacy skills to academic outcomes was examined in the two groups. Participants were 56 adolescents between 12 and 14 years old, 30 with ASD-WID and 26 with TD. Results showed no significant differences between the two groups on measures of reading fluency or literal and inferential comprehension. However, the performance of the group with ASD was significantly lower on reading comprehension processes that assess cognitive flexibility. Regarding their written expression skills, significant differences were observed between the group with ASD and the group with TD on most of the indicators analyzed as: productivity, lexical diversity, and overall coherence (resolution component). In addition, findings showed that the deficits in reading and writing observed in the adolescents with ASD significantly affected their academic achievement, which was lower than that of their peers with TD and below what would be expected based on their intellectual capacity. Moreover, their families’ perceptions of the transition to high school reflected worse adjustment and lower self-esteem, confidence, and motivation.

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by persistent difficulties in communication and social interactions, along with restricted interests and the presence of repetitive behaviors ( American Psychiatric Association, 2013 ). A key factor in the development of people with ASD is academic achievement, which undoubtedly contributes to access to employment opportunities and independent living. The inclusion of students with ASD in regular classrooms is a growing reality, and so it is necessary to analyze the factors that influence their educational performance.

Despite the relevance of this topic, research on the academic profile of students with ASD is limited, particularly in the adolescent stage or during the transition to secondary school. This is a complex period when important developmental changes occur, and it is characterized by greater academic and social demands. The inherent characteristics of ASD, such as difficulties in social communication, resistance to change, sensory hypersensitivity, or intolerance to uncertainty, make these students a particularly vulnerable population in this developmental period. In fact, anxiety, social pressure, and bullying have been found to be significant challenges for adolescents with ASD ( Nuske et al., 2018 ), who report negative experiences in this academic transition phase ( Makin et al., 2017 ). Therefore, identifying the variables that influence school performance and contribute to successful transition to secondary school should be a major research objective.

To date, studies that have attempted to analyze the academic performance of students with ASD have generally referred a variable performance, which is consistent with the disorder’s heterogeneity ( Keen et al., 2016 ). To account for this variability, studies have tried to establish different performance profiles in children and adolescents with diverse cognitive abilities. Thus, Wei et al. (2014) identified four distinct profiles based on five measures of academic achievement (word identification, rapid letter naming, passage comprehension, applied problems, and calculation). These profiles were the following: higher-achieving (39%, who have scored around the national average on most of the measures), hyperlexia (9%, who do well on decoding but with poor comprehension), hypercalculia (20%, with scores close to the national average on calculation skills, but significantly below average on the other four dimensions), and lower-achieving (32%, children who scored about two standard deviations below the mean on all five indicators). The higher-achieving and hyperlexia subgroups had significantly better functional cognitive skills and came from higher socioeconomic backgrounds.

Following a similar approach, Chen et al. (2019) , in a sample 7–14 years old participants with ASD with varied intelligence levels, could determine two distinct groups, low-achievement ASD and high-achievement ASD, based on their performance on four measures taken from the WIAT-II ( Weschler, 2001 ): numerical operations, mathematical reasoning, word reading, and reading comprehension. These differences were especially pronounced in the area of mathematics. As in the study by Wei et al. (2014) , the low-achievement subgroup scores were consistent with the intellectual capacity and other cognitive processes, such as working memory.

However, despite the expected relationship between cognitive ability and academic performance, other studies have identified discrepancies in this regard. Jones et al. (2009) found that approximately 70% of adolescents with ASD from 14 to 16 years old with different cognitive levels had a significant divergence between intellectual ability and one or more achievement domains. They described four subgroups in which either word reading (“reading peak” and “reading dip”) or arithmetic (“arithmetic peak” and “arithmetic dip”) was higher or lower than the WASI Full Scale Intelligence Quotient (IQ; Wechsler, 1999 ). Estes et al. (2011) identified these same differences in a sample of 30 children with ASD without intellectual disabilities. In 60% of them, a significantly lower achievement was found than what was predicted by their cognitive ability, in at least one of the domains analyzed (spelling, word reading, or basic number skills).

In conclusion, students with ASD present an irregular performance profile where intelligence plays an important role, although the research is not consistent in this regard. However, it is clear that many children and adolescents with ASD perform below what would be expected based on their intellectual capacity. Therefore, it is necessary to determine the areas of vulnerability and the factors involved in this low performance, in order to plan more appropriate and effective interventions. Certainly, in the school context, reading and writing are crucial instrumental skills and the basis for success in different curricular areas, and they have important implications throughout life, not only academically, but also socially and occupationally.

Reading Difficulties in ASD

Reading is a complex skill involving the orchestration of different components. From an overall perspective, two major processes may be distinguished as: decoding and comprehension. Decoding refers to the transformation of written words (graphemes) into phonological representations. Comprehension processes refer to the extraction of meaning from the written text. Specifically, and according to one of the most known models of reading, the Simple View of Reading Model ( Hoover and Gough, 1990 ), reading comprehension is the product of decoding skills and linguistic comprehension.

Many studies have found that people with ASD without intellectual disabilities (ASD-WID) have strengths in decoding skills, compared to their reading comprehension performance. Thus, in general, students with ASD-WID seem to master mechanisms involved in automatic word recognition, in contrast to their reading comprehension performance ( Jones et al., 2009 ; Norbury and Nation, 2011 ; Solari et al., 2017 ), which is below expectations for their chronological age or reading accuracy level ( Brown et al., 2013 ). To explain this discrepancy, good memory skills have been cited, as well as phonological and visual processing skills, which would contribute to adequate recognition of the written word.

As in the case of academic performance, the variability in reading skills has led studies to identify reading profiles in samples of children and adolescents with ASD. In a longitudinal and retrospective study, Åsberg et al. (2019) were able to determine three subgroups. A first subgroup, with “low reading performance,” which was the most frequent profile (approximately 50% of the participants), had below-average scores on both word reading and text comprehension. A second subgroup, made up of “skilled readers,” performed above average on both reading processes. Finally, the third subgroup was the least common (20%), and it was composed of “hyperlexical/low understanding” participants. Following a similar approach, namely latent profile analysis, McIntyre et al. (2017) found four different profiles in a sample of students with high-functioning autism from 8 to 16 years old: (1) readers with overall disturbance (32.2%), i.e., alterations in the decoding and comprehension processes; (2) readers with severe overall disturbance (14.1%); (3) readers with comprehension problems (20.6%); and (4) average readers (32.1%). In other words, approximately 70% of the participants experienced reading impairments, and of them, the majority had comprehension problems. Other studies using a cluster analysis methodology have also found lower reading comprehension scores than word reading scores, even in high-achieving subgroups of students with ASD ( Chen et al., 2019 ).

To determine the factors moderating reading comprehension performance in students with ASD, Brown et al. (2013) conducted a meta-analysis of 36 studies comparing ASD and control groups. The strongest individual predictors of reading comprehension were semantic knowledge and decoding skills. The study results highlight the contribution of oral language to reading comprehension, as well as the content of the texts, because individuals with ASD were significantly worse at comprehending highly social texts than less social texts.

In sum, decoding skills, language level, and text characteristics and content are variables to take into account when analyzing the reading comprehension difficulties of students with ASD. Other factors to consider are the development of comprehension strategies during reading ( Williamson et al., 2012 ) or the type of comprehension assessed (literal versus inferential) because students with ASD have shown greater difficulty with inferential comprehension processes ( Tirado and Saldaña, 2016 ). In addition to classical predictors, other cognitive factors may help us understand why students with ASD struggle with reading comprehension. Research in typical children has suggested that cognitive flexibility is positively associated with reading ( Yeniad et al., 2013 ). Cognitive flexibility requires the interaction of several mechanisms (attention shifting, conflict monitoring, and perception) that respond to specific environmental demands, such as rule changes, in order to achieve flexible behavior and to solve the problem in a new way ( Ionescu, 2012 ). Precisely, cognitive flexibility is one of the most significant affected executive function in the majority of children and adolescents with high-functioning ASD ( Lai et al., 2017 ). Therefore, it seems logical to expect that they have difficulties in deploying flexible strategies for accomplishing reading tasks.

Writing Difficulties in ASD

Similar to reading ability, good writing skills are crucial to academic and professional success. In addition, with the growing prevalence of online communication and social networks, the written expression has become a common means of daily interaction between people. Writing represents a major challenge for students with ASD. According to data provided by Mayes and Calhoun (2006) , -in a study with children and adolescents with heterogeneous IQ levels-, approximately 60% of students with ASD present some type of specific difficulty in learning to write.

Most of our understanding of the writing process has been based on the recursive and multi-layered model developed by Hayes and Flower (1980) and Hayes (2006) , which is composed of three main processes: (1) the planning process , directed to prepare the content of the text by retrieving ideas from memory and organizing them; (2) the translation process , which includes the grammatical and orthographical encoding, and the motor execution actions involved in handwriting; and (3) the revision process that allows writers to compare the written product with their mental representation of the intended text. Research on writing difficulties in ASD has mainly focused on the planning and translation processes. A meta-analysis found significantly worse performance of ASD students on several components of writing, related to the translation process (length, legibility, size, speed, and spelling) and to some indicators of the planning process, such as text structure ( Finnegan and Accardo, 2018 ). Likewise, a more recent study has demonstrated that children with ASD-WID write personal narrative texts that obtain lower ratings in holistic assessments of coherence, structure, and content, and have less lexical and syntactic complexity, in comparison with children with TD ( Hilvert et al., 2020 ). Moreover, fine motor and visuomotor speed problems ( Kushki et al., 2011 ) may often result in illegible or brief writing ( Fuentes et al., 2009 ).

Written expression difficulties of students with ASD have been found not only in narrative discourse, but also in expository and persuasive texts ( Brown et al., 2014 ; Price et al., 2020 ). In addition, their essays contain more grammatical errors and present less syntactic diversity and complexity, although they can achieve a lexical richness and coherence comparable to their peers with TD ( Hilvert et al., 2019 ).

In summary, variability is the trait that characterizes the academic performance and reading and writing abilities of students with ASD, which is linked to variables, such as intellectual ability, language level, the type of processes involved, and the characteristics of the tasks used to assess reading and writing. In any case, as students progress through the education system, there is a greater emphasis upon reading comprehension and writing expression which gives students access to school curriculum with more autonomy. The transition from primary to secondary school is one important and educational challenge. Research about the experience of young people with autism has identified a number of areas in which they may experience particular concerns compared to their TD peers, including structural/organizational and social demands. Secondary schools tend to be large, with different teachers for different subjects that students need to adapt to Maras and Aveling, (2006) . Furthermore, social complexity about forming relationships with a new peer group increases anxieties as well as academic demands of independence ( Tobin et al., 2012 ; Mandy et al., 2016 ). Our research focuses on the period of adolescence, a stage less studied in the literature, in particular, in the transition from primary to secondary school, an especially demanding challenge for individuals with ASD. Therefore, a measure of transition to secondary education of individuals with ASD without ID was included.

Consequently, the present study seeks to advance the knowledge about the reading and writing performance of students with ASD in several ways. First, there is a paucity of research on studying the relationships between reading and skills and school achievement in individuals with ASD. Second, it is carried out in Spanish, a language with a transparent spelling characterized by a series of phonological and orthographical specificities that can impact psycholinguistic processing. Third, different comprehension processes (literal and inferential) are considered, using, in addition, a reading-specific measure that requires cognitive flexibility. To the best of our knowledge, this measure has not been employed in the previous investigations assessing reading comprehension in ASD. Based on these considerations, the following objectives were addressed as follows:

• to analyze differences in a wide range of reading and writing skills between adolescents with ASD-WID and adolescents with TD;
• to analyze differences in academic outcomes in core subjects and on indicators of successful transition to secondary school between adolescents with ASD-WID and adolescents with TD; and
• to explore the potential contribution of reading and writing skills to academic outcomes in both groups, adolescents with ASD-WID and TD.

According to the literature review, it is expected to find similar results in both groups in reading accuracy and fluency. However, significant lower results are hypothesized in participants with ASD-WID regarding indicators of written expression and reading comprehension tasks tapping inferential and cognitive flexibility processes. Likewise, it is predicted that participants with ASD will obtain lower academic outcomes, as well as worse results in indicators of successful transition to secondary education. Given the prominent role that reading and writing play on school outcomes, it is anticipated that both instrumental skills will have a considerable weight in academic performance, both in the group with TD and in the group with ASD-WID.

Materials and Methods

Participants.

The present study included 56 adolescents between 12 and 14 years old, of whom 30 were adolescents with ASD-WID (28 males) and 26 were adolescents with typical development (TD; 17 males). The participants had an intellectual functioning within the limits of normality on the K-BIT ( Kaufman and Kaufman, 2000 ).

The group of adolescents with ASD-WID had received a previous clinical diagnosis of an autism spectrum condition by the Psychiatry and Child Neurology services in hospitals and medical centers in the Valencian community at ages ranging between 2 years and 11 months and 6 years old. According to the protocol for the ASD diagnosis, the criteria for ASD from the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV; American Psychiatric Association, 1994 ), the Autism Diagnostic Interview-Revised (ADI-R; Rutter et al., 2006 ), and/or the Autism Diagnostic Observation Schedule-WPS (ADOS-WPS; Lord et al., 1999 ) were administered by a multidisciplinary team. In order to confirm the ASD diagnosis for the present study, the Social Communication Questionnaire ( Rutter et al., 2003 ) and the Autism Diagnostic Interview-Revised (ADI-R; Rutter et al., 2006 ) were administered, taking into account the recommended cutoff points. The results appear in Table 1 . These two instruments were administered to the parents by a clinical psychologist from the research team who had been accredited in their application. Likewise, all the adolescents met the strict diagnostic criteria for ASD from the fifth edition of the DSM-5 ( American Psychiatric Association, 2013 ), based on information provided by teachers and parents. Both informants, in interviews with a clinical psychologist, rated the severity of the criteria in the two ASD dimensions on scales ranging from 0 to 3 points (0 represents “almost never,” 1 represents “sometimes,” 2 represents “often,” and 3 represents “many times”).

Socio-demographic characteristics.

Parental education measured as highest level of mother or father (0 = elementary school, 1 = Compulsory secondary school, 2 = Medium level vocational training, 3 = Upper secondary education (High School) or Superior level vocational training, and 4 = University degree). Repeat grade in S (Secondary), ADI-R (Autism Diagnostic Interview-Revised), ADI-R A (Qualitative alterations in the reciprocal social interaction), ADI-R B (Qualitative Alterations in Communication), ADI-R C (Restrictive and Stereotyped Behaviors), and SCQ (Social Communication Questionnaire) .

The majority of the adolescents with ASD had educational support at school. Specifically, seven adolescents with ASD (23.33%) were attending school in regular classrooms full time without educational support; nine adolescents (30.00%) attended regular classrooms but received educational support for their specific needs in the high school; and finally, 14 adolescents (46.66%) were placed in the communication and language classroom modality. Furthermore, 11 (36.66%) adolescents with ASD were taking antipsychotic medication (mostly risperidone) for behavioral problems.

The typically developing adolescents had no history of psychopathology or referral to pediatric mental health units (USMI), according to the information found in the school records, and they did not meet DSM-5 criteria for ASD on the screening carried out before beginning the evaluation. None of them were taking any psychoactive medication.

The exclusion criteria for the adolescents who participated in this study were evaluated through an extensive anamnesis carried out with the families. They included neurological or genetic diseases, brain lesions, sensory, auditory, or motor deficits, and an IQ below 80 (see Table 1 ).

The assessment measures were selected based on the objectives of this study. In addition, criteria, such as the psychometric properties of the measures, were taken into account, as well as their translation and adaptation to Spanish.

Reading Skills

The assessment of lexical and semantic reading processes was carried out through two tasks from the PROLEC-SE battery ( Evaluation of Reading Processes for Secondary Education Students ; Ramos and Cuetos, 1999 ). Furthermore, a subtest of the TLC Test ( Leer para Comprender; Reading for understanding ) was also administered ( Abusamra et al., 2010 ).

Lexical Processes Measures

Reading accuracy and reading fluency were assessed through the reading of 40 Spanish words that vary in length, frequency of use, and the complexity of their syllabic structure (i.e., high and low frequency, short and long words). The total accuracy score is obtained by adding up the words read correctly. To obtain the reading speed score, the time spent reading the complete list of 40 words is recorded. In our study reliability index of this measure, Cronbach’s alpha is 0.74.

Reading Comprehension Measures

Semantic processes were assessed using one of the tasks proposed in the semantic block of the PROLEC-SE battery. The task required silently reading two expository texts: “The Eskimos” and “The Australian Papuans.” After each text is read silently, the text is removed, and the participant has to answer 10 questions. Five questions are literal and can be answered from memory and five questions are inferential; that is, they can only be answered if the participant has understood the text and can make the appropriate inferences. Each correct answer receives 1 point. The total score is obtained by adding up the total number of correct answers on each text.

In this research, we use the direct scores. High direct scores on reading accuracy and comprehension and low scores on reading speed indicate better reading performance. The psychometric properties of the PROLEC-SE battery are adequate. For the reliability index, Cronbach’s alpha is 0.84 ( Ramos and Cuetos, 1999 ). In this study, α coefficients for the subscales used were 0.63 (literal comprehension), 0.68 (inferential comprehension), and 0.73 (total comprehension).

Moreover, to assess cognitive flexibility in the reading comprehension process, the “Mental flexibility” subtest from the Read to Understand Test (TLC) was administered ( Abusamra et al., 2010 ). In this subtest, instructions are given that involve different ways to approach the reading of a text, and, subsequently, the reader’s awareness of the strategies used is evaluated. Therefore, part of the evaluation is declarative because the student “tells what s/he does” to solve the task. This test assesses, for example, whether the student knows that, in some cases, a superficial understanding of the text is possible (specifically, on tasks, such as searching for five nouns in a paragraph), whereas in other cases, a deeper understanding is necessary. That is, it is not always necessary to pay attention to the meaning of words, sentences, and paragraphs in order to perform certain activities that focus exclusively on grammatical, syntactic, or stylistic aspects, or when searching for a specific piece of information. This test evaluates this type of metacognitive process, which is related to cognitive flexibility, that is, the ability to focus on the reading comprehension process by selecting appropriate strategies. This aspect of metacognition is defined as the ability to cope with a task by selecting the right strategies and modifying cognitive processes in response to changes: to shift attentional focus, select information to guide and choose necessary responses, form plans, and generate monitoring ( Abusamra et al., 2010 ). The test has psychometric properties, such as concurrent validity and internal consistency (Cronbach’s alpha of 0.79). α coefficient for this test in our sample is 0.66.

Written Expression

To obtain the spontaneous writing sample, the “Birthday” sheet from the Test of Written Language, fourth edition, was used (TOWL-4; Hammill and Larsen, 2009 ). The participants were given a blank sheet of paper and a pen and the following instruction: “Write a story about the events and activities shown in the picture.” They were given as much time as necessary to complete the written compositions, which were then transcribed using the Systematic Analysis of Language Transcripts (SALT; Miller and Iglesias, 2010 ). All the texts were coded on variables that assessed productivity, syntactic complexity, and overall coherence. An independent research assistant was trained in the measures coding during two sessions in a seminar of 5 h. In these sessions, the variables considered were defined and explained and the analysis was practiced on written samples. The research assistant was blind to the goal of the study and did not know the membership group of the texts (ASD or TD). For the reliability check, after the training sessions, the evaluators analyzed approximately 80% of the writings from each group (40 in all), which were randomly selected.

Productivity

Children’s productivity, or fluency, was measured as the total number of words in the text. Automated SALT analyses provided information about this variable.

Syntactic Complexity

Syntactic complexity was measured as the diversity of complex syntax ( Hilvert et al., 2019 ). This variable was determined by counting the number of different types of complex syntactic devices employed within the text: substantive subordinate clauses, adverbial subordinate clauses, relative subordinate clauses, and coordinated clauses. For the presence of each type of syntactic relationship, 1 point was awarded, with a maximum score of 4. In order to calculate inter-rater reliability, the formula proposed by Sackett (1978) was used (number of agreements divided by the number of agreements plus disagreements, x 100). The agreement was 90% for the substantive subordinate clauses, 100% for the adverbial subordinate clauses, 100% for the relative subordinate clauses, and 100% for the coordinated clauses. All disagreements were resolved by discussion.

Global Coherence

To assess the overall coherence of the compositions, the coding system proposed by Barnes and Baron-Cohen (2012) was followed. This system is specially addressed to capture how the story components are included. In this way, it can be identified if there is a cognitive style focused on details at the expense of globality, as the weak central coherence theory states. Thus, the texts were coded on a scale from 0 to 2 for each of the four different elements of the story: (1) setting (where the story takes place); (2) character (who the story is about); (3) conflict (what the story is about); and (4) resolution (how the story ends).

A score of 0 indicates that no information is provided about the element in question; a score of 1 indicates that the composition provides one or more details about the element, but the overall idea of the scene is not captured; and a score of 2 indicates that the narrative provides a well-founded and fully developed view of the corresponding element. With regard to the characters, a score of 0 is awarded if either of the story’s characters is not mentioned, and 1 point if the characters are mentioned, but without defining their relationship to each other or their role in the scene. For conflict, a score of 0 is assigned if the character’s desires or goals are not identified; a score of 1 if a character is defined as wanting something, but without mentioning an obstacle to that goal; and a score of 2 if both a goal and an obstacle to the character achieving that goal are established. Finally, in relation to the resolution component, 0 points are assigned when what happened at the end of the conflict is not mentioned; 1 point if an action that took place at the end of the scene is mentioned; and 2 points if an ending action is described and that action is linked to the overall theme of the scene.

According to the formula proposed by Sackett (1978) , the inter-rater reliability of these measures was as follows: in the case of the setting, 100% agreement was reached; for character, 100% agreement; for conflict, 97% agreement; and for resolution, 98% agreement. All disagreements were resolved by discussion.

Academic Results

Academic results were reported by parents and/or primary caregivers from the last math, language, and social science evaluation. The numerical range used in the Spanish educational system is from 0 to 10, where 0 is the minimum academic grade and 10 is the maximum.

Transition to Secondary Education

Parents filled out a questionnaire derived from a large scale, national transitions study, the Effective Preschool, Primary, and Secondary Education (EPPSE) transitions substudy ( Evangelou et al., 2008 ), used in Makin et al. (2017) to provide an index of “transition success.” Evangelou et al. (2008) defined “successful transition” as a multidimensional construct composed of five underlying factors: developing friendships and confidence, settling into school life, showing a growing interest in school and work, getting used to new routines, and experiencing curriculum continuity.

Parents had to answer six questions related to three of the five factors. Regarding the “developing friendships and confidence” dimension, parents were asked whether, compared to the last year in primary school, their child has more (3 points), the same number (2 points), or fewer (1 point) school friends, as well as more, the same, or less self-esteem, confidence, and motivation. The same scoring system was used in the “experiencing curriculum continuity” dimension, which was assessed by asking parents whether, compared to the last year in primary school, their child shows more, the same, or less interest in school and schoolwork. Regarding the adaptation to school life, parents were asked how they thought their child had settled in (very well, 4 points; quite well, 3 points; not very well, 2 points; and not well at all, 1 point). They were also asked how satisfied they were with the whole process of their child’s transition to secondary school (from very satisfied, 4 points and to not at all satisfied, 1 point), how they felt when their child first moved on to secondary school, and how they feel now (from not at all concerned, 4 points and to very concerned, 1 point). The index of internal consistency Cronbach’s alpha for this questionnaire in our sample is 0.91.

This research was performed in accordance with the ethical standards of the Research Ethics Committee of the University of Valencia, which is regulated by the Ethical Principles for Medical Research Involving Human Subjects (Declaration of Helsinki 1964; World Medical Association General Assembly, 2013 ). Likewise, the authors received authorization from the Board of Education of the Valencian Government to access the schools and locate the participants.

The evaluation was carried out in the high schools where the adolescents were enrolled, in specially prepared spaces that met optimal conditions for psychoeducational assessment. The informed oral and written consent of the parents of all the participants was also obtained after informing them about the research proposal. The different measures were administered to all the adolescents individually by trained examiners. The parents (mostly mothers) provided information about the adolescent’s transition to secondary education, ASD symptoms, and socio-demographic data.

Data Analyses

This paper presents a descriptive cross-sectional study of comparison between a group of adolescents with ASD and a group of adolescents with typical development.

The statistical analyses were performed with the statistical program for the social sciences SPSS v 26.0 (SPSS). Preliminary analyses checked all data for multicollinearity and multivariate outliers. The asymmetry and kurtosis data indicate that most of the variables followed a normal distribution (all values between −1 and 1). Variables that did not show a normal distribution were transformed using square-root transformation (coherence setting and coherence character). To compare the reading/writing skill, academic results, and successful transition to secondary school of ASD-WID and TD, Multivariate analysis of covariance (MANCOVA) was used. The data set was examined for violations of essential assumptions associated with the application of MANCOVA. Pearson correlations between all dependent variables pairs and dependent variable-covariate pairs suggested statistically significant linear relationships.

Adolescents’ IQ, vocabulary, and parents’ educational level were included as covariates due to its potential effect on reading and writing abilities and academic outcomes in general. Likewise, the differences between math, language, and social sciences academic outcomes were explored, as well as the differences regarding the transition to secondary education in adolescents with TD and with ASD-WID. Both academic outcomes and parents perceptions about the successful adaptation to secondary education form part of the academic curriculum, which encompasses different interrelated dimensions.

For the ANCOVAs, Bonferroni correction was applied to establish the significance level. The proportion of total variance accounted for by the independent variables was calculated using partial eta squared (according to Cohen (1988) : eta squared, 0.06 = small; 0.06–0.14 = medium; and 0.14 = large). To compare academic results and successful transition to secondary school of ASD-WID and TD, t -student was used. Moreover, two partial correlations, controlling for parents’ educational level and adolescents’ IQ and vocabulary, were conducted to examine the relationships between reading and writing skills and academic outcomes in both groups. Finally, multiple linear regression analyses were conducted to test the effect of reading and writing skills on the transition to secondary school and academic outcomes in adolescents with ASD-WID.

Differences in Reading and Writing Skills Between Adolescents With ASD-WID and Adolescents With TD

The MANCOVA between the ASD-WID and TD groups with the different reading skill scores (accuracy, speed, reading comprehension, and reading comprehension related to mental flexibility), controlling for parents’ educational level, IQ, and vocabulary, was statistically significant [Wilks’ Lambda (Λ) = 0.70, F 6,46 = 3.21, p = 0.01, η p 2 = 0.30 ]. Likewise, to calculate the additional ANCOVAs, a significance level of p < 0.008 was established, after applying the Bonferroni correction, and the value of η p 2 was calculated to check the strength of the association. Specifically, statistically significant differences were found on the reading comprehension “Mental flexibility” subtest (F 1,51 = 14.6; p < 0.01; η p 2 = 0.22 ). In addition, scores for accuracy (word reading), speed, and reading comprehension did not reach the required level of statistical significance between the group with TD and the group with ASD-ID ( Table 2 ).

Means, standard deviations (SD) of reading and writing skills, and statistically significant differences between ASD and TD adolescents.

P. (PROLEC), P. comprehension (PROLEC reading comprehension), P. Comprehension L. (PROLEC literal comprehension), P. Comprehension I (PROLEC inferential comprehension), RC. Flexibility (Reading Comprehension Mental flexibility), Syntactic C (Syntactic complexity), Coherence S (Setting), Coherence Ch (Character), Coherence C (Conflict), and Coherence R (Resolution) .

The MANCOVA between the ASD-WID and TD groups with the different writing skill scores (productivity, syntactic complexity, and coherence), controlling for parents’ educational level, IQ, and vocabulary, was statistically significant [Wilks’ Lambda (Λ) = 0.71, F 6,46 = 3.02, p = 0.014, η p 2 = 0.28 ]. Likewise, to calculate the additional ANCOVAs, a significance level of p < 0.008 was established, after applying the Bonferroni correction, and the value of η p 2 was calculated to check the strength of the association. Specifically, statistically significant differences were found in word productivity (F 1,51 = 7.78; p = 0.007; η p 2 = 0.23 ), Syntactic complexity (F 1,51 = 13.4; p = 0.001; η p 2 = 0.21 ), and Coherence (conflict resolution component; F 1,51 = 7.63; p = 0.007; η p 2 = 0.13 ; see Table 2 ).

Differences in Academic Outcomes and Transition to Secondary School Between Adolescents With ASD-WID and Adolescents With TD

The MANCOVA between the ASD-WID and TD groups with the different academic outcome scores (language, math, and social sciences) and the transition to the secondary stage was statistically significant [Wilks’ Lambda (Λ) = 0.71, F 6,46 = 3.02, p = 0.014, η p 2 = 0.28 ]. Statistically significant differences were found in language (F 1,51 = 7.78; p = 0.007; η p 2 = 0.23 ), mathematics (F 1,51 = 13.4; p = 0.001; η p 2 = 0.21 ), social sciences (F 1,51 = 7.63; p = 0.007; η p 2 = 0.13 ), and the index of successful transition to secondary education (F 1,51 = 7.63; p = 0.007; η p 2 = 0.13 ; see Table 3 ).

Means, standard deviations (SD) of academic results and successful transition to secondary, and statistically significant differences between ASD and TD adolescents.

Transition to SE (Transition to secondary education) .

Contribution of Reading and Writing Skills to the Academic Outcomes of Adolescents With ASD-ID and Adolescents With TD

Likewise, two partial correlations were performed, using the covariates of parents’ vocabulary, IQ, and educational level, to analyze the association between the reading and writing variables that showed significant differences between the ASD-WID and TD groups and the learning outcomes in the subjects of the Spanish language, mathematics, and social sciences in the ASD-WID and TD groups.

In the group of children with TD, significant positive correlations were observed between the reading comprehension score related to mental flexibility and the scores on language ( r = 0.45; p = 0.029), mathematics ( r = 0.56; p = 0.006), and social sciences ( r = 0.40; p = 0.050). Similarly, significant positive correlations were observed between the productivity subscale and the scores on language ( r = 0.51; p = 0.013) and mathematics ( r = 0.44; p = 0.035).

In the group of children with ASD-WID, significant positive correlations were observed between the reading comprehension score related to mental flexibility and the scores on language ( r = 0.37; p = 0.050) and mathematics ( r = 0.37; p = 0.050). Likewise, significant positive correlations were observed between the social sciences scores and productivity ( r = 0.46; p = 0.015), syntactic complexity ( r = 0.61; p < 0.001), and coherence ( r = 0.42; p = 0.029; see Table 4 ).

Partial correlations between reading/writing skill and academic outcomes.

RC. Flexibility (Reading Comprehension Cognitive flexibility), Syntactic C (Syntactic complexity), and Coherence R (Coherence resolution). * p < 0.05; ** p < 0.01. Controlling for IQ, vocabulary, and parental education .

Finally, multiple regression analyses were carried out in each group in order to evaluate the contribution of reading comprehension related to mental flexibility and writing skills of productivity, syntactic complexity, and coherence to academic outcomes in the core subjects of language, mathematics, and social sciences (see Table 5 ). The regressions carried out with the TD group indicated that the predictors that explained the highest percentage of variance in Spanish language were reading comprehension related to mental flexibility, productivity, and coherence, explaining 51% of the total variance. As for the mathematics outcomes, the results showed that reading comprehension related to mental flexibility and productivity were the significant individual predictors, together explaining 55% of the variance. In social sciences, there were no significant individual or collective predictors.

Multiple regression analysis of reading and writing skills that predict academic outcomes in TD and ASD groups.

RC. Flexibility (Reading Comprehension Mental flexibility), Syntactic C (Syntactic complexity), and Coherence R (Coherence resolution) .

The regressions performed with the ASD-WID group indicated that, on the one hand, reading comprehension related to mental flexibility was the single most significant predictor of language and mathematics outcomes, explaining 31 and 24% of the variance, respectively. On the other hand, the predictors that explained the highest percentage of variance in social sciences were syntactic complexity and coherence, explaining 57% of the total variance.

The purpose of this study was to extend the knowledge about academic achievement in adolescents with ASD by addressing various objectives. First, this study analyzed differences in reading and writing performance between adolescents with ASD-WID and adolescents with TD. In terms of reading, no significant differences were found between the two groups on measures of reading fluency (accuracy and speed), which is consistent with most of the research on the topic in languages with opaque orthographies, such as English ( Jones et al., 2009 ).

However, contrary to expectations, our study data failed to show significant differences between participants with ASD-WID and their peers with TD on either literal or inferential reading comprehension. These results contrast with what is commonly reported in the literature, which generally indicates lower reading comprehension competence in individuals with ASD (see meta-analysis by Brown et al., 2013 ). This discrepancy in the findings could be explained by different factors. Firstly, both groups were matched according to vocabulary knowledge which following the Simple View of Reading Model ( Hoover and Gough, 1990 ) is a fundamental factor for reading comprehension. Numerous investigations with children with ASD have exemplified the strong association between reading comprehension and language (see the meta-analysis by Brown et al., 2013 ), which emerges even as one of the strongest predictors of the reading comprehension abilities of these students ( Davidson et al., 2018 ). A second important factor is the type of texts employed in our study. We used two expository texts with little social content that do not require the student to display inferential skills related to Theory of Mind, which is clearly affected in ASD ( Bora and Pantelis, 2016 ). In other words, the reader would not have to apply skills that require taking the perspective of the characters, which, in contrast, would be necessary to understand narrative texts ( Dore et al., 2018 ). In fact, studies have shown that individuals with ASD are significantly worse at comprehending highly social texts than less social texts, such as those employed in this study ( Brown et al., 2013 ). Moreover, and in line with our results on inferential comprehension, experimental studies using eye-tracking techniques have shown that adolescents with ASD are capable of developing inferential comprehension skills that are activated automatically ( Saldaña and Frith, 2007 ; Micai et al., 2017 ), although they may have difficulties on tasks that require them to answer questions that rate this same process ( Tirado and Saldaña, 2016 ). Likewise, another explanation for our discordant results could be found in the composition of the sample, which might consist of students with ASD who have shown strengths in reading performance, both in decoding and comprehension. These profiles have been described in the literature as “skilled readers” ( Åsberg et al., 2019 ) or “average readers” ( McIntyre et al., 2017 ).

However, the results of our study allowed us to identify certain deficient reading comprehension processes in adolescents with ASD, specifically those that require the activation of cognitive flexibility skills and, in particular, metacognitive skills, such as explicitly describing the strategies used when summarizing, detecting the main idea, or giving a title to a text. Thus, significantly lower performance was observed on the reading-specific measure used in this study that requires cognitive flexibility. These results are congruent with the alterations in cognitive flexibility described in ASD. These disturbances have been considered one of its neuropsychological manifestations, although with mixed findings ( Leung and Zakzanis, 2014 ). These outcomes also coincide with the difficulties identified in students with ASD in adapting reading strategies to various reading materials and task demands ( Micai et al., 2019 ). A competent reader must be able to change strategies while reading a text and adapt them to the different objectives and/or requirements presented. Adequate mental flexibility ensures the reader’s active participation in the comprehension process, and its proper functioning facilitates independent learning, which has a great impact on academic performance. Thus, we can see the importance of mastering these processes involved in comprehension and the need to consider this specific area when designing reading intervention programs for individuals with ASD.

In terms of writing skills, as it was hypothesized, the data revealed significant differences between the group with ASD-WID and the group with TD on all the indicators analyzed as: productivity, syntactic diversity, and overall coherence (in the latter case, only in the resolution component). Adolescents with ASD wrote shorter texts with less varied syntactic structures, which is consistent with the results of the previous studies and reviews on the topic ( Dockrell et al., 2014 ; Finnegan and Accardo, 2018 ; Hilvert et al., 2019 ). Unexpectedly, both groups performed similarly on most of the variables used to assess overall coherence (setting, character, and conflict). However, significant differences could be identified in the resolution component; that is, the students with ASD failed to mention what happened at the end of the conflict presented in their stories. These difficulties may affect the overall coherence of the written composition, which is consistent with the tenets of the Weak Central Coherence Theory ( Happé and Frith, 2006 ). According to this theory, people with ASD tend to focus on local or marginal aspects of the information and fail to integrate them into meaningful global representations, in this case, by providing an ending related to the conflict narrated. This cognitive style has also been shown in different studies on written expression in ASD, both in children and adolescents ( Brown et al., 2014 ), as well as in the adult population ( Barnes and Baron-Cohen, 2012 ).

The second objective of this study was to analyze the differences in academic outcomes and the transition to secondary school between adolescents with ASD-WID and adolescents with TD. As it was expected, the results showed statistically significant differences in the academic grades reported by parents and teachers in the language arts, mathematics, and social science subjects, and in the families’ perceptions of the transition to high school. These findings reinforce the idea of a significant gap between cognitive ability and school performance, taking into account that the participants in our study did not present intellectual limitations. This means that students with ASD are not displaying their full academic potential, which is being undermined by various factors, including deficits in certain reading comprehension and written performance measures, as discussed below.

Furthermore, according to parents’ perceptions, a less successful transition process to high school and generally worse adaptation were observed in adolescents with ASD compared to their peers with TD. Families report fewer friends and lower self-esteem, confidence, and motivation. They are less satisfied with the transition process and are concerned about it. These results are consistent with the negative experiences described by parents of children with ASD in this period of educational change, referring to social isolation, bullying, and anxiety in their children ( Humphrey and Lewis, 2008 ). Families experience challenges and stress beyond what would typically be expected ( Dillon and Underwood, 2012 ; Mandy et al., 2016 ; Peters and Brooks, 2016 ). Therefore, as parents also point out, it is essential for secondary schools to understand the nature of autism and the impact it can have on the child and implement the assistance or support students need for a successful transition, optimal academic performance, and social adjustment ( Cremin et al., 2017 ; Tso and Strnadová, 2017 ).

Finally, the third objective of this study was to examine the contribution of reading and writing skills to the academic outcomes of adolescents with ASD-WID. As expected, a significant positive relationship was found (in both the ASD-WID and the TD groups) between the two variables being analyzed. Specifically, in the group with ASD-WID, significant positive associations were observed between the reading comprehension measure specifically tapping cognitive flexibility and the grades earned in the language and mathematics subjects. A similar relationship was found between the grades obtained in social sciences and the written expression indicators considered (productivity, syntactic diversity, and coherence). This association highlights the importance of instrumental skills, such as reading and writing, which have a clear influence on school performance. Specifically, on the one hand, our study data indicate that the reading comprehension task involving cognitive flexibility turned out to be the only significant predictor of the grades obtained in language and mathematics. On the other hand, the predictors that explained the highest percentage of social sciences grades were syntactic complexity and coherence.

The difficulties of these students exhibit in certain processes of reading comprehension and written expression have an impact on their academic outcomes, which should lead to designing interventions that fit their profile of strengths and weaknesses. Several research syntheses have supported the use of strategy instruction in the form of question generation, use of graphic organizers, or making predictions ( El Zein et al., 2014 ; Finnegan and Mazin, 2016 ). More recently, Singh et al. (2020) , in a systematic review of case studies, analyzed the effectiveness of a series of instructional procedures that contributed to improving the reading comprehension performance of students with ASD. They highlighted the use of comprehension-enhancing supports in the form of graphic organizers or visual diagrams, metacognitive strategies, collaborative strategies, such as peer tutoring, and computer-assisted instruction. In terms of writing skills, a recent research synthesis carried out by Accardo et al. (2020) identified several effective instructional practices: self-regulated strategy development, sentence frames, video modeling, Handwriting Without Tears®, and analytic task instruction with systematic prompting and graphic organizers. Some of the variables that improved with the application of these techniques were the number of elements in the text structure and the number of words and sentences. It should be noted that, as in the reading comprehension intervention, the studies reviewed were single case studies, and so research using experimental or quasi-experimental group designs is necessary in order to improve the levels of scientific evidence currently available. Apart from these teaching strategies, education professionals may also consider to adjust the assessment criteria or the mode of assessment for adolescents with ASD.

Likewise, parents’ perspectives on the transition process to secondary school suggest the need for tailored assistance at the time of the student’s move to secondary school. In this regard, Peters and Brooks (2016) show that parents describe a more positive transition when both pre-transition support and ongoing support in the learning and social environments of secondary school are implemented. To this end, a better understanding of the difficulties and strengths of students with ASD in this educational stage, their particular style of processing information, and their strengths and weaknesses in reading and writing skills are essential, due to their strong impact on academic performance.

Limitations

Despite the contributions of these findings, our research has several limitations. First, the relatively small sample size may be hiding some possible significant relationships between the study variables and limiting the possibility to detect small effects. One second limitation, which leads the results to be interpreted with caution, is related to the moderate values of reliability coefficients of the administrated tests. Therefore, future studies should increase the number of participants on a randomized sampling basis and include, apart from psychometric tests, other reading comprehension tasks. The information from criterion-referenced measures could help to design more accurate intervention programs for students with ASD-WID. Third, the mid-range cognitive ability and the gender of the participants with ASD, mostly male, are factors that should be considered, as they may influence the results and affect their generalization to girls or to individuals with ASD with other cognitive levels. In addition, the writing skills of adolescents with ASD were only assessed on a narrative text, and it would have been appropriate to expand the information to persuasive and expository genres. Furthermore, the indicator used to reflect the academic results was the qualification marks of the last evaluation, which may not be representative of the whole academic level of achievement. Finally, our study has a cross-sectional design, and future research should analyze developmental variations in the writing and reading profiles of individuals with ASD.

This research provides an overview of the school performance of adolescents with ASD and the factors involved in it. The results show that adolescents with ASD have strengths in reading-decoding mechanisms, but their performance on reading comprehension processes involving aspects of mental flexibility and writing skills continues to be significantly below expectations. Both deficits contribute significantly to their academic achievement, which is also below that of their peers with TD and what would be expected based on their intellectual capacity, at a medium range in this study. In any case, academic difficulties should be taken into account when analyzing the parents’ opinions in the transition period to secondary school because parents of students with ASD-WID report a more difficult adaptation process compared to students with TD. Consequently, education professionals face the challenge of adapting their teaching style and employing evidence-based teaching strategies that address students’ different needs while enhancing their capabilities. This may be a promising avenue for reducing the gap between the potential and current academic performance of students with ASD.

Data Availability Statement

Ethics statement.

The studies involving human participants were reviewed and approved by the University of Valencia. Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin.

Author Contributions

IB, AM, BR, and CB contributed to the design of the work and wrote the manuscript. CB was responsible for the analysis and interpretation of data for the study. BR was responsible for the literature search and assessment of the participants. All authors participated in data interpretation and draft the manuscript and approved the version to be submitted.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We would like to thank the adolescents, parents, and teachers who participated in this study.

Funding. This research was financed by the Spanish Ministry of Economy and Competitiveness (PSI2016-78109; AEI/FEDER, UE) and by the Generalitat Valenciana (grant no. GV/2020/C/005). The funding body had no role in the study design, data collection, analysis, interpretation, or writing of the report or the decision to submit the paper for publication.

• Abusamra V., Ferreres A., Raiter A., Beni D., Cornoldi C. (2010). Test Leer para Comprender (TLC). Evaluación de la comprensión de textos. Buenos Aires: Paidós. [ Google Scholar ]
• Accardo A. L., Finnegan E. G., Kuder S. J., Bomgardner E. M. (2020). Writing interventions for individuals with autism spectrum disorder: a research synthesis . J. Autism Dev. Disord. 50 , 1988–2006. 10.1007/s10803-019-03955-9, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• American Psychiatric Association (APA) (1994). Diagnostic and Statistical Manual of Mental Disorders. 4th Edn . Washington, DC: American Psychiatric Association. [ Google Scholar ]
• American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders. 5th Edn . Washington, DC: American Psychiatric Association. [ Google Scholar ]
• Åsberg J., Carlsson E., Norbury C., Gillberg C., Miniscalo C. (2019). Current profiles and early predictors of reading skills in school-age children with autism spectrum disorders: a longitudinal, retrospective population study . Autism 23 , 1449–1459. 10.1177/1362361318811153, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Barnes J. L., Baron-Cohen S. (2012). The big picture: storytelling ability in adults with autism spectrum disorders . J. Autism Dev. Disord. 42 , 1557–1565. 10.1007/s10803-011-1388-5, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bora E., Pantelis C. (2016). Meta-analysis of social cognition in attention-deficit/hyperactivity disorder (ADHD): comparison with healthy controls and autistic spectrum disorder . Psychol. Med. 46 , 699–716. 10.1017/S0033291715002573 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Brown H. M., Johnson A. M., Smyth R. E., Oram Cardy J. (2014). Exploring the persuasive writing skills of students with high-functioning autism spectrum disorder . Res. Autism Spectr. Disord. 8 , 1482–1499. 10.1016/j.rasd.2014.07.017 [ CrossRef ] [ Google Scholar ]
• Brown H. M., Oram-Cardy J., Johnson A. (2013). A meta-analysis of the reading comprehension skills of individuals on the autism spectrum . J. Autism Dev. Disord. 43 , 932–955. 10.1007/s10803-012-1638-1, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Chen L., Abrams D. A., Rosenberg-Lee M., Iuculano T., Wakeman H. N., Prathap S., et al.. (2019). Quantitative analysis of heterogeneity in academic achievement of children with autism . Clin. Psychol. Sci. 7 , 362–380. 10.1177/2167702618809353, PMID: [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Cohen J. (1988). Statistical Power Analysis for the Behavioral Sciences. 2nd Edn . Hillsdale, NJ: Erlbaum. [ Google Scholar ]
• Cremin K., Healy O., Gordon M. (2017). Parental perceptions on the transition to secondary school for their child with autism . Adv. Autism 3 , 87–99. 10.1108/AIA-09-2016-0024 [ CrossRef ] [ Google Scholar ]
• Davidson M. M., Kaushanskaya M., Ellis Weismer S. (2018). Reading comprehension in children with and without ASD: The role of word reading, oral language, and working memory . J. Autism Dev. Disord. 48 , 3524–3541. 10.1007/s10803-018-3617-7 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Dillon G. V., Underwood J. D. M. (2012). Parental perspectives of students with autism spectrum disorders transitioning from primary to secondary school in the United Kingdom . Focus Autism Dev. Dis. 27 , 111–121. 10.1177/1088357612441827 [ CrossRef ] [ Google Scholar ]
• Dockrell J. E., Ricketts J., Charman T., Lindsay G. (2014). Exploring writing in products in students with language impairment and autism spectrum disorders . Learn. Instr. 32 , 81–90. 10.1016/j.learninstruc.2014.01.008 [ CrossRef ] [ Google Scholar ]
• Dore R. A., Amendum S. J., Michnick Golinkoff R., Hirsh-Pasek K. (2018). Theory of mind: a hidden factor in reading comprehension? Educ. Psychol. Rev. 30 , 1067–1089. 10.1007/s10648-018-9443-9 [ CrossRef ] [ Google Scholar ]
• El Zein F., Solis M., Vaughn S., McCulley L. (2014). Reading comprehension interventions for students with autism spectrum disorders: a synthesis of research . J. Autism Dev. Disord. 44 , 1303–1322. 10.1007/s10803-013-1989-2, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Estes A., Rivera V., Bryan M., Cali P., Dawson G. (2011). Discrepancies between academic achievement and intellectual ability in higher-functioning school-aged children with autism spectrum disorder . J. Autism Dev. Disord. 41 , 1044–1052. 10.1007/s10803-010-1127-3, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Evangelou M., Taggart B., Sylva K., Melhuish E., Sammons P., Siraj-Blatchford I. (2008). What Makes a Successful Transition from Primary to Secondary School? Nottingham, United Kingdom: Department for Children Schools and Families. [ Google Scholar ]
• Finnegan E., Accardo A. L. (2018). Written expression in individuals with autism spectrum disorder: a meta-analysis . J. Autism Dev. Disord. 48 , 868–882. 10.1007/s10803-017-3385-9, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Finnegan E., Mazin A. L. (2016). Strategies for increasing reading comprehension skills in students with autism spectrum disorder: review of the literature . Educ. Treat. Children 39 , 187–219. 10.1353/etc.2016.0007 [ CrossRef ] [ Google Scholar ]
• Fuentes C. T., Mostofsky S. H., Bastian A. J. (2009). Children with autism show specific handwriting impairments . Neurology 73 , 1532–1537. 10.1212/WNL.0b013e3181c0d48c, PMID: [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hammill D. D., Larsen S. C. (2009). Test of Written Language. 4th Edn . (TOWL-4). Austin, TX: PRO-ED. [ Google Scholar ]
• Happé F., Frith U. (2006). The weak coherence account: detail-focused cognitive style in autism spectrum disorders . J. Autism Dev. Disord. 36 , 5–25. 10.1007/s10803-005-0039-0, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hayes J. R. (2006). “ New directions in writing theory ,” in Handbook of Writing Research. eds. Mac Arthur C., Graham S., Fitzgerald J. (New York: The Guildford Press; ). [ Google Scholar ]
• Hayes J. R., Flower L. (1980). “ Identifying the organization of writing processes ,” in Cognitive Processes in Writing. eds. Gregg L. W., Steinberg E. R. (Hillsdale, NJ: Lawrence Erlbaum Associates; ), 3–30. [ Google Scholar ]
• Hilvert E., Davidson D., Gámez P. B. (2020). Assessment of personal narrative writing in children with and without autism spectrum disorder . Res. Autism Spectr. Disord. 69 :101453. 10.1016/j.rasd.2019.101453, PMID: [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hilvert E., Davidson D., Scott C. M. (2019). An in-depth analysis of expository writing in children with and without autism spectrum disorder . J. Autism Dev. Disord. 49 , 3412–3425. 10.1007/s10803-019-04057-2, PMID: [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hoover W. A., Gough P. B. (1990). The simple view of reading . Read. Writ. 2 , 127–160. 10.1007/BF00401799 [ CrossRef ] [ Google Scholar ]
• Humphrey N., Lewis S. (2008). What does ‘inclusion’ mean for pupils on the autistic spectrum in mainstream secondary schools? J. Res. Spec. Educ. Needs 8 , 132–140. 10.1111/j.1471-3802.2008.00115.x [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ionescu T. (2012). Exploring the nature of cognitive flexibility . New Ideas Psychol. 30 , 190–200. 10.1016/j.newideapsych.2011.11.001 [ CrossRef ] [ Google Scholar ]
• Jones C. R., Happé F., Golden H., Marsden A. J., Tregay J., Simonoff E., et al.. (2009). Reading and arithmetic in adolescents with autism spectrum disorders: peaks and dips in attainment . Neuropsychology 23 , 718–728. 10.1037/a0016360, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kaufman A. S., Kaufman N. I. (2000). K-BIT, Test Breve de Inteligencia de Kauffman. Madrid: Pearson. [ Google Scholar ]
• Keen D., Webster A., Ridley G. (2016). How well are children with autism spectrum disorder doing academically at school? An overview of the literature . Autism 20 , 276–294. 10.1177/1362361315580962, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kushki A., Chau T., Anagnostou E. (2011). Handwriting difficulties in children with autism spectrum disorders: A scoping review . J. Autism Dev. Disord. 41 , 1706–1716. 10.1007/s10803-011-1206-0 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lai C. L. E., Lau Z., Lui S. S., Lok E., Tam V., Chan Q., et al.. (2017). Meta-analysis of neuropsychological measures of executive functioning in children and adolescent with high functioning autism spectrum disorder . Autism Res. 10 , 911–939. 10.1002/aur.1723, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Leung R. C., Zakzanis K. K. (2014). Brief report: cognitive flexibility in autism spectrum disorders: a quantitative review . J. Autism Dev. Disord. 44 , 2628–2645. 10.1007/s10803-014-2136-4, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lord C., Rutter M., DiLavore P. C., Risi S. (1999). Autism Diagnostic Observation Scale-WPS (ADOS-WPS). Los Angeles: Western Psychological Services. [ Google Scholar ]
• Makin C., Hill V., Pellicano E. (2017). The primary-to-secondary school transition for children on the autism spectrum: a multi-informant mixed-methods study . Autism Dev. Lang. Impairments 2 , 1–18. 10.1177/2396941516684834 [ CrossRef ] [ Google Scholar ]
• Mandy W., Murin M., Baykaner O., Staunton S., Hellriegel J., Anderson S., et al.. (2016). The transition from primary to secondary school in mainstream education for children with autism spectrum disorder . Autism 20 , 5–13. 10.1177/1362361314562616, PMID: [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Maras P., Aveling E. P. (2006). Students with special educational needs: transitions from primary to secondary school . Br. J. Spec. Educ. 33 , 196–203. 10.1111/j.1467-8578.2006.00439.x [ CrossRef ] [ Google Scholar ]
• Mayes S. D., Calhoun S. L. (2006). Frequency of reading, math, and writing disabilities in children with clinical disorders . Learn. Indiv. Differ. 16 , 145–157. 10.1016/j.lindif.2005.07.004 [ CrossRef ] [ Google Scholar ]
• McIntyre N. S., Solari E. J., Grimm R. P., Lerro L. E., Gonzales J. E., Mundy P. C. (2017). A comprehensive examination of reading heterogeneity in students with high functioning autism: distinct reading profiles and their relation to autism symptom severity . J. Autism Dev. Disord. 47 , 1086–1101. 10.1007/s10803-017-3029-0, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Micai M., Joseph H., Vulchanova M., Saldaña D. (2017). Strategies of readers with autism when responding to inferential questions: an eye-movement study . Autism Res. 10 , 888–900. 10.1002/aur.1731, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Micai M., Vulchanova M., Saldaña D. (2019). Do individuals with autism change their reading behavior to adapt to errors in the text? J. Autism Dev. Disord. 49 , 4232–4243. 10.1007/s10803-019-04108-8, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Miller J. F., Iglesias A. (2010). Systematic Analysis of Language Transcripts (SALT), Research Version 2010 [Computer software]. SALT Software .
• Norbury C., Nation K. (2011). Understanding variability in reading comprehension in adolescents with autism spectrum disorders: interactions with language status and decoding skill . Sci. Stud. Read. 15 , 191–210. 10.1080/10888431003623553 [ CrossRef ] [ Google Scholar ]
• Nuske H. J., McGhee Hassrick E., Bronstein B., Hauptman L., Aponte C., Levato L., et al.. (2018). Broken bridges-new school transitions for students with autism spectrum disorder: a systematic review and strategies for success . Autism 23 , 1–20. 10.1177/136236131875452 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Peters R., Brooks R. (2016). Parental perspectives on the transition to secondary school for students with Asperger syndrome and high-functioning autism: a pilot survey study . Br. J. Spec. Educ. 43 , 75–91. 10.1111/1467-8578.12125 [ CrossRef ] [ Google Scholar ]
• Price J. R., Martin G. E., Chen K., Jones J. (2020). A preliminary study of writing skills in adolescents with autism across persuasive, expository, and narrative genres . J. Autism Dev. Disord. 50 , 319–332. 10.1007/s10803-019-04254-z, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ramos J. S., Cuetos F. (1999). PROLEC-SE. Evaluación de los Procesos Lectores en Secundaria. Madrid: Tea Ediciones. [ Google Scholar ]
• Rutter M., Bailey A., Lord C. (2003). SCQ: The Social Communication Questionnaire. Torrance, CA: Western Psychological Services. [ Google Scholar ]
• Rutter M., Le Couteur A., Lord C. (2006). ADI-R; Entrevista Clínica Para el Diagnóstico del Autismo-Revisada. Madrid: TEA Ediciones. [ Google Scholar ]
• Sackett C. (1978). Observing Behavior. Vol . 2 . Baltimore, MD: University Park Press. [ Google Scholar ]
• Saldaña D., Frith U. (2007). Do readers with autism make bridging inferences from world knowledge? J. Exp. Child Psychol. 96 , 310–319. 10.1016/j.jecp.2006.11.002, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Singh B. D., Moore D. W., Furlonger B. E., Anderson A., Fall R., Howorth S., et al.. (2020). Reading comprehension and autism spectrum disorder: a systematic review of interventions involving single-case experimental designs . Rev. J. Autism Dev. Disord. 8 , 3–21. 10.1007/s40489-020-00200-3 [ CrossRef ] [ Google Scholar ]
• Solari E. J., Grimm R., McIntyre N. S., Swain-Lerrob L., Zajicb M., Mundya P. C., et al.. (2017). The relation between text reading fluency and reading comprehension for students with autism spectrum disorders . Res. Autism Spectr. Disord. 41-42 , 8–19. 10.1016/j.rasd.2017.07.002 [ CrossRef ] [ Google Scholar ]
• Tirado M. J., Saldaña D. (2016). Readers with autism can produce inferences, but they cannot answer inferential questions . J. Autism Dev. Disord. 46 , 1025–1037. 10.1007/s10803-015-2648-6, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Tobin H., Staunton S., Mandy W., Skuse D., Helligreil J., Baykaner O., et al.. (2012). A qualitative examination of parental experiences of the transition to mainstream secondary school for children with an autism spectrum disorder . Educ. Child Psychol. 29 , 75–85. [ Google Scholar ]
• Tso M., Strnadová I. (2017). Students with autism transitioning from primary to secondary schools: parents’ perspectives and experiences . Int. J. Incl. Educ. 21 , 389–403. 10.1080/13603116.2016.1197324 [ CrossRef ] [ Google Scholar ]
• Wechsler D. (1999). Wechsler Abbreviated Scale of Intelligence. San Antonio, Texas: The Psychological Corporation. [ Google Scholar ]
• Weschler D. (2001). WIAT II abbreviated: Wechsler Individual Achievement Test. San Antonio, Texas: Psychological Corporation. [ Google Scholar ]
• Wei X., Christiano E. R. A., Yu J. W., Wagner M., Spiker D. (2014). Reading and math achievement profiles and longitudinal growth trajectories of children with an autism spectrum disorder . Autism 19 , 200–210. 10.1177/1362361313516549, PMID: [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Williamson P., Carnahan C. R., Jacobs J. A. (2012). Reading comprehension profiles of high-functioning students on the autism spectrum: a grounded theory . Except. Child. 78 , 449–469. 10.1177/001440291207800404 [ CrossRef ] [ Google Scholar ]
• World Medical Association General Assembly (2013). Declaration of Helsinki: ethical principles for medical research involving human subjects. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/ [ PubMed ]
• Yeniad N., Malda M., Mesman J., Marinus H., van Ijzendoorn M. H., Pieper S. (2013). Shifting ability predicts math and reading performance in children: a meta-analytical study . Learn Indiv. Differ. 23 , 1–9. 10.1016/j.lindif.2012.10.004 [ CrossRef ] [ Google Scholar ]

• Current Issue
• Back Issues
• Article Topics
• ASN Events Calendar
• 2024 Leadership Awards Reception
• Editorial Calendar
• Submit an Article
• Sign Up For E-Newsletter

Improving the Written Expression of Children with ASD

• By: Kristie Asaro-Saddler, PhD University at Albany
• January 1st, 2013
• children , students , writing
• 13434    1

Writing has become an increasingly important element across curricular areas. However, many young children, including children with autism spectrum disorders (ASD), struggle with this key literacy skill. While it has […]

Writing has become an increasingly important element across curricular areas. However, many young children, including children with autism spectrum disorders (ASD), struggle with this key literacy skill. While it has been well-documented that many children with ASD have handwriting deficits, difficulties in the writing process, including planning, content generation, and revising text, are also pervasive. Therefore, it is essential to examine the writing of children with ASD, determine how their characteristics impact their writing ability, and discuss how parents and teachers may foster improvement in writing outcomes.

Writing is a foundational skill that can support and extend student learning across the curriculum. It allows the sharing of opinions, the demonstration of critical thinking skills, and the display of content knowledge. Writing is critical for school success, as it is the primary means by which students demonstrate their knowledge in school, and the major instrument that teachers use to evaluate academic performance (Graham & Harris, 2005). Beyond school, students need to be able to write well to succeed in society and to obtain and maintain employment.

Writing presents a unique challenge, as it requires putting thoughts on paper in such a way as to transmit a message to another person who may not have knowledge of what you are writing. While developing these thoughts, writers must coordinate the processes of planning, text production, and revision, while also self-monitoring their work. In addition, they must consider the conventions of the language, and the constraints of the topic and the genre, along with the audience needs and perspectives.

  Why Writing is Difficult for Children with ASD

Deficits in writing have been well-documented in ASD research. In one study (Mayes & Calhoun, 2008), for example, 63% of students diagnosed with ASD also exhibited a writing disability. It can be difficult for these students to think of ideas, organize their writing, and physically write their ideas. So what is it that makes writing so difficult for children with ASD?

Children with ASD characteristically exhibit a range of impairments that make written expression difficult. Among these characteristics are:

• An inability to use imagination, engage in abstract thinking, consider perspectives of others, and imagine future events or possible scenarios (Harbinson & Alexander, 2009; Myles, 2005; Myles & Simpson, 2001). These characteristics can lead to a literal interpretation of a writing task and an inability to comprehend or use metaphors, idioms, or rhetorical questions, and may hinder the exploration of counter-arguments and various perspectives.
• Deficits in theory of mind, or the ability to take another’s perspective or believe that others think differently from you (McCoy, 2011), which makes it difficult for students with ASD to recognize that their work will be read by someone else with different views and opinions. This unawareness of an “absent audience” may result in writings that are not well-developed, or that lack elaboration.
• Weak central coherence, or a tendency to focus on small details, which can lead to an inability to understand context or see the “big picture,” causing difficulty with distinguishing important from unimportant details.
• Deficits in the areas of language and communication, which make compiling, expressing, and recording thoughts a challenge, resulting in a composition that lacks a clear, central focus, or that is poorly organized.
• Motor/coordination issues that can contribute to difficulty with handwriting and composing, resulting in brief writings that students are unwilling to revise or elaborate because it is physically “too difficult.”
• Deficits in several executive function components, including planning, cognitive flexibility, inhibition, and self-monitoring (Hill, 2004), which directly impact an individual’s ability to maintaining his/her focus on the process of developing a main idea and details to support the topic, and to encourage engagement and continuous motivation throughout the writing process.

How Can You Help?

  There are several steps that parents and teachers can take to help students with ASD improve their writing skills and allow them to be more successful in school and in their everyday functioning. Here are five simple tips that you can use to help increase the motivation and written performance of children with ASD:

Make the environment conducive to writing. The home or classroom environment can impact a child’s willingness to write. Be sure that the lighting and noise level are acceptable for your child, given his/her sensory needs. Surround the child in a print-rich environment by posting model letters, book reviews, and other types of writing around the home or classroom. Teachers and parents may also consider providing alternatives to the typical pencil and paper. Vary writing implements to include items such as markers, stamps, stickers and magnetic letters, and allow students to work in a comfortable setting for them, as long as it is appropriate for writing (i.e. has a flat surface).

Create an audience and purpose. Since deficits in theory of mind my impact children with ASD’s ability to write for an absent audience, it is helpful to create an audience for them. It is beneficial for students to know before beginning the writing process that there will be an authentic audience, besides just their parent or teacher, viewing their writing. Different genres of writing offer different options of potential audiences. For example, persuasive letters can be written to a principal, a parent, or the head of a company, whereas fictional stories can be written and shared with younger siblings or students in younger grades. Online blogs for people with ASD provide a natural context for writing, in addition to social and emotional support, and may be used by young adults with ASD and younger students who are supervised by parents or teachers.

Use interests and fascination . In school, students must eventually learn to write in response to a prompt their teacher gives them. However, in order to increase students’ motivation and fluency with writing, it may help to allow them to start writing about things in which they are interested. These are topics in which children usually have a desire to share information, along with a great deal of background knowledge. For example, a child with ASD who has an interest in digital cameras may write a “how-to” piece about how to take a picture with a digital camera, or a child with a fascination with trains may write a persuasive piece on why trains are a better method of transportation than cars.

Provide supports. Students with ASD may require various types of supports in the classroom or at home. Graphic organizers and semantic maps (visual tools designed to organize thoughts and represent relationships between them) may aid in the planning process (Sansoti, Powell-Smith & Cohan, 2010). Framed paragraphs, which are partially completed paragraphs with a number of blanks strategically placed for the student to fill in, may also be used to scaffold students’ writing (Kluth & Chandler-Olcott, 2008), along with word banks or drawings/pictures (Hillock, 2011) and story starters, which provide a statement to start the story, such as, “I went for a walk in the woods and I found…” that the student has to continue. Siblings or other students in the class can also act as a support for children with ASD through scribing (writing down what the student says aloud) or shared writing, where students take turns making a contribution to the written product. Peers can also help students with the revising process after their first drafts have been completed.

Use technology. Sometimes the physical act of writing makes it difficult for children with ASD to create written products. Allowing the students to use a keyboard or speech-to-text software may reduce the physical burden and allow students to express themselves in another way. Technology can also be used to help children organize their writing. Software programs such as Kidspiration® and Inspiration® and iPad apps such as Popplet™ for example, can be used in the planning stages to help students organize their thoughts before beginning to write.

While writing can be a challenge for many students with ASD, providing support may prove beneficial. The basic tips offered here can help increase students’ motivation to write, resulting in more frequent writing with less resistance, and ultimately, better written products.

Kristie Asaro-Saddler, PhD is Assistant Professor of Special Education at The University at Albany. For more information, please contact Dr. Asaro-Saddler at [email protected] or visit www.albany.edu/special_education .

Graham, S., & Harris, K. R. (2005). Writing better: Teaching writing processes and self-regulation to students with learning problems . Baltimore, MD: Brookes.

Harbinson, H., & Alexander, J. (2009). Asperger Syndrome and the English curriculum: Addressing the challenges. Support for Learning, 24 , 10-17.

Hill, E. L. (2004). Evaluating the theory of executive dysfunction in autism. Developmental Review, 24 , 189-233.

Hillock, J. (2011). Written expression: Why is it difficult and what can be done? In K. McCoy (Ed). Autism from the teacher’s perspective . Denver: Love Publishing Company.

Kluth, P., & Chandler-Olcott, K. (2008). A land we can share . Baltimore: Paul H. Brooks Publishing.

Mayes, S., & Calhoun, S. L. (2008). WISC-IV and WIAT-II profiles in children with high functioning autism. Journal of Autism and Developmental Disorders, 38 , 428–439.

McCoy, K. M. (2011). Autism from the teacher’s perspective: Strategies for classroom instruction. Denver: Love Publishing Co.

Myles, B. S. (2005). Children and youth with Asperger syndrome . Thousand Oaks, CA: Corwin Press.

Myles, B. S., & Simpson, R. L. (2001) Effective practices for students with Asperger Syndrome. Focus on Exceptional Children, 34 , 1-14.

Sansoti, F., Powell-Smith, K., & Cohan, R. (2010). High-functioning Autism/Asperger syndrome in schools: Assessment and intervention . New York: Guilford Press

Related Articles

The power of sensory integration: enhancing communication for non-speaking individuals.

Communication is complex and extends beyond verbal expression. This is especially important to understand in non-speaking individuals. Non-verbal cues such as facial expression, body language, and sensory experiences play crucial […]

Rights and Challenges for Autistic People with Communication Disabilities in the Legal System

Police should be the last resort…. I shouldn’t have to call the police if my son is having a meltdown. When I get up in the morning, I say, “Thank […]

Enhancing Communication and Accessibility: Assistive Technology for Individuals with Autism

What do a wheelchair, closed captioning on a television screen, and a visual schedule all have in common? They are part of an extensive list of products or services that […]

How to Advocate for Your Nonspeaking or Minimally Verbal Child or Adult

Over the last decade, there has been an increase in autistic self-advocates coming into the public eye through their incredible means to advocate for themselves – and others like them. […]

Language Development and Communication for Nonverbal Autistic Children

Autism spectrum disorder is one that has a broad range of symptoms, but many with its diagnosis have similar “core” symptoms. Difficulties with language and communication is a shared struggle […]

Have a Question?

One response.

[…] https://www.autismspectrumnews.org/improving-the-written-expression-of-children-with-asd/ […]

Have a Comment?

You can use these tags: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>

Individuals, Families, and Service Providers

View our extensive library of over 1,500 articles for vital autism education, information, support, advocacy, and quality resources

Reach an Engaged Autism Readership Over the past year, the ASN website has had 550,000 pageviews and 400,000 unique readers. ASN has over 55,000 social media followers

View the Current Issue

ASN Spring 2024 Issue "Navigating the Healthcare System"

Writing Interventions for Individuals with Autism Spectrum Disorder

• Living reference work entry
• First Online: 12 December 2019
• Cite this living reference work entry

• Amy Accardo 2 &
• S. Jay Kuder 2  

166 Accesses

Writing is a means to communicate and express ideas, thoughts, feelings, and information. Writing interventions refer to effective and evidence-based instructional practices used to support individuals in developing varied elements of writing including but not limited to letter formation, handwriting, length of writing, sentence structure, and quality of writing. Writing interventions often target specific genres of writing including but not limited to descriptive writing, expository writing, narrative writing, and persuasive writing.

Historical Background

The topic of writing interventions and students with autism spectrum disorder (ASD) was not widely considered prior to the twenty-first century. Preceding the enactment of legislation in the 1970s, students with disabilities were denied access to general education. In 1973, Section 504 of the Rehabilitation Act was signed, mandating the inclusion of individuals with disabilities in all programs that receive federal...

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References and Reading

Accardo, A. L., Finnegan, E. G., Kuder, S. J., & Bomgardner, E. M. (2019). Writing interventions for individuals with autism spectrum disorder: A research synthesis. Journal of Autism and Developmental Disorders . https://doi.org/10.1007/s10803-019-03955-9 .

Asaro-Saddler, K. (2014). Self-regulated strategy development: Effects on writers with autism spectrum disorders. Education and Training in Autism and Developmental Disabilities, 49 , 78–91. Retrieved from http://www.jstor.org/stable/23880656

Asaro-Saddler, K. (2016). Writing instruction and self-regulation for students with autism spectrum disorders: A systematic review of the literature. Topics in Language Disorders, 36 (3), 266–283. https://doi.org/10.1097/TLD.0000000000000093 .

Article   Google Scholar  

Asaro-Saddler, K., & Bak, N. (2014). Persuasive writing and self-regulation training: Pairing writers with autism spectrum disorder. Journal of Special Education, 48 , 92–105.

Ashburner, J., Ziviani, J., & Pennington, A. (2012). The introduction of keyboarding to children with autism spectrum disorders with handwriting difficulties: A help or a hindrance? Australasian Journal of Special Education, 36 , 32–61.

Atherton, G., Lummis, B., Day, S. X., & Cross, L. (2019). What am I thinking? Perspective-taking from the perspective of adolescents with autism. Autism, 23 (5), 1186–1200. https://doi.org/10.1177/1362361318793409 .

Article   PubMed   Google Scholar  

Baron-Cohen, S., Leslie, A., & Frith, U. (1985). Does the autistic child have “theory of mind”? Cognition, 21 , 31–46. https://doi.org/10.1016/0010-0277(85)90022-8 .

Bishop, A. E., Sawyer, M., Alber-Morgan, S. R., & Boggs, M. (2015). Effects of a graphic organizer training package on the persuasive writing of middle school students with autism. Education and Training in Autism and Developmental Disabilities, 50 , 290–302. Stable URL: http://www.jstor.org/stable/24827511

Brown, H. M., & Klein, P. D. (2011). Writing, Asperger syndrome and theory of mind. Journal of Autism and Developmental Disorders, 41 (11), 1464–1474. https://doi.org/10.1007/s10803-010-1168-7 .

Delano, M. E. (2007). Use of strategy instruction to improve the story writing skills of a student with Asperger syndrome. Focus on Autism and Other Developmental Disabilities, 22 (4), 252. https://doi.org/10.1177/10883576070220040701 .

Individuals with Disabilities Education Improvement Act of 2004, 20 U.S.C §1400, Pub. L. No. 108–446.

Google Scholar  

Jackson, L., Duffy, M., Brady, M., & McCormick, J. (2018). Effects of learning strategy training on the writing performance of college students with Asperger’s syndrome. Journal of Autism and Developmental Disorders, 48 (3), 708–721.

Kagohara, D. M., Sigafoos, J., Achmadi, D., O’Reilly, M., & Lancioni, G. (2012). Teaching children with autism spectrum disorders to check the spelling of words. Research in Autism Spectrum Disorders, 6 , 304–310.

Kinney, E. M., Vedora, J., & Stromer, R. (2003). Computer-presented video models to teach generative spelling to a child with an autism spectrum disorder. Journal of Positive Behavior Interventions, 5 , 22–29.

Lee, A., Browder, D., Hawley, K., Flowers, C., & Wakeman, S. (2016). Teaching writing in response to text to students with developmental disabilities who participate in alternate assessments. Education and Training in Autism and Developmental Disabilities, 51 (3), 238–251.

Mayes, S., & Calhoun, S. L. (2008). WISC-IV and WIAT-II profiles in children with high functioning autism. Journal of Autism and Developmental Disorders, 38 (3), 428–439. https://doi.org/10.1007/s10803-007-0410-4 .

National Professional Development Center on Autism Spectrum Disorder. (2014). Evidence-based practices. Retrieved 4 Aug 2019, from https://autismpdc.fpg.unc.edu/national-professional-development-center-autism-spectrum-disorder

Pennington, R. C., & Delano, M. E. (2012). Writing instruction for students with autism spectrum disorders: A review of literature. Focus on Autism and Other Developmental Disabilities, 27 (3), 158–167. https://doi.org/10.1177/1088357612451318 .

Pennington, R. C., Ault, M. J., Schuster, J. W., & Sanders, A. (2010). Using simultaneous prompting and computer-assisted instruction to teach story writing to students with autism. Assistive Technology Outcomes and Benefits, 7 (1), 24–38.

Pennington, R. C., Collins, B. C., Stenhoff, D. M., Turner, K., & Gunselman, K. (2014). Using simultaneous prompting and computer-assisted instruction to teach narrative writing skills to students with autism. Education and Training in Autism and Developmental Disabilities, 49 , 396–414. Stable URL: http://www.jstor.org/stable/23881260

Pennington, R., Flick, A., & Smith-Wehr, K. (2018). The use of response prompting and frames for teaching sentence writing to students with moderate intellectual disability. Focus on Autism and Other Developmental Disabilities, 33 (3), 142–149. https://doi.org/10.1177/1088357616673568 .

Reichow, B., Volkmar, F. R., & Cicchetti, D. V. (2008). Development of the evaluative method for evaluating and determining evidence-based practices in autism. Journal of Autism and Developmental Disorders, 38 (7), 1311–1399. https://doi.org/10.1007/s10803-007-0517-7 .

Santangelo, T., Harris, K. R., & Graham, S. (2008). Using self-regulated strategy development to support students who have “trubol giting thangs into werds”. Remedial and Special Education, 29 (2), 78–89.

Schlosser, R. W., & Blischak, D. M. (2004). Effects of speech and print feedback on spelling by children with autism. Journal of Speech, Language, and Hearing Research, 47 (4), 848–862. https://doi.org/10.1044/1092-4388(2004/063) .

Schlosser, R. W., Blischak, D. M., Belfiore, P. J., Bartley, C., & Barnett, N. (1998). Effects of synthetic speech output and orthographic feedback on spelling in a student with autism: A preliminary study. Journal of Autism and Developmental Disorders, 28 (4), 309–319.

Stromer, R., Mackay, H. A., Howell, S. R., & McVay, A. A. (1996). Teaching computer-based spelling to individuals with developmental and hearing disabilities: Transfer of stimulus control to writing tasks. Journal of Applied Behavior Analysis, 29 , 25–42.

Wong, C., Odom, S., Hume, K., Cox, A., Fettig, A., Kucharczyk, S., Brock, M., Plavnick, J., Fleury, V., & Schultz, T. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45 (7), 1951–1966. https://doi.org/10.1007/s10803-014-2351-z .

Download references

Author information

Authors and affiliations.

Department of Interdisciplinary and Inclusive Education, College of Education, Rowan University, Glassboro, NJ, USA

Amy Accardo & S. Jay Kuder

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Amy Accardo .

Editor information

Editors and affiliations.

Yale Child Study Center, New Haven, CT, USA

Fred R. Volkmar

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Science+Business Media, LLC, part of Springer Nature

About this entry

Cite this entry.

Accardo, A., Kuder, S.J. (2020). Writing Interventions for Individuals with Autism Spectrum Disorder. In: Volkmar, F. (eds) Encyclopedia of Autism Spectrum Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6435-8_102456-1

Download citation

DOI : https://doi.org/10.1007/978-1-4614-6435-8_102456-1

Received : 22 August 2019

Accepted : 17 September 2019

Published : 12 December 2019

Publisher Name : Springer, New York, NY

Print ISBN : 978-1-4614-6435-8

Online ISBN : 978-1-4614-6435-8

eBook Packages : Springer Reference Behavioral Science and Psychology Reference Module Humanities and Social Sciences Reference Module Business, Economics and Social Sciences

• Publish with us

Policies and ethics

• Find a journal
• Track your research

Children with high-functioning autism spectrum disorder show unique handwriting patterns

Integrative education system should consider this factor, say experts.

The handwriting performance of children with high-functioning autism differs from that of children without autism. Accordingly, the education system should consider the types and formats of tasks given to these children when they are integrated in regular schools. This conclusion emerges from a new study undertaken at the University of Haifa. "The typical process of handwriting performance among children with high-functioning autism is unique, but while the education system addresses reading skills, it pays almost no attention to handwriting skills," explains Prof. Sara Rosenblum, the author of the study.

Children with high-functioning autism experience difficulties in the social, sensory, and movement fields, but differ from other children on the autism spectrum in terms of their linguistic and cognitive development. Among other differences, these children are usually integrated in regular schools where they are required to perform routine activities such as reading and writing. Writing tasks play an important part in academic progress: writing-related activities account for 30-60 percent of daily activity time in schools. Despite this, the education system places a strong emphasis on reading, whereas skills development, monitoring, and assistance in handwriting performance are much less frequent. There is also a lack of teacher training in this important area.

The present study is unique and the first of its kind in the world. The study was undertaken as part of the thesis prepared by Hemda Amit Ben Simhon of the Neuro-developmental Center at Maccabi HMO, supervised by Prof. Rosenblum, and in consultation with Dr. Eynat Gal, an autism specialist, both from the Department of Occupational Therapy at the University of Haifa. The study included 60 children aged 9-12 from the 3rd through 6th grades at various schools. Half the subjects were children with high-functioning autism spectrum disorder with IQs above 80, while the other half were children with normal development. The children were asked to complete three writing tasks: writing the first name and family name; copying a paragraph; and writing a story describing a picture that was shown to them.

The writing tasks were completed using a special system developed by Prof. Rosenblum that provides objective, computerized data relating not only to the rhythm and speed of handwriting, but also to the degree of pressure applied on the page by the writer, the length of time the pen is in the air, the degree of slant of the pen during handwriting, and so forth.

The study findings show that in 91.5 percent of the instances, the objective indicators provided by the computerized system enabled the identification of children with high-functioning autism as distinct from children with normal development. In other words, the handwriting performances of the two groups showed statistically significant differences. The children with high-functioning autism produced taller and broader letters; waiting times on paper and in the air were longer; and the degree of slant of the pen was smaller.

It also emerged that the differences between the children with high-functioning autism and those with normal development were particularly prominent in the copying task, and less so in the free writing task. The text copying task required significantly more time. The researchers suggest that the need to invest a long period of time in the handwriting task may exacerbate fatigue, impair concentration, and even hamper the ability to produce handwritten content. This investment in the handwriting task may come at the expense of availability for other academic tasks the children receive, as well as their availability for social challenges in the classroom. "When a child has difficulty writing, they effectively have to cope with this difficulty over many hours a day, making it harder for them to cope with the additional challenges they face (social, cognitive, and functional). For example, if a child has to stay behind in recess to copy text from the board, they will have less time to practice social skills," the researchers explained.

The researchers added that the study findings are particularly important in light of the trend to integrate children with different disabilities in the regular education system, in accordance with the Special Education Law. "Since children with high-functioning autism are integrated in classes together with children with normal development, it is important to be careful not to pressure them during the performance of handwriting tasks. They should be given sufficient time, because time pressure creates cognitive stress and may impair the content of their handwriting. Given the central role of writing throughout the academic process, including in academic studies, improving handwriting skills with the assistance of an occupational therapist may improve academic abilities and contribute to an improvement in achievements and in self-confidence," concluded the study authors Ben Simhon and Prof.

• Children's Health
• Attention Deficit Disorder
• Infant's Health
• Medical Education and Training
• Learning Disorders
• Child Development
• Educational Psychology
• Autistic spectrum
• Obsessive-compulsive personality disorder
• Asperger syndrome
• Left-handed
• Adult attention-deficit disorder
• Clinical depression
• Psychiatric service dog

Story Source:

Materials provided by University of Haifa . Note: Content may be edited for style and length.

Cite This Page :

Explore More

• Future Climate Impacts Put Whale Diet at Risk
• Charge Your Laptop in a Minute?
• Caterpillars Detect Predators by Electricity
• 'Electronic Spider Silk' Printed On Human Skin
• Engineered Surfaces Made to Shed Heat
• Innovative Material for Sustainable Building
• Human Brain: New Gene Transcripts
• Epstein-Barr Virus and Resulting Diseases
• Origins of the Proton's Spin
• Symbiotic Bacteria Communicate With Plants

Trending Topics

Strange & offbeat.

Autism and writing: how to teach your child to write

by Jessica Millis

Research has shown that students with autism experience specific challenges regarding the learning process. Learning to write is a critical skill in order for a child to succeed in an academic environment. Writing is a challenge for many autistic students because it involves coordination, muscle strength, motor planning, language skills, organization, and sensory issues.

Autistic children may display these symptoms: • Marked deficit in communication • Complete or partial delay in spoken language • Repetition of words • Deficit in receptive language • Deficit in social language and social behavior • Self-stimulatory behavior such as finger flipping or hand flapping

Some children with autism benefit from augmentative communication devices, such as letterboards, IPADS, and Facilitated Communication (FC).

The importance of writing

Writing allows an individual to translate thoughts into text. It allows non-verbal children to communicate their needs. Writing is an important skill for graduation from high school.

Tips on how to teach children with autism to write

Many autistic children have some level of fine and gross motor difficulty which is manifested through poor handwriting and problems with coordination.

Hand Therapy

Hand therapy is recommended for those with fine motor skill deficits. The purpose of hand therapy is to help the child build muscle tone. An occupational therapists can assist with this therapy and offer professional consultation. Many schools have such therapists. In some cases, the child may be given a pencil grip which can be used to build stamina.

Other hand therapy activities may include but not limited to: • Involve vertical surfaces – you can further build the muscle tone by asking your autistic child to paint on a vertical surface. As they paint up and down the surface, they’ll develop muscles in their wrist. There is magnetic wallpaper you can purchase that allows children to write on walls.

• Squeezing – this can greatly help build muscle tone. Incorporate stress balls and play-dough until the muscles in the fingers strengthen. Start with something soft then you can increase the hardness as the therapy progresses. • Stretchy bands – you may also consider getting a stretchy rubber that will help with tension strengthening around the arms and the wrist area.

All these practices are aimed at strengthening the muscle tone which is critical to writing. If they are done correctly, in no time you should have the hand and fingers ready to start practicing.

What activities encourage writing?

Thinking outside the box is important. Get creative! Consider tag team learning where the child copies what you write. When beginning, it’s best to start with shapes. Draw a vertical line and then have your child copy it. Then do the same with a horizontal line and a circle. Create thick lines that make it easy for your child to trace over. It may be necessary to place your hand over your child’s hand. This type of hand-over-hand support can be faded as the child progresses in skills.

When learning how to write letters, big papers with lines is suggested. Again write the letters with fat lines and have your child trace them.

Since the point of all the exercises is to get your child to write, do not limit them to pencils and worksheets alone. Encourage them to write anywhere and with other tools, such as crayons and brightly-colored markers. There are some markers which are fat and shaped like animals.

Art can help with writing

Invest in watercolors and paints! Art can help develop a child’s fine-motor skills and assist with motor planning and the skills needed for writing.

Be aware of sensory issues regarding writing

Many autistic people have sensory issues. Bombardment of sights, sounds, smells and movements surrounding the activity can cause a meltdown when the child is being challenged to learn something new. Many autistic children have trouble sitting for extended periods of time. Make sure you alternate the sitting activity with movement breaks.

Be flexible

Remember writing should be fun! If your child is not in the mood, listen to her and do not push things because you may just end up risking it all.

Every child is unique in their own ways. Not everyone can fit in a cookie-cutter. Forcing a child to do something they are not comfortable with can only create more resistance. Approach a child in a positive manner while still considering their individual needs.

Jessica Millis, freelance writer, editor on EssayMama writing agency and educator at JMU writing courses. Find her on Twitter and Google+

You may also like

5 tips for teaching students on the autism spectrum

8 Tips for College Success for those on the Autism Spectrum

Monarch Center for Autism for Teens and Young Adults Helps Students Learn to Fly

Understanding the spectrum – a comic strip explanation

An open letter to my autistic son’s teacher

The power of expectations

For my son, his writing is exponentially improved by being in a quiet, visually non-stimulating environment… Thanks for the tips!

I posted this on my Pinterest account. Penmanship is important.

My son had other sensory issues that were not immediately recognized. He didn’t like having his fingernails trimmed because he didn’t want to feel the paper on his fingertips as he wrote. He also had a hard time tolerating writing with pencils–the lead dragging across the paper gave him the chills like fingernails on a chalkboard. This is extremely important to consider since many young children are given pencils to write with in the primary grades.

Thank you for that insight. How did you resolve the sensory issues and writing?

This article is ridiculous. To the author: Your child does not need to be “taught” how to write. They don’t need fun animal toys or squeezy adaptation devices. Your child has motor planning issues and possibly dyspraxia, not stupidity! Instead of treating him like an infant, give him a computer keyboard to type and let him be free to be himself. What is this obsession with handwriting?

Dear Henny, I think u have never worked with autistic kids. Please read to understand not to reply.

She is right….why are obsessed with making a child write when they hate it and it’s hard for them. Functionally in life as adults we barely sign our name these days! However if you can not operate a keyboard or electronic device to co.minicate you are basically not employable…not at the gas station, burger joint, or Walmart will you see employees writing but using electronic devices. In an office setting you must be able to communicate by email….let’s set them up for the future not the pasture!

In some places like ours the skill of properly handling a pencil is a requirement for children even with special needs to be included in schools.

Thanks Jessica for sharing this post. This helps parents like us to be equipped with info on how to assist our children in their needs. God bless!

I agree with deepak. Please be an outside of the box thinking. Autism is not a cookie cutter experience. Each autistic child, youth, or adult especially non verbal has their own unique challenges. Computers are great tools, there is also the over stimulation component, as well as ipads etc do not have the ability to take outside or to a store to partake in social components, which many autistic non verbal teens and adults want to to. They too want to be accepted. Sometimes it has to do with the the emotions within their environment and sensitivity to change.

I know Henny personally. She is deeply autistic — AND she is a teacher, who teaches autistic children every day.

Handwriting has been shown to have a range of benefits for children, so while assistive writing techniques of various kinds may be useful, why not also find effective, innovative ways to learn handwriting? And why be so MEAN, Henny? Someone wrote a heartfelt piece on handwriting struggles and tips and you call then “ridiculous”???

I agree with deepak. Please be an outside of the box thinking. Autism is not a cookie cutter experience. Each autistic child, youth, or adult especially non verbal has their own unique challenges. Sometimes it has to do with the the emotions within their environment and sensitivity to change

In the reality world, they don’t care how good hand writing you are. They only care how fast you type .Unless hand writing is beneficial for autistic sensor or something, I would not encourage them to do hand writing.

So my child can type and does some writing she fatigues easily, but is unable to express her feelings, thoughts, and expressions. When this is mentioned she totally shuts down. Any ideas school can’t figure it out. Thanks Cindy

I have an older autistic son. We saw the autism, but back in the day many doctors didn’t understand it and refused to. He reads wonderfully and can write. His spelling isn’t the best, unless he’s typing on a computer. The processing of thinking of how the letters are formed, how the word is spelled and putting them on paper is a greater task than just typing it out. However, he is very grateful today that he was given the chance and opportunity to learn how to write as it has been useful to him during certain times in life, especially when he has to sign his name too. These kids aren’t dumb at all. They’re very brilliant. They just need to be taught in different ways and we should never deny them the access to learning everything others are taught, including writing by hand!

I have found this article very enlightening. My 8 yr. old, moderate autistic, verbal granddaughter can read very well, but will not hold a pencil, marker or other writing instruments. She can type with two fingers, but is not a great speller. I think this may be worth a try, grateful for any suggestions that may help.

My grandson is struggling to hold the pen/pencil/crayon/texta. I am looking for any tips to encourage this as he starts prep next year and will struggle as the curriculum is difficult let alone having ASD. He loves books but doesn’t want anything to do with writing!

My son is 5+ and reading in an inclusive school. He has mild autism. He know the alphabet very well and his memory is very sharp. He always used to ask about the new thing like what is it…and he never forget the name of item/people….but the problem is that still he dont want to write…

Maybe he just has a hard time leaning a bit forward. You could try playing with him airplane, where you hold his body, he is facing the floor and you imitate an airplane while you help him “fly”. Kind of like a swing but facing down. Try this but if you see he is very uncomfortable, then try to fly him in a different position and very slowly after each day try to slowly get to the “facing down” position. This will help him in leaning forward while writing. Also, you could use colored paper but not yellow. Yellow and white background might irritate him….too contrasting. These could be reasons why he doesn’t want to try writing. They need constant praise even if things don’t go well. If he is trying even for a few seconds, praise him. Good luck and I hope these suggestions help a little.

hi am amira pls my son have problem with names of people like calling me mummy , instead he will just say i want to eat or i want to pee. please how do i get to learn how to call people by their names. thanks,

Hi Amira, My suggestion is: teach him with pictures, real pictures of people you want him to recognize. Facial recognition is hard for many atypical people. Ask him: who is this? And help him answer. Use the same pictures in the beginning, then use different ones with the same people to see if he can transition. Hope this help, good luck!

Thanks Claudia Torok

My 9 year old daughter is considered to be high functioning. Her reading skills are high. She loves to draw but still lacks the skills to write. I have tried the tag team method and had little success but after reading this I see where I may have gone wrong. I am going to try the shapes first then move to actual letters. Thanks for such great ideas.

An a Therapist, I work with a mild Autistic child. He can communicate his needs and also says No to things he don’t like, he can sound all the letters well and we have even improved in the aspect of blending three letter words. He can now read but my problem is, he hate to write. I have worked on his pincer grip and is very good. His letter formation are also my concern too. When is time to write on the schedule board. He will say “I don’t want to write, I hate writhing”. Please what other thing can I do to improve his writing skills.

My 7 year old grandson is in 2nd grade and we are in tears every night by the time he finishes his homework. On top of 2-4 work sheets, they send any worksheets home that he did not finish in school. Since school only started 2 weeks ago, we have not had his IEP meeting yet. I plan to insist that they implement a keyboard into his day instead of insisting he do all thie writing these worksheets require. He has always hated writing, coloring and painting because he gets scolded when he writes too big and messy. I do not understand why these special ed teachers aS WELL AS ALL OTHERS NOT BE MADE AWARE OF the struggles these kids have trying to write. If they are going to have inclusive classes they need to attend workshops in regards to autism and these kids wellbeing.

I think there are a lot of ways make learning effective but the most effective way is to make it fun. Learner will sometimes find the topic too boring that their brain might never grasp it or it will just be forgotten right away. So to make the learning stick to the mind of the learner is to make it fun and memorable. Appealing to the emotion makes it memorable. If the teacher could find a way to make this strategy works, then the learner will really learn a lot.

I saw nothing wrong with this article. It all made sense to me , coming from a parent of a child on the spectrum.

There are even more autism-friendly aids to Handwriting then you have mentioned in this piece. I wonder if you would like to take a look at these two, both offered by National Autism Resources:

https://www.nationalautismresources.com/trion-grips-set-of-4

https://www.nationalautismresources.com/search.php?search_query=Stage%20write&section=product

Comments are closed.

More Stories

35 Personal Autism Secrets you may not know

Comparing the writing skills of autistic and nonautistic university students: A collaboration with autistic university students

Affiliations.

• 1 The City University of New York, USA.
• 2 University of California, Davis, USA.
• 3 University of Virginia, USA.
• 4 Fairleigh Dickinson University, USA.
• PMID: 32640841
• DOI: 10.1177/1362361320929453

We do not know very much about the writing skills of autistic university students. Studies with autistic children and teenagers show that some autistic young people have difficulties writing. Other autistic people are talented writers. In fact, some autistic people would rather write than speak. Good writers often imagine other people's points of view when writing. Autistic people sometimes have difficulties understanding others' points of view. Yet, autistic people often work much harder to understand others' points of view than not-autistic people do. We collaborated with autistic university student researchers to see if autistic university students are better or worse at writing than nonautistic students. Autistic university students in our study were better writers than nonautistic students. Autistic students in our study had higher nonverbal intelligence than nonautistic students. Autistic students also put themselves under more pressure to write perfectly than nonautistic students did. Autistic students did not show any difficulties understanding other minds. This study shows that some autistic university students have stronger writing skills and higher intelligence than nonautistic university students. Yet, autistic students may be too hard on themselves about their writing. Fun activities that help students explore their ideas without pressure (like theater games) may help autistic students be less hard on their writing. Teachers can help autistic students express themselves through writing by encouraging them to write about their interests, by giving them enough time to write, and by letting them write using computers if they want to. This study shows that collaborations with autistic people can help us understand strengths that can help autistic people succeed.

Keywords: autism; autistic; college; intelligence; neurodiversity; participatory; university; writing.

Publication types

• Research Support, U.S. Gov't, Non-P.H.S.
• Autism Spectrum Disorder*
• Autistic Disorder*
• Universities

ORIGINAL RESEARCH article

Reading and writing skills in adolescents with autism spectrum disorder without intellectual disability.

• 1 Occupational Sciences, Speech Language Therapy, Developmental and Educational Psychology Department, Catholic University of Valencia, Campus Capacitas, Valencia, Spain
• 2 Developmental and Educational Psychology, University of Valencia, Valencia, Spain
• 3 Neuropediatrics Section, Hospital la Fe de Valencia, Valencia, Spain

The purpose of this study is to extend the knowledge about academic achievement in individuals with autism spectrum disorder (ASD). To this end, first, we analyzed differences in a wide range of reading and writing skills in adolescents with ASD without intellectual disability (ASD-WID) and adolescents with typical development (TD). Second, these two groups were compared on academic outcomes in core subjects and indicators of successful transition to secondary school. Third, the potential contribution of literacy skills to academic outcomes was examined in the two groups. Participants were 56 adolescents between 12 and 14 years old, 30 with ASD-WID and 26 with TD. Results showed no significant differences between the two groups on measures of reading fluency or literal and inferential comprehension. However, the performance of the group with ASD was significantly lower on reading comprehension processes that assess cognitive flexibility. Regarding their written expression skills, significant differences were observed between the group with ASD and the group with TD on most of the indicators analyzed as: productivity, lexical diversity, and overall coherence (resolution component). In addition, findings showed that the deficits in reading and writing observed in the adolescents with ASD significantly affected their academic achievement, which was lower than that of their peers with TD and below what would be expected based on their intellectual capacity. Moreover, their families’ perceptions of the transition to high school reflected worse adjustment and lower self-esteem, confidence, and motivation.

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by persistent difficulties in communication and social interactions, along with restricted interests and the presence of repetitive behaviors ( American Psychiatric Association, 2013 ). A key factor in the development of people with ASD is academic achievement, which undoubtedly contributes to access to employment opportunities and independent living. The inclusion of students with ASD in regular classrooms is a growing reality, and so it is necessary to analyze the factors that influence their educational performance.

Despite the relevance of this topic, research on the academic profile of students with ASD is limited, particularly in the adolescent stage or during the transition to secondary school. This is a complex period when important developmental changes occur, and it is characterized by greater academic and social demands. The inherent characteristics of ASD, such as difficulties in social communication, resistance to change, sensory hypersensitivity, or intolerance to uncertainty, make these students a particularly vulnerable population in this developmental period. In fact, anxiety, social pressure, and bullying have been found to be significant challenges for adolescents with ASD ( Nuske et al., 2018 ), who report negative experiences in this academic transition phase ( Makin et al., 2017 ). Therefore, identifying the variables that influence school performance and contribute to successful transition to secondary school should be a major research objective.

To date, studies that have attempted to analyze the academic performance of students with ASD have generally referred a variable performance, which is consistent with the disorder’s heterogeneity ( Keen et al., 2016 ). To account for this variability, studies have tried to establish different performance profiles in children and adolescents with diverse cognitive abilities. Thus, Wei et al. (2014) identified four distinct profiles based on five measures of academic achievement (word identification, rapid letter naming, passage comprehension, applied problems, and calculation). These profiles were the following: higher-achieving (39%, who have scored around the national average on most of the measures), hyperlexia (9%, who do well on decoding but with poor comprehension), hypercalculia (20%, with scores close to the national average on calculation skills, but significantly below average on the other four dimensions), and lower-achieving (32%, children who scored about two standard deviations below the mean on all five indicators). The higher-achieving and hyperlexia subgroups had significantly better functional cognitive skills and came from higher socioeconomic backgrounds.

Following a similar approach, Chen et al. (2019) , in a sample 7–14 years old participants with ASD with varied intelligence levels, could determine two distinct groups, low-achievement ASD and high-achievement ASD, based on their performance on four measures taken from the WIAT-II ( Weschler, 2001 ): numerical operations, mathematical reasoning, word reading, and reading comprehension. These differences were especially pronounced in the area of mathematics. As in the study by Wei et al. (2014) , the low-achievement subgroup scores were consistent with the intellectual capacity and other cognitive processes, such as working memory.

However, despite the expected relationship between cognitive ability and academic performance, other studies have identified discrepancies in this regard. Jones et al. (2009) found that approximately 70% of adolescents with ASD from 14 to 16 years old with different cognitive levels had a significant divergence between intellectual ability and one or more achievement domains. They described four subgroups in which either word reading (“reading peak” and “reading dip”) or arithmetic (“arithmetic peak” and “arithmetic dip”) was higher or lower than the WASI Full Scale Intelligence Quotient (IQ; Wechsler, 1999 ). Estes et al. (2011) identified these same differences in a sample of 30 children with ASD without intellectual disabilities. In 60% of them, a significantly lower achievement was found than what was predicted by their cognitive ability, in at least one of the domains analyzed (spelling, word reading, or basic number skills).

In conclusion, students with ASD present an irregular performance profile where intelligence plays an important role, although the research is not consistent in this regard. However, it is clear that many children and adolescents with ASD perform below what would be expected based on their intellectual capacity. Therefore, it is necessary to determine the areas of vulnerability and the factors involved in this low performance, in order to plan more appropriate and effective interventions. Certainly, in the school context, reading and writing are crucial instrumental skills and the basis for success in different curricular areas, and they have important implications throughout life, not only academically, but also socially and occupationally.

Reading Difficulties in ASD

Reading is a complex skill involving the orchestration of different components. From an overall perspective, two major processes may be distinguished as: decoding and comprehension. Decoding refers to the transformation of written words (graphemes) into phonological representations. Comprehension processes refer to the extraction of meaning from the written text. Specifically, and according to one of the most known models of reading, the Simple View of Reading Model ( Hoover and Gough, 1990 ), reading comprehension is the product of decoding skills and linguistic comprehension.

Many studies have found that people with ASD without intellectual disabilities (ASD-WID) have strengths in decoding skills, compared to their reading comprehension performance. Thus, in general, students with ASD-WID seem to master mechanisms involved in automatic word recognition, in contrast to their reading comprehension performance ( Jones et al., 2009 ; Norbury and Nation, 2011 ; Solari et al., 2017 ), which is below expectations for their chronological age or reading accuracy level ( Brown et al., 2013 ). To explain this discrepancy, good memory skills have been cited, as well as phonological and visual processing skills, which would contribute to adequate recognition of the written word.

As in the case of academic performance, the variability in reading skills has led studies to identify reading profiles in samples of children and adolescents with ASD. In a longitudinal and retrospective study, Åsberg et al. (2019) were able to determine three subgroups. A first subgroup, with “low reading performance,” which was the most frequent profile (approximately 50% of the participants), had below-average scores on both word reading and text comprehension. A second subgroup, made up of “skilled readers,” performed above average on both reading processes. Finally, the third subgroup was the least common (20%), and it was composed of “hyperlexical/low understanding” participants. Following a similar approach, namely latent profile analysis, McIntyre et al. (2017) found four different profiles in a sample of students with high-functioning autism from 8 to 16 years old: (1) readers with overall disturbance (32.2%), i.e., alterations in the decoding and comprehension processes; (2) readers with severe overall disturbance (14.1%); (3) readers with comprehension problems (20.6%); and (4) average readers (32.1%). In other words, approximately 70% of the participants experienced reading impairments, and of them, the majority had comprehension problems. Other studies using a cluster analysis methodology have also found lower reading comprehension scores than word reading scores, even in high-achieving subgroups of students with ASD ( Chen et al., 2019 ).

To determine the factors moderating reading comprehension performance in students with ASD, Brown et al. (2013) conducted a meta-analysis of 36 studies comparing ASD and control groups. The strongest individual predictors of reading comprehension were semantic knowledge and decoding skills. The study results highlight the contribution of oral language to reading comprehension, as well as the content of the texts, because individuals with ASD were significantly worse at comprehending highly social texts than less social texts.

In sum, decoding skills, language level, and text characteristics and content are variables to take into account when analyzing the reading comprehension difficulties of students with ASD. Other factors to consider are the development of comprehension strategies during reading ( Williamson et al., 2012 ) or the type of comprehension assessed (literal versus inferential) because students with ASD have shown greater difficulty with inferential comprehension processes ( Tirado and Saldaña, 2016 ). In addition to classical predictors, other cognitive factors may help us understand why students with ASD struggle with reading comprehension. Research in typical children has suggested that cognitive flexibility is positively associated with reading ( Yeniad et al., 2013 ). Cognitive flexibility requires the interaction of several mechanisms (attention shifting, conflict monitoring, and perception) that respond to specific environmental demands, such as rule changes, in order to achieve flexible behavior and to solve the problem in a new way ( Ionescu, 2012 ). Precisely, cognitive flexibility is one of the most significant affected executive function in the majority of children and adolescents with high-functioning ASD ( Lai et al., 2017 ). Therefore, it seems logical to expect that they have difficulties in deploying flexible strategies for accomplishing reading tasks.

Writing Difficulties in ASD

Similar to reading ability, good writing skills are crucial to academic and professional success. In addition, with the growing prevalence of online communication and social networks, the written expression has become a common means of daily interaction between people. Writing represents a major challenge for students with ASD. According to data provided by Mayes and Calhoun (2006) , -in a study with children and adolescents with heterogeneous IQ levels-, approximately 60% of students with ASD present some type of specific difficulty in learning to write.

Most of our understanding of the writing process has been based on the recursive and multi-layered model developed by Hayes and Flower (1980) and Hayes (2006) , which is composed of three main processes: (1) the planning process , directed to prepare the content of the text by retrieving ideas from memory and organizing them; (2) the translation process , which includes the grammatical and orthographical encoding, and the motor execution actions involved in handwriting; and (3) the revision process that allows writers to compare the written product with their mental representation of the intended text. Research on writing difficulties in ASD has mainly focused on the planning and translation processes. A meta-analysis found significantly worse performance of ASD students on several components of writing, related to the translation process (length, legibility, size, speed, and spelling) and to some indicators of the planning process, such as text structure ( Finnegan and Accardo, 2018 ). Likewise, a more recent study has demonstrated that children with ASD-WID write personal narrative texts that obtain lower ratings in holistic assessments of coherence, structure, and content, and have less lexical and syntactic complexity, in comparison with children with TD ( Hilvert et al., 2020 ). Moreover, fine motor and visuomotor speed problems ( Kushki et al., 2011 ) may often result in illegible or brief writing ( Fuentes et al., 2009 ).

Written expression difficulties of students with ASD have been found not only in narrative discourse, but also in expository and persuasive texts ( Brown et al., 2014 ; Price et al., 2020 ). In addition, their essays contain more grammatical errors and present less syntactic diversity and complexity, although they can achieve a lexical richness and coherence comparable to their peers with TD ( Hilvert et al., 2019 ).

In summary, variability is the trait that characterizes the academic performance and reading and writing abilities of students with ASD, which is linked to variables, such as intellectual ability, language level, the type of processes involved, and the characteristics of the tasks used to assess reading and writing. In any case, as students progress through the education system, there is a greater emphasis upon reading comprehension and writing expression which gives students access to school curriculum with more autonomy. The transition from primary to secondary school is one important and educational challenge. Research about the experience of young people with autism has identified a number of areas in which they may experience particular concerns compared to their TD peers, including structural/organizational and social demands. Secondary schools tend to be large, with different teachers for different subjects that students need to adapt to Maras and Aveling, (2006) . Furthermore, social complexity about forming relationships with a new peer group increases anxieties as well as academic demands of independence ( Tobin et al., 2012 ; Mandy et al., 2016 ). Our research focuses on the period of adolescence, a stage less studied in the literature, in particular, in the transition from primary to secondary school, an especially demanding challenge for individuals with ASD. Therefore, a measure of transition to secondary education of individuals with ASD without ID was included.

Consequently, the present study seeks to advance the knowledge about the reading and writing performance of students with ASD in several ways. First, there is a paucity of research on studying the relationships between reading and skills and school achievement in individuals with ASD. Second, it is carried out in Spanish, a language with a transparent spelling characterized by a series of phonological and orthographical specificities that can impact psycholinguistic processing. Third, different comprehension processes (literal and inferential) are considered, using, in addition, a reading-specific measure that requires cognitive flexibility. To the best of our knowledge, this measure has not been employed in the previous investigations assessing reading comprehension in ASD. Based on these considerations, the following objectives were addressed as follows:

1. to analyze differences in a wide range of reading and writing skills between adolescents with ASD-WID and adolescents with TD;

2. to analyze differences in academic outcomes in core subjects and on indicators of successful transition to secondary school between adolescents with ASD-WID and adolescents with TD; and

3. to explore the potential contribution of reading and writing skills to academic outcomes in both groups, adolescents with ASD-WID and TD.

According to the literature review, it is expected to find similar results in both groups in reading accuracy and fluency. However, significant lower results are hypothesized in participants with ASD-WID regarding indicators of written expression and reading comprehension tasks tapping inferential and cognitive flexibility processes. Likewise, it is predicted that participants with ASD will obtain lower academic outcomes, as well as worse results in indicators of successful transition to secondary education. Given the prominent role that reading and writing play on school outcomes, it is anticipated that both instrumental skills will have a considerable weight in academic performance, both in the group with TD and in the group with ASD-WID.

Materials and Methods

Participants.

The present study included 56 adolescents between 12 and 14 years old, of whom 30 were adolescents with ASD-WID (28 males) and 26 were adolescents with typical development (TD; 17 males). The participants had an intellectual functioning within the limits of normality on the K-BIT ( Kaufman and Kaufman, 2000 ).

The group of adolescents with ASD-WID had received a previous clinical diagnosis of an autism spectrum condition by the Psychiatry and Child Neurology services in hospitals and medical centers in the Valencian community at ages ranging between 2 years and 11 months and 6 years old. According to the protocol for the ASD diagnosis, the criteria for ASD from the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV; American Psychiatric Association, 1994 ), the Autism Diagnostic Interview-Revised (ADI-R; Rutter et al., 2006 ), and/or the Autism Diagnostic Observation Schedule-WPS (ADOS-WPS; Lord et al., 1999 ) were administered by a multidisciplinary team. In order to confirm the ASD diagnosis for the present study, the Social Communication Questionnaire ( Rutter et al., 2003 ) and the Autism Diagnostic Interview-Revised (ADI-R; Rutter et al., 2006 ) were administered, taking into account the recommended cutoff points. The results appear in Table 1 . These two instruments were administered to the parents by a clinical psychologist from the research team who had been accredited in their application. Likewise, all the adolescents met the strict diagnostic criteria for ASD from the fifth edition of the DSM-5 ( American Psychiatric Association, 2013 ), based on information provided by teachers and parents. Both informants, in interviews with a clinical psychologist, rated the severity of the criteria in the two ASD dimensions on scales ranging from 0 to 3 points (0 represents “almost never,” 1 represents “sometimes,” 2 represents “often,” and 3 represents “many times”).

Table 1 . Socio-demographic characteristics.

The majority of the adolescents with ASD had educational support at school. Specifically, seven adolescents with ASD (23.33%) were attending school in regular classrooms full time without educational support; nine adolescents (30.00%) attended regular classrooms but received educational support for their specific needs in the high school; and finally, 14 adolescents (46.66%) were placed in the communication and language classroom modality. Furthermore, 11 (36.66%) adolescents with ASD were taking antipsychotic medication (mostly risperidone) for behavioral problems.

The typically developing adolescents had no history of psychopathology or referral to pediatric mental health units (USMI), according to the information found in the school records, and they did not meet DSM-5 criteria for ASD on the screening carried out before beginning the evaluation. None of them were taking any psychoactive medication.

The exclusion criteria for the adolescents who participated in this study were evaluated through an extensive anamnesis carried out with the families. They included neurological or genetic diseases, brain lesions, sensory, auditory, or motor deficits, and an IQ below 80 (see Table 1 ).

The assessment measures were selected based on the objectives of this study. In addition, criteria, such as the psychometric properties of the measures, were taken into account, as well as their translation and adaptation to Spanish.

Reading Skills

The assessment of lexical and semantic reading processes was carried out through two tasks from the PROLEC-SE battery ( Evaluation of Reading Processes for Secondary Education Students ; Ramos and Cuetos, 1999 ). Furthermore, a subtest of the TLC Test ( Leer para Comprender; Reading for understanding ) was also administered ( Abusamra et al., 2010 ).

Lexical Processes Measures

Reading accuracy and reading fluency were assessed through the reading of 40 Spanish words that vary in length, frequency of use, and the complexity of their syllabic structure (i.e., high and low frequency, short and long words). The total accuracy score is obtained by adding up the words read correctly. To obtain the reading speed score, the time spent reading the complete list of 40 words is recorded. In our study reliability index of this measure, Cronbach’s alpha is 0.74.

Reading Comprehension Measures

Semantic processes were assessed using one of the tasks proposed in the semantic block of the PROLEC-SE battery. The task required silently reading two expository texts: “The Eskimos” and “The Australian Papuans.” After each text is read silently, the text is removed, and the participant has to answer 10 questions. Five questions are literal and can be answered from memory and five questions are inferential; that is, they can only be answered if the participant has understood the text and can make the appropriate inferences. Each correct answer receives 1 point. The total score is obtained by adding up the total number of correct answers on each text.

In this research, we use the direct scores. High direct scores on reading accuracy and comprehension and low scores on reading speed indicate better reading performance. The psychometric properties of the PROLEC-SE battery are adequate. For the reliability index, Cronbach’s alpha is 0.84 ( Ramos and Cuetos, 1999 ). In this study, α coefficients for the subscales used were 0.63 (literal comprehension), 0.68 (inferential comprehension), and 0.73 (total comprehension).

Moreover, to assess cognitive flexibility in the reading comprehension process, the “Mental flexibility” subtest from the Read to Understand Test (TLC) was administered ( Abusamra et al., 2010 ). In this subtest, instructions are given that involve different ways to approach the reading of a text, and, subsequently, the reader’s awareness of the strategies used is evaluated. Therefore, part of the evaluation is declarative because the student “tells what s/he does” to solve the task. This test assesses, for example, whether the student knows that, in some cases, a superficial understanding of the text is possible (specifically, on tasks, such as searching for five nouns in a paragraph), whereas in other cases, a deeper understanding is necessary. That is, it is not always necessary to pay attention to the meaning of words, sentences, and paragraphs in order to perform certain activities that focus exclusively on grammatical, syntactic, or stylistic aspects, or when searching for a specific piece of information. This test evaluates this type of metacognitive process, which is related to cognitive flexibility, that is, the ability to focus on the reading comprehension process by selecting appropriate strategies. This aspect of metacognition is defined as the ability to cope with a task by selecting the right strategies and modifying cognitive processes in response to changes: to shift attentional focus, select information to guide and choose necessary responses, form plans, and generate monitoring ( Abusamra et al., 2010 ). The test has psychometric properties, such as concurrent validity and internal consistency (Cronbach’s alpha of 0.79). α coefficient for this test in our sample is 0.66.

Written Expression

To obtain the spontaneous writing sample, the “Birthday” sheet from the Test of Written Language, fourth edition, was used (TOWL-4; Hammill and Larsen, 2009 ). The participants were given a blank sheet of paper and a pen and the following instruction: “Write a story about the events and activities shown in the picture.” They were given as much time as necessary to complete the written compositions, which were then transcribed using the Systematic Analysis of Language Transcripts (SALT; Miller and Iglesias, 2010 ). All the texts were coded on variables that assessed productivity, syntactic complexity, and overall coherence. An independent research assistant was trained in the measures coding during two sessions in a seminar of 5 h. In these sessions, the variables considered were defined and explained and the analysis was practiced on written samples. The research assistant was blind to the goal of the study and did not know the membership group of the texts (ASD or TD). For the reliability check, after the training sessions, the evaluators analyzed approximately 80% of the writings from each group (40 in all), which were randomly selected.

Productivity

Children’s productivity, or fluency, was measured as the total number of words in the text. Automated SALT analyses provided information about this variable.

Syntactic Complexity

Syntactic complexity was measured as the diversity of complex syntax ( Hilvert et al., 2019 ). This variable was determined by counting the number of different types of complex syntactic devices employed within the text: substantive subordinate clauses, adverbial subordinate clauses, relative subordinate clauses, and coordinated clauses. For the presence of each type of syntactic relationship, 1 point was awarded, with a maximum score of 4. In order to calculate inter-rater reliability, the formula proposed by Sackett (1978) was used (number of agreements divided by the number of agreements plus disagreements, x 100). The agreement was 90% for the substantive subordinate clauses, 100% for the adverbial subordinate clauses, 100% for the relative subordinate clauses, and 100% for the coordinated clauses. All disagreements were resolved by discussion.

Global Coherence

To assess the overall coherence of the compositions, the coding system proposed by Barnes and Baron-Cohen (2012) was followed. This system is specially addressed to capture how the story components are included. In this way, it can be identified if there is a cognitive style focused on details at the expense of globality, as the weak central coherence theory states. Thus, the texts were coded on a scale from 0 to 2 for each of the four different elements of the story: (1) setting (where the story takes place); (2) character (who the story is about); (3) conflict (what the story is about); and (4) resolution (how the story ends).

A score of 0 indicates that no information is provided about the element in question; a score of 1 indicates that the composition provides one or more details about the element, but the overall idea of the scene is not captured; and a score of 2 indicates that the narrative provides a well-founded and fully developed view of the corresponding element. With regard to the characters, a score of 0 is awarded if either of the story’s characters is not mentioned, and 1 point if the characters are mentioned, but without defining their relationship to each other or their role in the scene. For conflict, a score of 0 is assigned if the character’s desires or goals are not identified; a score of 1 if a character is defined as wanting something, but without mentioning an obstacle to that goal; and a score of 2 if both a goal and an obstacle to the character achieving that goal are established. Finally, in relation to the resolution component, 0 points are assigned when what happened at the end of the conflict is not mentioned; 1 point if an action that took place at the end of the scene is mentioned; and 2 points if an ending action is described and that action is linked to the overall theme of the scene.

According to the formula proposed by Sackett (1978) , the inter-rater reliability of these measures was as follows: in the case of the setting, 100% agreement was reached; for character, 100% agreement; for conflict, 97% agreement; and for resolution, 98% agreement. All disagreements were resolved by discussion.

Academic Results

Academic results were reported by parents and/or primary caregivers from the last math, language, and social science evaluation. The numerical range used in the Spanish educational system is from 0 to 10, where 0 is the minimum academic grade and 10 is the maximum.

Transition to Secondary Education

Parents filled out a questionnaire derived from a large scale, national transitions study, the Effective Preschool, Primary, and Secondary Education (EPPSE) transitions substudy ( Evangelou et al., 2008 ), used in Makin et al. (2017) to provide an index of “transition success.” Evangelou et al. (2008) defined “successful transition” as a multidimensional construct composed of five underlying factors: developing friendships and confidence, settling into school life, showing a growing interest in school and work, getting used to new routines, and experiencing curriculum continuity.

Parents had to answer six questions related to three of the five factors. Regarding the “developing friendships and confidence” dimension, parents were asked whether, compared to the last year in primary school, their child has more (3 points), the same number (2 points), or fewer (1 point) school friends, as well as more, the same, or less self-esteem, confidence, and motivation. The same scoring system was used in the “experiencing curriculum continuity” dimension, which was assessed by asking parents whether, compared to the last year in primary school, their child shows more, the same, or less interest in school and schoolwork. Regarding the adaptation to school life, parents were asked how they thought their child had settled in (very well, 4 points; quite well, 3 points; not very well, 2 points; and not well at all, 1 point). They were also asked how satisfied they were with the whole process of their child’s transition to secondary school (from very satisfied, 4 points and to not at all satisfied, 1 point), how they felt when their child first moved on to secondary school, and how they feel now (from not at all concerned, 4 points and to very concerned, 1 point). The index of internal consistency Cronbach’s alpha for this questionnaire in our sample is 0.91.

This research was performed in accordance with the ethical standards of the Research Ethics Committee of the University of Valencia, which is regulated by the Ethical Principles for Medical Research Involving Human Subjects (Declaration of Helsinki 1964; World Medical Association General Assembly, 2013 ). Likewise, the authors received authorization from the Board of Education of the Valencian Government to access the schools and locate the participants.

The evaluation was carried out in the high schools where the adolescents were enrolled, in specially prepared spaces that met optimal conditions for psychoeducational assessment. The informed oral and written consent of the parents of all the participants was also obtained after informing them about the research proposal. The different measures were administered to all the adolescents individually by trained examiners. The parents (mostly mothers) provided information about the adolescent’s transition to secondary education, ASD symptoms, and socio-demographic data.

Data Analyses

This paper presents a descriptive cross-sectional study of comparison between a group of adolescents with ASD and a group of adolescents with typical development.

The statistical analyses were performed with the statistical program for the social sciences SPSS v 26.0 (SPSS). Preliminary analyses checked all data for multicollinearity and multivariate outliers. The asymmetry and kurtosis data indicate that most of the variables followed a normal distribution (all values between −1 and 1). Variables that did not show a normal distribution were transformed using square-root transformation (coherence setting and coherence character). To compare the reading/writing skill, academic results, and successful transition to secondary school of ASD-WID and TD, Multivariate analysis of covariance (MANCOVA) was used. The data set was examined for violations of essential assumptions associated with the application of MANCOVA. Pearson correlations between all dependent variables pairs and dependent variable-covariate pairs suggested statistically significant linear relationships.

Adolescents’ IQ, vocabulary, and parents’ educational level were included as covariates due to its potential effect on reading and writing abilities and academic outcomes in general. Likewise, the differences between math, language, and social sciences academic outcomes were explored, as well as the differences regarding the transition to secondary education in adolescents with TD and with ASD-WID. Both academic outcomes and parents perceptions about the successful adaptation to secondary education form part of the academic curriculum, which encompasses different interrelated dimensions.

For the ANCOVAs, Bonferroni correction was applied to establish the significance level. The proportion of total variance accounted for by the independent variables was calculated using partial eta squared (according to Cohen (1988) : eta squared, 0.06 = small; 0.06–0.14 = medium; and 0.14 = large). To compare academic results and successful transition to secondary school of ASD-WID and TD, t -student was used. Moreover, two partial correlations, controlling for parents’ educational level and adolescents’ IQ and vocabulary, were conducted to examine the relationships between reading and writing skills and academic outcomes in both groups. Finally, multiple linear regression analyses were conducted to test the effect of reading and writing skills on the transition to secondary school and academic outcomes in adolescents with ASD-WID.

Differences in Reading and Writing Skills Between Adolescents With ASD-WID and Adolescents With TD

The MANCOVA between the ASD-WID and TD groups with the different reading skill scores (accuracy, speed, reading comprehension, and reading comprehension related to mental flexibility), controlling for parents’ educational level, IQ, and vocabulary, was statistically significant [Wilks’ Lambda (Λ) = 0.70, F 6,46 = 3.21, p = 0.01, η p 2 = 0.30 ]. Likewise, to calculate the additional ANCOVAs, a significance level of p < 0.008 was established, after applying the Bonferroni correction, and the value of η p 2 was calculated to check the strength of the association. Specifically, statistically significant differences were found on the reading comprehension “Mental flexibility” subtest (F 1,51 = 14.6; p < 0.01; η p 2 = 0.22 ). In addition, scores for accuracy (word reading), speed, and reading comprehension did not reach the required level of statistical significance between the group with TD and the group with ASD-ID ( Table 2 ).

Table 2 . Means, standard deviations (SD) of reading and writing skills, and statistically significant differences between ASD and TD adolescents.

The MANCOVA between the ASD-WID and TD groups with the different writing skill scores (productivity, syntactic complexity, and coherence), controlling for parents’ educational level, IQ, and vocabulary, was statistically significant [Wilks’ Lambda (Λ) = 0.71, F 6,46 = 3.02, p = 0.014, η p 2 = 0.28 ]. Likewise, to calculate the additional ANCOVAs, a significance level of p < 0.008 was established, after applying the Bonferroni correction, and the value of η p 2 was calculated to check the strength of the association. Specifically, statistically significant differences were found in word productivity (F 1,51 = 7.78; p = 0.007; η p 2 = 0.23 ), Syntactic complexity (F 1,51 = 13.4; p = 0.001; η p 2 = 0.21 ), and Coherence (conflict resolution component; F 1,51 = 7.63; p = 0.007; η p 2 = 0.13 ; see Table 2 ).

Differences in Academic Outcomes and Transition to Secondary School Between Adolescents With ASD-WID and Adolescents With TD

The MANCOVA between the ASD-WID and TD groups with the different academic outcome scores (language, math, and social sciences) and the transition to the secondary stage was statistically significant [Wilks’ Lambda (Λ) = 0.71, F 6,46 = 3.02, p = 0.014, η p 2 = 0.28 ]. Statistically significant differences were found in language (F 1,51 = 7.78; p = 0.007; η p 2 = 0.23 ), mathematics (F 1,51 = 13.4; p = 0.001; η p 2 = 0.21 ), social sciences (F 1,51 = 7.63; p = 0.007; η p 2 = 0.13 ), and the index of successful transition to secondary education (F 1,51 = 7.63; p = 0.007; η p 2 = 0.13 ; see Table 3 ).

Table 3 . Means, standard deviations (SD) of academic results and successful transition to secondary, and statistically significant differences between ASD and TD adolescents.

Contribution of Reading and Writing Skills to the Academic Outcomes of Adolescents With ASD-ID and Adolescents With TD

Likewise, two partial correlations were performed, using the covariates of parents’ vocabulary, IQ, and educational level, to analyze the association between the reading and writing variables that showed significant differences between the ASD-WID and TD groups and the learning outcomes in the subjects of the Spanish language, mathematics, and social sciences in the ASD-WID and TD groups.

In the group of children with TD, significant positive correlations were observed between the reading comprehension score related to mental flexibility and the scores on language ( r = 0.45; p = 0.029), mathematics ( r = 0.56; p = 0.006), and social sciences ( r = 0.40; p = 0.050). Similarly, significant positive correlations were observed between the productivity subscale and the scores on language ( r = 0.51; p = 0.013) and mathematics ( r = 0.44; p = 0.035).

In the group of children with ASD-WID, significant positive correlations were observed between the reading comprehension score related to mental flexibility and the scores on language ( r = 0.37; p = 0.050) and mathematics ( r = 0.37; p = 0.050). Likewise, significant positive correlations were observed between the social sciences scores and productivity ( r = 0.46; p = 0.015), syntactic complexity ( r = 0.61; p < 0.001), and coherence ( r = 0.42; p = 0.029; see Table 4 ).

Table 4 . Partial correlations between reading/writing skill and academic outcomes.

Finally, multiple regression analyses were carried out in each group in order to evaluate the contribution of reading comprehension related to mental flexibility and writing skills of productivity, syntactic complexity, and coherence to academic outcomes in the core subjects of language, mathematics, and social sciences (see Table 5 ). The regressions carried out with the TD group indicated that the predictors that explained the highest percentage of variance in Spanish language were reading comprehension related to mental flexibility, productivity, and coherence, explaining 51% of the total variance. As for the mathematics outcomes, the results showed that reading comprehension related to mental flexibility and productivity were the significant individual predictors, together explaining 55% of the variance. In social sciences, there were no significant individual or collective predictors.

Table 5 . Multiple regression analysis of reading and writing skills that predict academic outcomes in TD and ASD groups.

The regressions performed with the ASD-WID group indicated that, on the one hand, reading comprehension related to mental flexibility was the single most significant predictor of language and mathematics outcomes, explaining 31 and 24% of the variance, respectively. On the other hand, the predictors that explained the highest percentage of variance in social sciences were syntactic complexity and coherence, explaining 57% of the total variance.

The purpose of this study was to extend the knowledge about academic achievement in adolescents with ASD by addressing various objectives. First, this study analyzed differences in reading and writing performance between adolescents with ASD-WID and adolescents with TD. In terms of reading, no significant differences were found between the two groups on measures of reading fluency (accuracy and speed), which is consistent with most of the research on the topic in languages with opaque orthographies, such as English ( Jones et al., 2009 ).

However, contrary to expectations, our study data failed to show significant differences between participants with ASD-WID and their peers with TD on either literal or inferential reading comprehension. These results contrast with what is commonly reported in the literature, which generally indicates lower reading comprehension competence in individuals with ASD (see meta-analysis by Brown et al., 2013 ). This discrepancy in the findings could be explained by different factors. Firstly, both groups were matched according to vocabulary knowledge which following the Simple View of Reading Model ( Hoover and Gough, 1990 ) is a fundamental factor for reading comprehension. Numerous investigations with children with ASD have exemplified the strong association between reading comprehension and language (see the meta-analysis by Brown et al., 2013 ), which emerges even as one of the strongest predictors of the reading comprehension abilities of these students ( Davidson et al., 2018 ). A second important factor is the type of texts employed in our study. We used two expository texts with little social content that do not require the student to display inferential skills related to Theory of Mind, which is clearly affected in ASD ( Bora and Pantelis, 2016 ). In other words, the reader would not have to apply skills that require taking the perspective of the characters, which, in contrast, would be necessary to understand narrative texts ( Dore et al., 2018 ). In fact, studies have shown that individuals with ASD are significantly worse at comprehending highly social texts than less social texts, such as those employed in this study ( Brown et al., 2013 ). Moreover, and in line with our results on inferential comprehension, experimental studies using eye-tracking techniques have shown that adolescents with ASD are capable of developing inferential comprehension skills that are activated automatically ( Saldaña and Frith, 2007 ; Micai et al., 2017 ), although they may have difficulties on tasks that require them to answer questions that rate this same process ( Tirado and Saldaña, 2016 ). Likewise, another explanation for our discordant results could be found in the composition of the sample, which might consist of students with ASD who have shown strengths in reading performance, both in decoding and comprehension. These profiles have been described in the literature as “skilled readers” ( Åsberg et al., 2019 ) or “average readers” ( McIntyre et al., 2017 ).

However, the results of our study allowed us to identify certain deficient reading comprehension processes in adolescents with ASD, specifically those that require the activation of cognitive flexibility skills and, in particular, metacognitive skills, such as explicitly describing the strategies used when summarizing, detecting the main idea, or giving a title to a text. Thus, significantly lower performance was observed on the reading-specific measure used in this study that requires cognitive flexibility. These results are congruent with the alterations in cognitive flexibility described in ASD. These disturbances have been considered one of its neuropsychological manifestations, although with mixed findings ( Leung and Zakzanis, 2014 ). These outcomes also coincide with the difficulties identified in students with ASD in adapting reading strategies to various reading materials and task demands ( Micai et al., 2019 ). A competent reader must be able to change strategies while reading a text and adapt them to the different objectives and/or requirements presented. Adequate mental flexibility ensures the reader’s active participation in the comprehension process, and its proper functioning facilitates independent learning, which has a great impact on academic performance. Thus, we can see the importance of mastering these processes involved in comprehension and the need to consider this specific area when designing reading intervention programs for individuals with ASD.

In terms of writing skills, as it was hypothesized, the data revealed significant differences between the group with ASD-WID and the group with TD on all the indicators analyzed as: productivity, syntactic diversity, and overall coherence (in the latter case, only in the resolution component). Adolescents with ASD wrote shorter texts with less varied syntactic structures, which is consistent with the results of the previous studies and reviews on the topic ( Dockrell et al., 2014 ; Finnegan and Accardo, 2018 ; Hilvert et al., 2019 ). Unexpectedly, both groups performed similarly on most of the variables used to assess overall coherence (setting, character, and conflict). However, significant differences could be identified in the resolution component; that is, the students with ASD failed to mention what happened at the end of the conflict presented in their stories. These difficulties may affect the overall coherence of the written composition, which is consistent with the tenets of the Weak Central Coherence Theory ( Happé and Frith, 2006 ). According to this theory, people with ASD tend to focus on local or marginal aspects of the information and fail to integrate them into meaningful global representations, in this case, by providing an ending related to the conflict narrated. This cognitive style has also been shown in different studies on written expression in ASD, both in children and adolescents ( Brown et al., 2014 ), as well as in the adult population ( Barnes and Baron-Cohen, 2012 ).

The second objective of this study was to analyze the differences in academic outcomes and the transition to secondary school between adolescents with ASD-WID and adolescents with TD. As it was expected, the results showed statistically significant differences in the academic grades reported by parents and teachers in the language arts, mathematics, and social science subjects, and in the families’ perceptions of the transition to high school. These findings reinforce the idea of a significant gap between cognitive ability and school performance, taking into account that the participants in our study did not present intellectual limitations. This means that students with ASD are not displaying their full academic potential, which is being undermined by various factors, including deficits in certain reading comprehension and written performance measures, as discussed below.

Furthermore, according to parents’ perceptions, a less successful transition process to high school and generally worse adaptation were observed in adolescents with ASD compared to their peers with TD. Families report fewer friends and lower self-esteem, confidence, and motivation. They are less satisfied with the transition process and are concerned about it. These results are consistent with the negative experiences described by parents of children with ASD in this period of educational change, referring to social isolation, bullying, and anxiety in their children ( Humphrey and Lewis, 2008 ). Families experience challenges and stress beyond what would typically be expected ( Dillon and Underwood, 2012 ; Mandy et al., 2016 ; Peters and Brooks, 2016 ). Therefore, as parents also point out, it is essential for secondary schools to understand the nature of autism and the impact it can have on the child and implement the assistance or support students need for a successful transition, optimal academic performance, and social adjustment ( Cremin et al., 2017 ; Tso and Strnadová, 2017 ).

Finally, the third objective of this study was to examine the contribution of reading and writing skills to the academic outcomes of adolescents with ASD-WID. As expected, a significant positive relationship was found (in both the ASD-WID and the TD groups) between the two variables being analyzed. Specifically, in the group with ASD-WID, significant positive associations were observed between the reading comprehension measure specifically tapping cognitive flexibility and the grades earned in the language and mathematics subjects. A similar relationship was found between the grades obtained in social sciences and the written expression indicators considered (productivity, syntactic diversity, and coherence). This association highlights the importance of instrumental skills, such as reading and writing, which have a clear influence on school performance. Specifically, on the one hand, our study data indicate that the reading comprehension task involving cognitive flexibility turned out to be the only significant predictor of the grades obtained in language and mathematics. On the other hand, the predictors that explained the highest percentage of social sciences grades were syntactic complexity and coherence.

The difficulties of these students exhibit in certain processes of reading comprehension and written expression have an impact on their academic outcomes, which should lead to designing interventions that fit their profile of strengths and weaknesses. Several research syntheses have supported the use of strategy instruction in the form of question generation, use of graphic organizers, or making predictions ( El Zein et al., 2014 ; Finnegan and Mazin, 2016 ). More recently, Singh et al. (2020) , in a systematic review of case studies, analyzed the effectiveness of a series of instructional procedures that contributed to improving the reading comprehension performance of students with ASD. They highlighted the use of comprehension-enhancing supports in the form of graphic organizers or visual diagrams, metacognitive strategies, collaborative strategies, such as peer tutoring, and computer-assisted instruction. In terms of writing skills, a recent research synthesis carried out by Accardo et al. (2020) identified several effective instructional practices: self-regulated strategy development, sentence frames, video modeling, Handwriting Without Tears®, and analytic task instruction with systematic prompting and graphic organizers. Some of the variables that improved with the application of these techniques were the number of elements in the text structure and the number of words and sentences. It should be noted that, as in the reading comprehension intervention, the studies reviewed were single case studies, and so research using experimental or quasi-experimental group designs is necessary in order to improve the levels of scientific evidence currently available. Apart from these teaching strategies, education professionals may also consider to adjust the assessment criteria or the mode of assessment for adolescents with ASD.

Likewise, parents’ perspectives on the transition process to secondary school suggest the need for tailored assistance at the time of the student’s move to secondary school. In this regard, Peters and Brooks (2016) show that parents describe a more positive transition when both pre-transition support and ongoing support in the learning and social environments of secondary school are implemented. To this end, a better understanding of the difficulties and strengths of students with ASD in this educational stage, their particular style of processing information, and their strengths and weaknesses in reading and writing skills are essential, due to their strong impact on academic performance.

Limitations

Despite the contributions of these findings, our research has several limitations. First, the relatively small sample size may be hiding some possible significant relationships between the study variables and limiting the possibility to detect small effects. One second limitation, which leads the results to be interpreted with caution, is related to the moderate values of reliability coefficients of the administrated tests. Therefore, future studies should increase the number of participants on a randomized sampling basis and include, apart from psychometric tests, other reading comprehension tasks. The information from criterion-referenced measures could help to design more accurate intervention programs for students with ASD-WID. Third, the mid-range cognitive ability and the gender of the participants with ASD, mostly male, are factors that should be considered, as they may influence the results and affect their generalization to girls or to individuals with ASD with other cognitive levels. In addition, the writing skills of adolescents with ASD were only assessed on a narrative text, and it would have been appropriate to expand the information to persuasive and expository genres. Furthermore, the indicator used to reflect the academic results was the qualification marks of the last evaluation, which may not be representative of the whole academic level of achievement. Finally, our study has a cross-sectional design, and future research should analyze developmental variations in the writing and reading profiles of individuals with ASD.

This research provides an overview of the school performance of adolescents with ASD and the factors involved in it. The results show that adolescents with ASD have strengths in reading-decoding mechanisms, but their performance on reading comprehension processes involving aspects of mental flexibility and writing skills continues to be significantly below expectations. Both deficits contribute significantly to their academic achievement, which is also below that of their peers with TD and what would be expected based on their intellectual capacity, at a medium range in this study. In any case, academic difficulties should be taken into account when analyzing the parents’ opinions in the transition period to secondary school because parents of students with ASD-WID report a more difficult adaptation process compared to students with TD. Consequently, education professionals face the challenge of adapting their teaching style and employing evidence-based teaching strategies that address students’ different needs while enhancing their capabilities. This may be a promising avenue for reducing the gap between the potential and current academic performance of students with ASD.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics Statement

The studies involving human participants were reviewed and approved by the University of Valencia. Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin.

Author Contributions

IB, AM, BR, and CB contributed to the design of the work and wrote the manuscript. CB was responsible for the analysis and interpretation of data for the study. BR was responsible for the literature search and assessment of the participants. All authors participated in data interpretation and draft the manuscript and approved the version to be submitted.

This research was financed by the Spanish Ministry of Economy and Competitiveness (PSI2016-78109; AEI/FEDER, UE) and by the Generalitat Valenciana (grant no. GV/2020/C/005). The funding body had no role in the study design, data collection, analysis, interpretation, or writing of the report or the decision to submit the paper for publication.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We would like to thank the adolescents, parents, and teachers who participated in this study.

Abusamra, V., Ferreres, A., Raiter, A., Beni, D., and Cornoldi, C. (2010). Test Leer para Comprender (TLC). Evaluación de la comprensión de textos. Buenos Aires: Paidós.

Google Scholar

Accardo, A. L., Finnegan, E. G., Kuder, S. J., and Bomgardner, E. M. (2020). Writing interventions for individuals with autism spectrum disorder: a research synthesis. J. Autism Dev. Disord. 50, 1988–2006. doi: 10.1007/s10803-019-03955-9

PubMed Abstract | CrossRef Full Text | Google Scholar

American Psychiatric Association (APA) (1994). Diagnostic and Statistical Manual of Mental Disorders. 4th Edn . Washington, DC: American Psychiatric Association.

American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders. 5th Edn . Washington, DC: American Psychiatric Association.

Åsberg, J., Carlsson, E., Norbury, C., Gillberg, C., and Miniscalo, C. (2019). Current profiles and early predictors of reading skills in school-age children with autism spectrum disorders: a longitudinal, retrospective population study. Autism 23, 1449–1459. doi: 10.1177/1362361318811153

Barnes, J. L., and Baron-Cohen, S. (2012). The big picture: storytelling ability in adults with autism spectrum disorders. J. Autism Dev. Disord. 42, 1557–1565. doi: 10.1007/s10803-011-1388-5

Bora, E., and Pantelis, C. (2016). Meta-analysis of social cognition in attention-deficit/hyperactivity disorder (ADHD): comparison with healthy controls and autistic spectrum disorder. Psychol. Med. 46, 699–716. doi: 10.1017/S0033291715002573

CrossRef Full Text | Google Scholar

Brown, H. M., Johnson, A. M., Smyth, R. E., and Oram Cardy, J. (2014). Exploring the persuasive writing skills of students with high-functioning autism spectrum disorder. Res. Autism Spectr. Disord. 8, 1482–1499. doi: 10.1016/j.rasd.2014.07.017

Brown, H. M., Oram-Cardy, J., and Johnson, A. (2013). A meta-analysis of the reading comprehension skills of individuals on the autism spectrum. J. Autism Dev. Disord. 43, 932–955. doi: 10.1007/s10803-012-1638-1

Chen, L., Abrams, D. A., Rosenberg-Lee, M., Iuculano, T., Wakeman, H. N., Prathap, S., et al. (2019). Quantitative analysis of heterogeneity in academic achievement of children with autism. Clin. Psychol. Sci. 7, 362–380. doi: 10.1177/2167702618809353

Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. 2nd Edn . Hillsdale, NJ: Erlbaum.

Cremin, K., Healy, O., and Gordon, M. (2017). Parental perceptions on the transition to secondary school for their child with autism. Adv. Autism 3, 87–99. doi: 10.1108/AIA-09-2016-0024

Davidson, M. M., Kaushanskaya, M., and Ellis Weismer, S. (2018). Reading comprehension in children with and without ASD: The role of word reading, oral language, and working memory. J. Autism Dev. Disord. 48, 3524–3541. doi: 10.1007/s10803-018-3617-7

Dillon, G. V., and Underwood, J. D. M. (2012). Parental perspectives of students with autism spectrum disorders transitioning from primary to secondary school in the United Kingdom. Focus Autism Dev. Dis. 27, 111–121. doi: 10.1177/1088357612441827

Dockrell, J. E., Ricketts, J., Charman, T., and Lindsay, G. (2014). Exploring writing in products in students with language impairment and autism spectrum disorders. Learn. Instr. 32, 81–90. doi: 10.1016/j.learninstruc.2014.01.008

Dore, R. A., Amendum, S. J., Michnick Golinkoff, R., and Hirsh-Pasek, K. (2018). Theory of mind: a hidden factor in reading comprehension? Educ. Psychol. Rev. 30, 1067–1089. doi: 10.1007/s10648-018-9443-9

El Zein, F., Solis, M., Vaughn, S., and McCulley, L. (2014). Reading comprehension interventions for students with autism spectrum disorders: a synthesis of research. J. Autism Dev. Disord. 44, 1303–1322. doi: 10.1007/s10803-013-1989-2

Estes, A., Rivera, V., Bryan, M., Cali, P., and Dawson, G. (2011). Discrepancies between academic achievement and intellectual ability in higher-functioning school-aged children with autism spectrum disorder. J. Autism Dev. Disord. 41, 1044–1052. doi: 10.1007/s10803-010-1127-3

Evangelou, M., Taggart, B., Sylva, K., Melhuish, E., Sammons, P., and Siraj-Blatchford, I. (2008). What Makes a Successful Transition from Primary to Secondary School? Nottingham, United Kingdom: Department for Children Schools and Families.

Finnegan, E., and Accardo, A. L. (2018). Written expression in individuals with autism spectrum disorder: a meta-analysis. J. Autism Dev. Disord. 48, 868–882. doi: 10.1007/s10803-017-3385-9

Finnegan, E., and Mazin, A. L. (2016). Strategies for increasing reading comprehension skills in students with autism spectrum disorder: review of the literature. Educ. Treat. Children 39, 187–219. doi: 10.1353/etc.2016.0007

Fuentes, C. T., Mostofsky, S. H., and Bastian, A. J. (2009). Children with autism show specific handwriting impairments. Neurology 73, 1532–1537. doi: 10.1212/WNL.0b013e3181c0d48c

Hammill, D. D., and Larsen, S. C. (2009). Test of Written Language. 4th Edn . (TOWL-4). Austin, TX: PRO-ED.

Happé, F., and Frith, U. (2006). The weak coherence account: detail-focused cognitive style in autism spectrum disorders. J. Autism Dev. Disord. 36, 5–25. doi: 10.1007/s10803-005-0039-0

Hayes, J. R. (2006). “New directions in writing theory,” in Handbook of Writing Research. eds. C. Mac Arthur, S. Graham, and J. Fitzgerald (New York: The Guildford Press).

Hayes, J. R., and Flower, L. (1980). “Identifying the organization of writing processes,” in Cognitive Processes in Writing. eds. L. W. Gregg and E. R. Steinberg (Hillsdale, NJ: Lawrence Erlbaum Associates), 3–30.

Hilvert, E., Davidson, D., and Gámez, P. B. (2020). Assessment of personal narrative writing in children with and without autism spectrum disorder. Res. Autism Spectr. Disord. 69:101453. doi: 10.1016/j.rasd.2019.101453

Hilvert, E., Davidson, D., and Scott, C. M. (2019). An in-depth analysis of expository writing in children with and without autism spectrum disorder. J. Autism Dev. Disord. 49, 3412–3425. doi: 10.1007/s10803-019-04057-2

Hoover, W. A., and Gough, P. B. (1990). The simple view of reading. Read. Writ. 2, 127–160. doi: 10.1007/BF00401799

Humphrey, N., and Lewis, S. (2008). What does ‘inclusion’ mean for pupils on the autistic spectrum in mainstream secondary schools? J. Res. Spec. Educ. Needs 8, 132–140. doi: 10.1111/j.1471-3802.2008.00115.x

Ionescu, T. (2012). Exploring the nature of cognitive flexibility. New Ideas Psychol. 30, 190–200. doi: 10.1016/j.newideapsych.2011.11.001

Jones, C. R., Happé, F., Golden, H., Marsden, A. J., Tregay, J., Simonoff, E., et al. (2009). Reading and arithmetic in adolescents with autism spectrum disorders: peaks and dips in attainment. Neuropsychology 23, 718–728. doi: 10.1037/a0016360

Kaufman, A. S., and Kaufman, N. I. (2000). K-BIT, Test Breve de Inteligencia de Kauffman. Madrid: Pearson.

Keen, D., Webster, A., and Ridley, G. (2016). How well are children with autism spectrum disorder doing academically at school? An overview of the literature. Autism 20, 276–294. doi: 10.1177/1362361315580962

Kushki, A., Chau, T., and Anagnostou, E. (2011). Handwriting difficulties in children with autism spectrum disorders: A scoping review. J. Autism Dev. Disord. 41, 1706–1716. doi: 10.1007/s10803-011-1206-0

Lai, C. L. E., Lau, Z., Lui, S. S., Lok, E., Tam, V., Chan, Q., et al. (2017). Meta-analysis of neuropsychological measures of executive functioning in children and adolescent with high functioning autism spectrum disorder. Autism Res. 10, 911–939. doi: 10.1002/aur.1723

Leung, R. C., and Zakzanis, K. K. (2014). Brief report: cognitive flexibility in autism spectrum disorders: a quantitative review. J. Autism Dev. Disord. 44, 2628–2645. doi: 10.1007/s10803-014-2136-4

Lord, C., Rutter, M., DiLavore, P. C., and Risi, S. (1999). Autism Diagnostic Observation Scale-WPS (ADOS-WPS). Los Angeles: Western Psychological Services.

Makin, C., Hill, V., and Pellicano, E. (2017). The primary-to-secondary school transition for children on the autism spectrum: a multi-informant mixed-methods study. Autism Dev. Lang. Impairments 2, 1–18. doi: 10.1177/2396941516684834

Mandy, W., Murin, M., Baykaner, O., Staunton, S., Hellriegel, J., Anderson, S., et al. (2016). The transition from primary to secondary school in mainstream education for children with autism spectrum disorder. Autism 20, 5–13. doi: 10.1177/1362361314562616

Maras, P., and Aveling, E. P. (2006). Students with special educational needs: transitions from primary to secondary school. Br. J. Spec. Educ. 33, 196–203. doi: 10.1111/j.1467-8578.2006.00439.x

Mayes, S. D., and Calhoun, S. L. (2006). Frequency of reading, math, and writing disabilities in children with clinical disorders. Learn. Indiv. Differ. 16, 145–157. doi: 10.1016/j.lindif.2005.07.004

McIntyre, N. S., Solari, E. J., Grimm, R. P., Lerro, L. E., Gonzales, J. E., and Mundy, P. C. (2017). A comprehensive examination of reading heterogeneity in students with high functioning autism: distinct reading profiles and their relation to autism symptom severity. J. Autism Dev. Disord. 47, 1086–1101. doi: 10.1007/s10803-017-3029-0

Micai, M., Joseph, H., Vulchanova, M., and Saldaña, D. (2017). Strategies of readers with autism when responding to inferential questions: an eye-movement study. Autism Res. 10, 888–900. doi: 10.1002/aur.1731

Micai, M., Vulchanova, M., and Saldaña, D. (2019). Do individuals with autism change their reading behavior to adapt to errors in the text? J. Autism Dev. Disord. 49, 4232–4243. doi: 10.1007/s10803-019-04108-8

Miller, J. F., and Iglesias, A. (2010). Systematic Analysis of Language Transcripts (SALT), Research Version 2010 [Computer software]. SALT Software.

Norbury, C., and Nation, K. (2011). Understanding variability in reading comprehension in adolescents with autism spectrum disorders: interactions with language status and decoding skill. Sci. Stud. Read. 15, 191–210. doi: 10.1080/10888431003623553

Nuske, H. J., McGhee Hassrick, E., Bronstein, B., Hauptman, L., Aponte, C., Levato, L., et al. (2018). Broken bridges-new school transitions for students with autism spectrum disorder: a systematic review and strategies for success. Autism 23, 1–20. doi: 10.1177/136236131875452

Peters, R., and Brooks, R. (2016). Parental perspectives on the transition to secondary school for students with Asperger syndrome and high-functioning autism: a pilot survey study. Br. J. Spec. Educ. 43, 75–91. doi: 10.1111/1467-8578.12125

Price, J. R., Martin, G. E., Chen, K., and Jones, J. (2020). A preliminary study of writing skills in adolescents with autism across persuasive, expository, and narrative genres. J. Autism Dev. Disord. 50, 319–332. doi: 10.1007/s10803-019-04254-z

Ramos, J. S., and Cuetos, F. (1999). PROLEC-SE. Evaluación de los Procesos Lectores en Secundaria. Madrid: Tea Ediciones.

Rutter, M., Bailey, A., and Lord, C. (2003). SCQ: The Social Communication Questionnaire. Torrance, CA: Western Psychological Services.

Rutter, M., Le Couteur, A., and Lord, C. (2006). ADI-R; Entrevista Clínica Para el Diagnóstico del Autismo-Revisada. Madrid: TEA Ediciones.

Sackett, C. (1978). Observing Behavior. Vol . 2. Baltimore, MD: University Park Press.

Saldaña, D., and Frith, U. (2007). Do readers with autism make bridging inferences from world knowledge? J. Exp. Child Psychol. 96, 310–319. doi: 10.1016/j.jecp.2006.11.002

Singh, B. D., Moore, D. W., Furlonger, B. E., Anderson, A., Fall, R., Howorth, S., et al. (2020). Reading comprehension and autism spectrum disorder: a systematic review of interventions involving single-case experimental designs. Rev. J. Autism Dev. Disord. 8, 3–21. doi: 10.1007/s40489-020-00200-3

Solari, E. J., Grimm, R., McIntyre, N. S., Swain-Lerrob, L., Zajicb, M., Mundya, P. C., et al. (2017). The relation between text reading fluency and reading comprehension for students with autism spectrum disorders. Res. Autism Spectr. Disord. 41-42, 8–19. doi: 10.1016/j.rasd.2017.07.002

Tirado, M. J., and Saldaña, D. (2016). Readers with autism can produce inferences, but they cannot answer inferential questions. J. Autism Dev. Disord. 46, 1025–1037. doi: 10.1007/s10803-015-2648-6

Tobin, H., Staunton, S., Mandy, W., Skuse, D., Helligreil, J., Baykaner, O., et al. (2012). A qualitative examination of parental experiences of the transition to mainstream secondary school for children with an autism spectrum disorder. Educ. Child Psychol. 29, 75–85.

Tso, M., and Strnadová, I. (2017). Students with autism transitioning from primary to secondary schools: parents’ perspectives and experiences. Int. J. Incl. Educ. 21, 389–403. doi: 10.1080/13603116.2016.1197324

Wechsler, D. (1999). Wechsler Abbreviated Scale of Intelligence. San Antonio, Texas: The Psychological Corporation.

Weschler, D. (2001). WIAT II abbreviated: Wechsler Individual Achievement Test. San Antonio, Texas: Psychological Corporation.

Wei, X., Christiano, E. R. A., Yu, J. W., Wagner, M., and Spiker, D. (2014). Reading and math achievement profiles and longitudinal growth trajectories of children with an autism spectrum disorder. Autism 19, 200–210. doi: 10.1177/1362361313516549

Williamson, P., Carnahan, C. R., and Jacobs, J. A. (2012). Reading comprehension profiles of high-functioning students on the autism spectrum: a grounded theory. Except. Child. 78, 449–469. doi: 10.1177/001440291207800404

World Medical Association General Assembly (2013). Declaration of Helsinki: ethical principles for medical research involving human subjects. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/

Yeniad, N., Malda, M., Mesman, J., Marinus, H., van Ijzendoorn, M. H., and Pieper, S. (2013). Shifting ability predicts math and reading performance in children: a meta-analytical study. Learn Indiv. Differ. 23, 1–9. doi: 10.1016/j.lindif.2012.10.004

Keywords: autism, reading, writing, academic achievement, secondary school

Citation: Baixauli I, Rosello B, Berenguer C, Téllez de Meneses M and Miranda A (2021) Reading and Writing Skills in Adolescents With Autism Spectrum Disorder Without Intellectual Disability. Front. Psychol . 12:646849. doi: 10.3389/fpsyg.2021.646849

Received: 28 December 2020; Accepted: 07 June 2021; Published: 19 July 2021.

Reviewed by:

Copyright © 2021 Baixauli, Rosello, Berenguer, Téllez de Meneses and Miranda. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Belen Rosello, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Autism - List of Essay Samples And Topic Ideas

Autism, or Autism Spectrum Disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech, and nonverbal communication. Essays could explore the causes, symptoms, and treatment of autism, the experiences of individuals with autism, and societal understanding and acceptance of autism. We’ve gathered an extensive assortment of free essay samples on the topic of Autism you can find at Papersowl. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

Rain Man and Autism

The film Rain man was released into theaters in 1988 and was awarded many awards along with an Academy Award. The movie starts off by showing Charlie who works as a car salesman, attempting to close on a deal involving four Lamborghinis. Charlie decides to drive with his girlfriend Susanna to ensure that this deal goes through. On the drive over Charlie receives a call telling him that his father has just passed away. Charlie and his girlfriend go his […]

Applied Behavior Analysis and its Effects on Autism

Abstract During my research i have found several studies that have been done to support the fact that Applied Behavioral Analysis (ABA) does in fact make a positive impact on children with Autism through discrete trials. It is based on the thought that when a child is rewarded for a positive behavior or correct social interaction the process will want to be repeated. Eventually one would phase out the reward. Dr Lovaas, who invented this method, has spent his career […]

The Unique Parenting Challenges are Faced by the Parents of Special Children

Introduction For typical children, parenting experiences are shared by other parents whereas the unique parenting challenges are faced by the parents of special children. Mobility and Inclusion of the parents as well as children are affected many a times. Even though careful analysis often reveals abilities, habitual tendency to perceive the disabilities from society’s part often hinders effective normalization and proper rehabilitation. All impose severe identity crisis and role restrictions even in knowledgeable parents.. In some conditions, as in the […]

We will write an essay sample crafted to your needs.

Autism in Japanese Manga and its Significance on Current Progression in J-pop Culture

Abstract In this paper I will explore and examine Autism in Manga, the social and cultural context of Autism in Manga, its movement, and importance of Tobe Keiko’s, “With the Light.” Manga is a huge part of Japanese culture and can be appreciated by so many different people. There are different types of Manga that have been specifically produced for that type of audience. In this paper, I will address the less talked about, women’s Manga or also known as […]

Speech Therapist for Autism

Abstract Autism Spectrum Disorder is a condition that consists of various challenges to an individual such as social skills, nonverbal communication, repetitive behaviors and difficulties with speech. So far doctors have not been able to find out what causes autism although it is believed that it involves both environmental and genetic factors. Autism can usually be detected at an early age, therefore giving the patient and therapist an early start to improve their verbal skills. Speech language pathologists also known […]

Virtual Reality in Regards to Health and how it Can be Life-Changing

        Exploring Virtual Reality in Health Diego Leon Professor Ron Frazier October 29, 2018, Introduction When most individuals think of technology involving computers, they think it can solely involve two of the five senses we humans have – vision (sight) and hearing (audition). But what if we could interact with more than two sensorial channels? Virtual reality deals with just that. Virtual reality is defined as a “high-end user interface that involves real-time simulation and interaction through […]

Growing up with Autism

Autism is a profound spectrum disorder; symptoms, as well as severity, range. It is one of the fastest-growing developmental disorders in America. For every 68 children born in the United States, 1 is diagnosed with a neurological development disorder that impairs their ability to interact and communicate on what we constitute as normal levels. Autism is multifaceted; it affects the brain development of millions worldwide. Not only are those diagnosed on the Autism Spectrum facing difficulties, but the family members […]

Kids with Autism

In this earth we have many different lifeforms. Animals, plants, insects, and people. Humans have populated the earth all throughout it. Some people are born healthy and some are born will disorders and illnesses and diseases. One of the disorders is Autism. Autism is constantly affecting the people who have it and the people around them all over the world. So what is Autism? Autism is a disorder that impairs the ability for social interaction and communication. It is very […]

My Personal Experience of Getting to Know Asperger’s Syndrome

The beginning of this paper covers the history of Asperger’s Syndrome, followed by an explanation of what Asperger’s is. The history provides detailed insights into Hans Asperger and Leo Kanner, and their relationship to each other. Their work has significantly enriched our understanding of the research surrounding Autism and Asperger’s Syndrome. The paper also discusses the process leading to Asperger’s becoming a recognized diagnosis, including the contributions of Lorna Wing and Ulta Frita. Furthermore, it traces Asperger’s entry into the […]

Cultural Stereotypes and Autism Disorder

“It’s the fastest growing developmental disability, autism” (Murray, 2008, p.2). “It is a complex neurological disorder that impedes or prevents effective verbal communication, effective social interaction, and appropriate behavior” (Ennis-Cole, Durodoye, & Harris, 2013). “Autism spectrum disorder (ASD) is a lifelong disorder that may have comorbid conditions like attention deficit disorder (ADD)/attention deficit/hyperactivity disorder (ADHD), anxiety disorder, stereotypical and self-stimulatory behaviors, insomnia, intellectual disabilities, obsessive compulsive disorder, seizure disorder/epilepsy, Tourette syndrome, Tic disorders, gastrointestinal problems, and other conditions. Another certainty, […]

Understanding Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder (ASD) is a cognitive disability that affects a person’s “communication, social, verbal, and motor skills” . The umbrella term of ASD created in 2013 by the American Psychiatric Association that covered 5 separate autism diagnosis and combined them into one umbrella term, the previous terms being Autistic Disorder, Rett syndrome, Asperger’s Disorder, Childhood disintegrative Disorder, and Pervasive Developmental Disorders. The word spectrum in the diagnosis refers to the fact that the disability does not manifest itself in […]

Defining Altruism Issue

In current society, it can be justified that the level of autonomy directly influences the amount of altruism an autistic adolescent implements. Defining Altruism: When it comes to the comprehension of socialization within the development of behaviors in adolescents, altruism is vital. Although there is no true altruism, more or less altruism can be determined based upon the involuntary actions and behaviors of an individual. In the absence of motivation, altruism cannot transpire. An altruist must have the inherent belief […]

911 Telecommunicators Response to Autism

Autism is becoming more prevalent every day. The Center for Disease Control and Prevention released new statistics in 2018. Nationally, 1 in 59 children have autism spectrum disorder (ASD) and boys are 4 (four) times more likely to have autism than girls. 1 in 37 boys and 1 in 151 girls were found to have autism. These are incredibly high statistics that will affect our communities across the United States We, as Telecommunicators, need to know how to understand and […]

Representation of Autism in the Netflix TV Show “Atypical”

In the first season of the TV show “Atypical”, the viewer meets the Gardner family, a seemingly normal family with an autistic teenage son, Sam, as the focus. This show failed initially to deviate from typical portrayals of autistic people on screens, as a white male, intellectually gifted, and seemingly unrelatable, although it seemed to try. Sam acts in ways that seem almost unbelievable for even someone with autism to, such as when he declares his love for someone else […]

Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a group of developmental disorders that challenges a child’s skills in social interaction, communication, and behavior. ASD’s collective signs and symptoms may include: making little eye contact, repetitive behaviors, parallel play, unexplainable temper tantrums, misunderstanding of nonverbal cues, focused interests, and/or sensory overload. Positive symptoms of ASD may reflect above-average intelligence, excellence in math, science, or art, and the ability to learn things in detail. A question that many parent has is whAlthough an individual […]

The Complexity of Autism

Autism spectrum disorder is a complex disease that affects the developmental and speech capabilities of adolescents that carries with them to adulthood. It is distinctly apparent when the child is still very young and able to be diagnosed from about a year and a half old onwards. Although the disease cannot be pinpointed to one specific area of the brain, it is believed to stem from a glitchy gene that makes the child more susceptible to developing autism, oxygen deprivation […]

An Overview of the Five Deadly Diseases that Affect the Human Brain

There are hundreds of diseases that affect the brain. Every day, we fight these diseases just as vehemently as they afflict their carriers. Parkinson's disease, Alzheimer's, depression, autism, and strokes are just five of the most lethal and debilitating diseases that afflict human brains. Parkinson's disease alone claims up to 18,000 lives a year (Hagerman 1). But what is it? Parkinson's disease occurs when a brain chemical called dopamine begins to die in a region that facilitates muscle movement. Consequently, […]

Autism Genes: Unveiling the Complexities

“Autism is a brain disorder that typically affects a person’s ability to communicate, form relationships with others and respond appropriately to the environment (www.childdevelopmentinfo.com).” There are different levels of autism. “There is the autistic disorder, Asperger's syndrome and pervasive developmental syndrome (www.asws.org).” According to (www.everydayhealth.com/autism/types), “Each situation is unique as there are many levels and severities of it. Many cases also include sensory difficulties. These can range from imaginary sights and sounds to other sensations.” There are many different characteristics […]

Autism and Assistive Technology for Autistic Children

Autism is a complex neurobehavioral condition that is found in a person from early childhood days where the person faces difficulty in communicating with another person. It is also known as ASD or Autism Spectrum Disorder. It is a spectrum disorder because its effect varies from person to person. This is caused due to some changes that happen during early brain development. It is suggested that it may arise from abnormalities in parts of the brain that interpret sensory input […]

The Evolution of Autism Diagnosis: from Misunderstanding to Scientific Approach

Autism has come a long way from the early 1980s when it was rarely diagnosed to today where 100 out 10,000 kids are diagnosed. Autism is defined as a developmental disorder that affects communication and behavior (NIMH 2018). There are many aspects surrounding Autism and the underlying effects that play a role in Autism. According to the Diagnostic and Statistical Manual of Mental Disorders, people with Autism have “Difficulty with communication and interaction with other people Restricted interests and repetitive […]

Do Vaccines Cause Autism

In a world of medicines and “mommy bloggers”, there is a controversy between pro-vaxxers and anti-vaxxers. The vaccination controversy cause an uproar for many people, understandably, it’s very polarized- you strongly believe in them or you strongly do not. For me, at the age of 15, I strongly believe in the Pro-Vaccine movement and I have data that can back me up. For starters, you may wonder ‘what is a vaccine’ or ‘how to do they work’. For a general […]

Autism: Characteristics, Diagnosis, and Understanding

The prevalence of Autism Spectrum Disorder has nearly doubled in recent years, and the numbers are staggering: nearly 1 in every 59 children are diagnosed with autism in the United States alone. Yet, there are so many questions surrounding the complexity and increase in diagnoses of this condition that affects so many in such diverse ways. (Autism Speaks) How autism originates in the first place and its impact on communication, both verbal and nonverbal, are questions that need to be […]

Autism Spectrum Disorder and its Positive Effects

 What would it feel like if you were constantly ignored or treated as though you have little usefulness? Many people experience this kind of treatment their entire lives. Long has it been assumed that people with mental disabilities such as Autism, were meant to be cared for but to never expect any value from them. Evil men such as Hitler even went so far as to kill them because he thought they had no use to society. However, there is […]

Adolescents with Autism Spectrum Disorders and ADHD

Autism spectrum disorder (ASD) is a complex lifelong neurodevelopmental disorder that affects communication and behavior, generally diagnosed within the early stages of life. No two individuals living with Autism experience the same symptoms, as the type and severity varies with each case (Holland, 2018.). Autism has been around for hundreds of years, but the definition has evolved immensely. In 1943, scientists Leo Kanner and Hans Asperger conducted research on individuals with social and emotional deficits to better refine the definition […]

Raising a Child with Autism

All impose severe identity crisis and role restrictions even in knowledgeable parents.. In some conditions, as in the case of physical challenges, the child needs physical reassurance and support from the parents against those conditions of cognitive deficits in which the demands are always parent’s constant attention and feedback. As far as autism is concerned, the child’s deficits are many namely social, emotional, communicational, sensual, as well as behavioral. Symptoms are usually identified between one and two years of age. […]

Is Autism a Kind of Brain Damage

Many people have different views about autism. Autism may be only one simple word, but with this one word comes many forms in the way it could affect people with this disability. Autism should not be looked down on as much as this disability is from others in society. It may seem as if it has more “cons” than “pros” as some call them, but if looked at from a better perspective, there could be more pros than cons and […]

Trouble with Social Aspects and People on the Autism Spectrum

Autism in childhood starts as early as age two, and symptoms will become more severe as children continue into elementary school. When a child goes to a psychiatrist, they will work on social development. Adolescence with autism struggle when attempting to project others pain. For example, my brother has Asperger's and when I have a bone graph done on my hand, he could not stop touching my hand. He needed constant reminders to not touch and remind him of when […]

Effects of Autism

When he was eight years old, the parents of Joshua Dushack learned that their son was different. He had been diagnosed with Autism. According to the doctors, Joshua would never be able to read, write, talk, or go to school on his own. This might have been the case, had his parents accepted it. But his mother saw her son as a normal boy, and treated him as such. He did need some extra help in school, but because of […]

How Different Types of Assistive Technology Can Help Children with Autism

I. Introduction An anonymous speaker once said, “some people with Autism may not be able to speak or answer to their name, but they can still hear your words and feel your kindness.” Approximately thirty percent of people diagnosed with Autism Spectrum Disorder never learn to speak more than a few words (Forman & Rudy, 2018). Fortunately in today’s society, new technologies have made it possible for these individuals to communicate and socialize with others. Purpose The primary focus of […]

Searching Employment Autism

Over the last 20 years, there has been an alarming increase for children who have been diagnosed with Autism Spectrum Disorder (ASD) in the United States. According to the Centers for Disease Control, in the year 2000 1 in 159 children would be diagnosed with ASD. In the latest version of the study, the number has been reduced to 1 in 59 children will be diagnosed with ASD (Centers for Disease Control and Prevention, 2018). This is a subject that […]

Additional Example Essays

• Substance Abuse and Mental Illnesses
• How do Video Games affect the Mental Health of Young Adults
• Social Media: Depression 
• House Taken Over by Julio Cortaza
• Leadership and the Army Profession
• Letter From Birmingham Jail Rhetorical Analysis
• Why College Should Not Be Free
• Shakespeare's Hamlet Character Analysis
• A Raisin in the Sun Theme
• A Reflection on Mental Health Awareness and Overcoming Stigma
• Homeless Veterans
• A Rose for Emily Setting

How To Write an Essay About Autism

Understanding autism.

Before writing an essay about autism, it's essential to understand what autism is and the spectrum of conditions it encompasses. Autism, or Autism Spectrum Disorder (ASD), is a complex developmental disorder that affects communication and behavior. It is characterized by challenges with social skills, repetitive behaviors, speech, and nonverbal communication. Start your essay by explaining the nature of autism, its symptoms, and the spectrum concept, which acknowledges a range of strengths and challenges experienced by individuals with autism. It's also important to discuss the causes and diagnosis of autism, as well as the common misconceptions and stereotypes surrounding it. This foundational knowledge will set the stage for a more in-depth exploration of the topic.

Developing a Focused Thesis Statement

A strong essay on autism should be centered around a clear, focused thesis statement. This statement should present a specific angle or argument about autism. For example, you might discuss the importance of early intervention and therapy, the representation of autism in media, or the challenges faced by individuals with autism in education and employment. Your thesis will guide the direction of your essay and ensure that your analysis is structured and coherent.

Gathering and Analyzing Data

To support your thesis, gather relevant data and research from credible sources. This might include scientific studies, statistics, reports from autism advocacy organizations, and personal narratives. Analyze this data critically, considering different perspectives and the quality of the evidence. Including a range of viewpoints will strengthen your argument and demonstrate a comprehensive understanding of the topic.

Discussing Implications and Interventions

A significant portion of your essay should be dedicated to discussing the broader implications of autism and potential interventions. This can include the impact of autism on individuals and families, educational strategies, therapeutic approaches, and social support systems. Evaluate the effectiveness of these interventions, drawing on case studies or research findings. Discussing both the successes and challenges in managing and understanding autism will provide a balanced view and demonstrate a comprehensive understanding of the topic.

Concluding the Essay

Conclude your essay by summarizing the key points of your discussion and restating your thesis in light of the evidence and examples provided. Your conclusion should tie together your analysis and emphasize the significance of understanding and supporting individuals with autism. You might also want to highlight areas where further research or development is needed or the potential for societal changes to improve the lives of those with autism.

Final Review and Editing

After completing your essay, it's important to review and edit your work. Ensure that your arguments are clearly articulated and supported by evidence. Check for grammatical accuracy and ensure that your essay flows logically from one point to the next. Consider seeking feedback from peers or experts in the field to refine your essay further. A well-crafted essay on autism will not only inform but also engage readers in considering the complexities of this condition and the collective efforts required to support those affected by it.

1. Tell Us Your Requirements

2. Pick your perfect writer

3. Get Your Paper and Pay

Hi! I'm Amy, your personal assistant!

Don't know where to start? Give me your paper requirements and I connect you to an academic expert.

short deadlines

100% Plagiarism-Free

Certified writers

Jackie Schuld Art Therapy Blog

• Feb 17, 2023

The Great List of Autistic Essays

I’m a late-identified autistic who loves writing about autism. How much do I love it? I’ve written over 150 essays on it in the past six months alone.

How do I think of so many autistic topics to write about? I’m an art therapist who specializes in late-identified autistic adults. That means I not only have my personal experience to draw from, but also the hundreds of hours spent listening to my clients.

I share most of my essays here on Medium, which means it has now become quite the library. In an effort to make my essays more accessible to those wanting clear, relatable information about late-identified autism in adults, I’ve sorted my essays into topics below. While I wish I could provide a link to each of them for you… I’ve got to prioritize my time and energy. So if a specific essay interests you, just pop it into the search and it’ll come up

Autism in a Neurotypical World

What Would a World Designed by Autistic People Be Like

The Harm in "They're a Little Autistic"

Autism Does Not Directly Cause Socializing Problems

Please Trust My Lived Autistic Experience

Can Someone Please Create a Neurodivergent Intentional Living Community

What if I Accept that Most Neurotypicals Won't Like Me

How Neuro-Bias Shows Up in Professional Testing

Your Autistic Experience Sounds Just LIke my Neurotypical One

Neurotypical Words that Don't Work for Autistics: Overachiever

But Neurotypicals Experience That, Too!

Neurotypical Norms That Don’t Work for Autistics: Hustle Goals

The Fear of Being a Hypocritical Autistic

Neurodiversity: Us vs Them?

How to Meet an Autistic Adult Exactly Where They're At

Autism Characteristics

The Autistic Mind Loves to Take Detours

4 Reasons Why Autism Symptoms Lists are Confusing

My Autistic Brain: Sunshine and Detours

The Joys of Being Autistic: Part 1

Stop Saying Autistic People Can't Empathize

Redefining Fun for Autistic Adults

9 Reasons Why Autism Looks So Similar to CPTSD

We Need More Depictions of the Interior Experience of Autism

Clarity is What my Autistic Mind Craves

How Trauma and Autism Can be a Confusing Mix to Decipher

Why am I like This? Understanding the Autistic Brain

My Autistic Mind Does What it Wants

The Dissociated Autistic Performance State

The Joys of Being Autistic: Increased Creativity and Innovation

My Autistic Memory Is Not the Same as Others

The Firehouse Dilemma: Autism and Infodumping

The Variability of the Autistic Sensory System

5 Reasons Autistics are Especially Hard on Themselves

The Shame That Often Accompanies Autism

Knowing You’re Different as an Autistic Adult

3 Reasons Autism is Worse After You Learn You're Autistic

Disability and Internalized Ableism

I Had to Dismantle My Fear of Autistic People

Is Autism a Disability?

I’m Ok With Saying I have a Disability, Right?

Dog Training

The Difficulties of Adjusting to a New Dog When You're Autistic

Tips for Adjusting to a New Dog When You're Autistic

5 Tips to Integrate a Dog into Your Autistic Life

Defining and Explaining Autism

What I Wish Others Knew About Autism

Let’s Drop the “Disorder” From Autism Spectrum Disorder

How Low and High Autism Labels are Misleading

We Need All the Autism Theories and Models

Autism Can Be a Murky Thing To Understand

How I Explain Autism to Someone Unfamiliar With It

What is Late Identified Autism

Autistic Statistics are Not Accurate for Late-Identified Autistics

I'm Here for the Autistic Awakening

How It Helps to Know You’re Autistic

Why It Matters to Know You're Neurodivergent

What is Neurodiversity and Why Does it Matter

How Neurodivergent Acceptance Can Improve Our Lived Experiences

How Unidentified Autistics are Taught to Socially Camouflage and Mask

Is There a World Where I can Be Unmasked?

The False Dichotomy of Masked and Unmasked Autism

6 Reasons Why UnMasking Is Harder Than it Sounds

What if You have to Mask Everywhere?

My Personal Experience as an Autistic

Hating Cooking as an Autistic Adult

I Make Giant Lists About Autism for Fun

The Challenges of Writing Publically About Autism

The Risk of Sharing my Autistic Passions with Others

I'm Reclaiming Weird for My Autistic Self

I Expand and Then I Contract

I Stopped Seeing Myself As Broken When I learned I was Autistic

Respecting my Limits as an Autistic Business Owner

I Need to Lessen the Pressure on my Autistic Self

My Autistic Brain Doesn’t Want to Watch TV Right Now

Embracing Who I am as an Autistic Adult

I Used to be a Very Judgemental When I Didn’t Know I was Autistic

A Letter from An Autistic Adult to Trust

Don’t Get So Upset: A Line that Doesn’t Work for This Autist

Why This Autistic Writer Didn't Respond to Your Comment

Relationships

Is Dating Worth it as an Autistic Adult?

Is it Possible to be Happily Partnered as an Autistic Adult?

Not Liking People as an Autistic Adult

Self-Identification

So You Think You Might Be Autistic

Dearly Newly Identified Autistic Person

Am I Actually Autistic?

Dearest Smart, Weird, and Caring Autistic

I Am Deeply Unsure About Autism

How to Self Identify Autism as an Adult

When the Past Makes Sense after a Late-Identification of Autism

Where to Start When You First Learn You’re Autistic

6 Strategies to Harness the Hyperfocus Power of an Autistic Mind

Leave the Gremlin In the Cave: Self-Isolation as a Necessary Autistic Tool

No Plans Days as an Autistic Tool

Making Accommodations for Myself as an Autistic Adult

How Many Accommodations Can We Ask for as Autistic Adults?

Using Art to Help Your Autistic Mind

Dissociation as an Autistic Tool

The Power of the Home Environment for Autistics

Is It Ok to Honor My Autistic Needs?

Recognizing When It's Not Time to Make Decisions as an Autistic

Therapy for Autistics

Dearest Autistic Client of Mine

8 Ways Therapy Can Help With Late Identified Autism

Gaslighting the Autistic Experience

Dearest Therapist Who Knows Barely Anything About Autism

I'm an Autistic Therapist: Sometimes It's Easier Than Everyday Life

Does Your Therapist Know Enough About Autism to Help You?

Questions to Ask a Potential Therapist When You're Autistic

How I Work with Newly Identified Autistic People

What to Ask When You're Seeking Therapy for Late-Identified Autism

12 Ways Therapy Can Enhance Life for Late Identified Autistic Adults

Therapy is Not for Fixing Autism

The Harm I Caused When I Didn't Know about Autism

A Newly Identified Autistic Therapist Working with Newly Identified Autistics

Common Therapy Advice That is Counterproductive for Autistics

A Therapist Told Me Treating Autism is Like Treating Depression

Who Can Diagnose Autism in Adults?

Autistic Adults Deserve Better from the Mental Health Field

Undiagnosed Autism

The Correlation Between Intelligence and Undiagnosed Autism

10 Consequences of a Life with Unidentified Autism

The Gap Between “Diagnosable Autism” and a Lifetime of Unidentified Autism

Autism Diagnosis Criteria are Limiting for Men Too

No Autistic Should Receive a Diagnosis Letter Like Mine

Identifying Autism in Undiagnosed Women Abstract

How I Identify Autism in Undiagnosed Women

Autistic Stereotypes Block People From Knowing They're Autistic

Thank you for reading. If you’d like to read more, sign up for my FUNletter . If you would like to explore your autistic identity with an autistic therapist, you can learn more about my therapy services here .

Recent Posts

My Autistic Sensory System is a Demanding, Bougie Princess

My Autistic Silence Does Not Mean Agreement

This Autistic is Quitting the News

Want to read more on topics that interest you?   Subscribe to my FUNletter.

Thanks for submitting!

Autism Spectrum Disorder (ASD) Essay

Introduction, biological and genetic aspects of autism spectrum disorders, asd etiology, prevalence of asd, diagnosis of asd, treatment of asd.

Autism is a serious disorder that has the potential to disrupt the success of people living with it. This report shall set out to explore various aspects regarding this disorder. To this end, an overview of the symptoms, causes, diagnosis and treatment shall be offered. This shall aim at expanding our understanding regarding this disorder so as to enable us to be better prepared to handle it whenever the need arises.

Autism has been noted to be among the most prevalent childhood psychiatric disorder. Kuder (2003) denotes that in the USA, an estimated 2.1% of the population aged between 8 and 17 is affected by autism in its various forms.

Autism is manifested by varied behavior but it is chiefly characterized by inability to communicate, lingual deficits, lack of a sustained attention, low level of activity, temper tantrums, sleep disturbance, aggression inadequate motor control and other non-compliant behavior. These behaviors are detrimental to the social and educational endeavors of the people involved.

Autism spectrum is a medical term that is used to describe children and adults who experience difficulties in motor coordination, socializing, communicating (verbal and non-verbal) and language acquisition (Tager-Flusberg, Paul and Lord, 2005). The authors describe autism as a neurological disorder that stems from the brain’s inability to carryout some functions normally.

The causes of Autism as well as the reasons why it affects lingual and communication skills are not entirely known though there is a close linkage between Autism and genetics.

Studies indicate that Autism Spectrum Disorder (ASD) is inherited between family members. A study conducted by the American Psychiatric Association (2000) indicated that there is a 3-6% chance of getting autism amongst siblings.

However, Korvatska et al (2002) state that the difficulty experienced by scientists in pinpointing the genetic aspects of autism emanates from the lack of extended family histories. In most cases, autistic individual become more detached socially that they rarely marry or have children. As such, finding a family that has detailed genetic information regarding autism is difficult.

On a brighter note, twins have been used to explore the genetics behind autism (Beaudet, 2007). One study indicated an 82% likelihood of an autistic identical twin having the same disorder. This is in contrast to the 10% likelihood indicated by results from fraternal twins. More sophisticated studies have in the recent past concluded that 90% of autism related behavioral phenotypes are as a result of inherited genes (Happé & Ronald, 2008). This shows that there is a strong relationship between autism and genes.

Biologically, the root cause of autism has been difficult due to relative inability to access and study the brain systematically. However, technological innovations and advancements such as MRIs, CT scans and SPECT have made it possible to study the structure and functionality of the brain.

As a result, specialists have been able to deduce that majority of the brain’s structures play a pivotal role in the development of ASD. According to NIMH (2009, p. 1) they include but are not limited to “the cerebellum, cerebral cortex, limbic system, corpus callosum, basal ganglia, and brain stem”.

Similarly, other studies indicate that various neurotransmitters such as serotonin and epinephrine have a strong link to autism. The diagram below shows the biological basis of Autism Spectrum Disorder. It shows various structures of the brain and explains the functions that each play. Various symptoms of ASD are as a result of the structures’ inability to carry out their normal function.

A diagram showing brain structures linked to ASD

As mentioned earlier, the causes of ASD are not well known. However, researches conducted in this regard indicate that genetic, nutritional and environmental factors play a pivotal role in the development of the disorders. Results from numerous studies indicate that genetic factors predominate.

Others indicate that certain foods, infectious diseases, plastic and metallic extracts could cause autism. Similarly, smoking, alcohol, illicit drugs and some (mercury-based) childhood vaccines have also been attributed to causing autism. However, none of these causes are conclusive and more research needs to be conducted. This is to mean that the theory of causation regarding autism is not complete as yet.

The most recent survey conducted by center of disease control (CDC) indicated that autism rates have increased significantly over the past three decades. In most cases, studies indicate that autism is most prevalent among children. According to Rutter (2005), boys are four times more likely to be autistic than their female counterparts.

In addition, the author states that the symptoms of autism exhibit themselves from childbirth until three years of age. Parents are the most likely to discover these symptoms. As a result, they should ensure that they have their children checked at the onset of various abnormal behaviors.

Rutter (2005) asserts that the prevalence of autism disorder has been facilitated by ignorance and assumptions made by caretakers. In some cases, parents assume that their children are ‘slow and that they will develop as they grow up. However, this approach has proven to be costly since autism can best be handled as soon as it is detected.

Delaying makes it difficult to come up with remedies and coping mechanisms for both parents and the individuals having autism disorders. The main symptoms of this disorder include communication (verbal and non-verbal) difficulties, inability to develop and maintain relations with other people, abnormal lingual patterns and repetitive behaviors. Whenever any of these symptoms are discovered, it is highly recommended that medical or psychiatric assistance be sought.

An early diagnosis of ASD is important since it enables the people involved to come up with effective interventions before its too late. Recent studies show that intensive interventions administered in a control environment for a minimum of two years during preschool leads to behavioral and social improvements among children with ASD.

Clinicians base their diagnosis depending on the behavioral traits exhibited by a child. For a diagnosis to be made, NIMH (2009) asserts that at least one of the symptoms associated with ASD must be present. This means that a patient must have abnormal patterns of communication, socialization and restrictive behaviors.

In most cases, the diagnosis is made through a two-stage process. The first stage is “a developmental screening normally conducted during the routine childhood check-ups, while the second one involves a more comprehensive behavioral analysis by a team of experts (NIMH, 2009, p. 1).” Below are the stages that are followed to diagnose ASD.

The American Psychiatric Association (2000) recommends that every parent should ensure that a developmental screening test is carried out for his/her child during the “well child” check-up. The author contends that screening plays a pivotal role in the early identification of ASD symptoms.

Due to its importance, there are various screening instruments that have been developed to facilitate the diagnosis process. They include but are not limited to Checklist of Autism in Toddlers (CHAT) and its modified version; M-CHAT. Similarly, the Screening Tool for Autism in Two-Year-Olds (STAT) as well as the Social Communication Questionnaire (SCQ) have proven to be effective in diagnosing ASD in children aged between two years old and above four years old respectively.

According to Tadevosyan-Leyfer et al (2003), questionnaires given to parents provide important information during the diagnosis process. As such, some instruments rely on such responses while others depend on these responses as well as observations made by the caregiver. However, these screening instruments are not as effective as they should be when it comes to identifying mild ASD or Asperger syndrome. As a result, other screening instruments such as the Autism Spectrum Screening Questionnaire (ASSQ) and the Childhood Asperger Syndrome Test (CAST) among others have been developed so as to diagnose these forms of ASD (NIMH, 2009).

Comprehensive Diagnostic Evaluation

This is the second stage of diagnosis and it relies on the skills of a team of different experts such as psychologists, psychiatrists, neurologists, and therapists among others. This evaluation entails a comprehensive analysis of neural, genetic, cognitive and language testing in order to conclude whether a patient is suffering from autism or other behavioral disorders.

Some of the instruments used at this stage include: Autism Diagnosis Interview-Revised (ADI-R), which is a structured interview designed to test a child’s “communication, social interaction, restrictive behaviors and age-of-onset symptoms, and the Autism Diagnosis Observation Scheduling (ADOS-G), which is designed to identify abnormal, missing or delayed communication and social behaviors (NIMH, 2009, p. 1).”

The teams of experts that conduct this diagnosis determine the strengths and weaknesses of the child and recommend various treatment options that should be undertaken.

According to Freitag (2007) there is no one-shoe-fits-all approach to treating ASD. However, specialists in this area seem to agree on the fact that early interventions are of great importance. Arguably, the best treatment is one that considers the interests of the patient, allows the patient to learn in accordance to his/her ability and causes no harm to the overall well being of the patient. With this in mind, there are specialized programs and treatments that have proven to be effective against ASD symptoms.

For starters, Applied Behavioral Analysis (ABA) is among the most used intervention in treating ASD (SAMHSA, 2011). Similarly, there are dietary and medical interventions that help suppress unwanted behaviors among autistic children (NIMH, 2009). In regard to learning, there are specialized educational programs that seek to enhance the socio-communicative, cognitive and language skills of autistic students.

It can be articulated from this report that Autism is a problem that needs to be focused on. With proper understanding as to what the condition entails, parents and practitioners are better armed to assist patients overcome the weaknesses brought about by the condition and therefore achieve successful lives.

From this study, it can be authoritatively stated that early diagnosis and treatment of Autism spectrum is necessary to increase the chances of success in learning for the child suffering from this disease. Whereas Autism is not curable, it can be managed so as to ensure that it is not disruptive to the life of the individual during his/her future endeavors.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (fourth edition, text revision). Washington DC: American Psychiatric Association.

Beaudet, A. L. (2007). Autism: highly heritable but not inherited. Nat Med, 13(5): 534–6.

Freitag, C. M. (2007). The genetics of autistic disorders and its clinical relevance: a review of the literature. Mol Psychiatry. 12(1): 2–22.

Happé, F., & Ronald, A. (2008). The ‘fractionable autism triad’: a review of evidence from behavioral, genetic, cognitive and neural research. Neuropsychol Rev, 18(4): 287–304.

Korvatska, E et al. (2002). Genetic and immunologic considerations in autism. Neurobiology of Disease , 9: 107-125.

Kuder, S. (2003). Teaching Students with Language and Communication Disabilities. USA: Allyn and Bacon.

NIMH. (2009) Autism Spectrum Disorders (Pervasive Developmental Disorders) . Web.

Rutter, M. (2005). Incidence of autism spectrum disorders: changes over time and their meaning. Acta Paediatr. 94(1): 2–15.

SAMHSA. (2011). Autism Spectrum Disorders . Web.

Tadevosyan-Leyfer, O et al. (2003). A principal components analysis of the autism diagnostic interview-revised. Journal of the American Academy of Child and Adolescent Psychiatry, 42(7): 864-872.

Tager-Flusberg, H., & Lord, C. (2005). Language and Communication in Autism. Web.

• Autism Spectrum Disorder in Children and Its Impact on the Family
• Autism Spectrum Disorders: Diagnostic Procedure
• Autism Spectrum Disorder: Diagnosis, Impact, Treatment
• Mental Illnesses History and Treatment
• Psychopathologies: Co-occurring Diagnoses
• The Identification of Bipolar Disorders
• How Do People Labelled With a Mental Illness Deal With Their Stigmatization?
• Attention Deficit Hyperactivity Disorder Causes
• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2019, March 24). Autism Spectrum Disorder (ASD). https://ivypanda.com/essays/autism-spectrum-disorder-asd/

"Autism Spectrum Disorder (ASD)." IvyPanda , 24 Mar. 2019, ivypanda.com/essays/autism-spectrum-disorder-asd/.

IvyPanda . (2019) 'Autism Spectrum Disorder (ASD)'. 24 March.

IvyPanda . 2019. "Autism Spectrum Disorder (ASD)." March 24, 2019. https://ivypanda.com/essays/autism-spectrum-disorder-asd/.

1. IvyPanda . "Autism Spectrum Disorder (ASD)." March 24, 2019. https://ivypanda.com/essays/autism-spectrum-disorder-asd/.

Bibliography

IvyPanda . "Autism Spectrum Disorder (ASD)." March 24, 2019. https://ivypanda.com/essays/autism-spectrum-disorder-asd/.