ASD and reading comprehension

[Nibledbyducks]

DS3 has being diagnosed with ADHD and is suspected of being on the autistic spectrum. He had a SALT assesment that showed he has a poor understanding of social motivations. He has always read very well but has just had an test at school to assess his reading age and he has failed miserably. Does anyone have any experience of how ASD might affect his comprehension of what he's reading? or has his last school just got it all wrong?. tbh I'm quite shocked as his CAT scoring came out alot lower than everyone expected, and verbally he comes across as quite bright.
DS1 has aspergers but very high functioning and copes well and also dyslexia, DS2 has ADHD and also does very well. They do well because I have spent years battling with everyone at school to get things right for them, I guess I was hoping it would be easier this time :( think it's just going to be another battle. DS3 also has moderate hearing loss due to glue ear and hypermobility that has ruined his pen grip. I feel guilty because I've had to handle one child at a time and his last school wasn't that worried so I've not worried either. He had an OT assessment that showed his pen grip is very poor and will never be improved very much as it should have been looked at when he was 5, he's nearly 10 now. I feel like I've ignored him and it's all gone wrong when his last school was addament he was bright and doing well, his last report was excellent. It's all just not adding up and I'm really confused :(

Absolutely ASD can effect his comprehension score.

Once you can read what they are testing is do they understand the text.

So for example questions like 'Why was Katy sad'.

They also test a lot of 'inference', again 'Why was Katy sad', but when you have to 'read between the lines' to understand why.

So, yes, he could well score low on this even though he is an excellent reader.

CAT scores I think test verbal and non-verbal reasoning. You will probably find his non-verbal reasoning was very high, and his verbal reasoning was low. What you need to ask was 'was there a discrepancy between his subtests?' apparently a difference of 10 is significant.

My ds 7 AS is the same, reading comprehension of fiction compared to non fiction is miles apart.

He reads at well above his age, but he doesn't understand the nuances of the story, when he was answering q's about his reading book, the q was why did tom think his neighbour was a burglar answer should have been because he went out at night with a large bag, he put because he had a moustache.

Will watch this thread with interest because I have no advice but could do with some myself. :)

His non verbal reasoning came out low as well, which doesn't add up with his optional sats from last year, he got 3b in maths, 3a in reading, and 2a in writing, those are year 4 marks, we have a three tier school system here, first, middle and upper. Starting to0 think his last school just got him all wrong and he's not nearly as bright as they thought, it's not making sense. DS2 thinks he's messing up on purpose because he doesn't like school but I'm not sure I agree. Got a meeting with the SENCO next tuesday and paediatrician begining of next month, so will see how that goes.

What year did he get 3b, 3a and 2a?

If in Y4 those marks are fine. Average in maths and reading and low in writing.

But your school levels aren't the same thing as your CAT scores. That's the whole point of CAT scores. They're much more like an IQ test. Which school levels def aren't.

There's a big leap in the amount of comprehension required to go from a level 3 in reading to a level 4.

Same with maths - a level 4 requires far more literacy skills (ie word problems) than a level 3. Which might catch him out.

I don't think it's about whether or not he's bright. It's about whether or not he can answer the questions the school asks him, in the way they want him to.

This is what he needs to be taught..... And this is what school are there to teach him.

DS2 is being assessed for suspected ADHD and ASD (paed won't give dx until he's 7 or 8, so no official dx for a while), and he has stellar reading and number skills. Concrete stuff like that he thrives on. But comprehension and "reading between the lines" is a whole different story. He has a tendency to memorise things incredibly quickly (although not always understanding them), so often he "recycles" conversations and can sound like he knows exactly what he is talking about.... until he trips up because the conversation veers a bit and he either doesn't know what to say or says something from a previous conversation and we end up stopping because it's finally kicked in that he is just regurgitating another conversation. It can be extremely difficult sometimes figuring out whether he REALLY gets it or is simply saying something he's heard previously.

I would say this is one of the main reasons that the GPs insisted he was fine developmentally because they heard him saying things and took it at face value. When the speech therapist put him through some testing, it was very obvious that he was delayed and having difficulties. He didn't go through a lot of the same stages of language development that other children do - for example DS3 (2yrs) is in the stage where he is saying "I no find Daddy, where Daddy go?" DS2 never went through that - he used mainly key words to get his meaning across, and then repeated phrases (such as "would you like a biscuit" when HE wanted one, because that's what he heard US saying to him). It's been complicated and somewhat confusing muddling through this all. But SALT said it's all tied together with the comprehension and language usage and such.

Triggles - that sounds very like my son who is nearly 4. There are some signs he may have borderline Asperger's.
His language and vocab are good but his conversation is often - but not always - formulaic and repetitive.
He used to do the question thing too. So if we said 'What do you want?' he would either repeat this or say 'What do I want?' The second is a bit better cos he's turning it around and using 'I' but still not quite right. He was not saying 'I want...'
I think he has pretty much grown out of this now, but is repetitive in other ways. Eg Each time he watches Toy Story, he makes the same comments at the same times. And if I ask what he had for lunch at nursery he always says 'pasta'!
As for questions like 'why is the boy/girl sad?' he would probably just not answer. he'd usually know from a picture of someone's face whether they were happy/sad or not but would probably not be able to say why. In real life, he sometimes knows someone will be sad or angry if they get physically hurt or don't get what they want and he does empathise to a degree.
Not sure whether he is just delayed in these areas or whether he is on the spectrum in a high-functioning way. I suppose time will tell...
It is very hard to not constantly analyse his behaviour though and that gets exhausting.

Nibledbyducks

"DS3 has being diagnosed with ADHD and is suspected of being on the autistic spectrum."
"DS3 also has moderate hearing loss due to glue ear and hypermobility that has ruined his pen grip"

ASD and dyslexia are both diagnosed by subjective observations, traits, but you have also mentioned some of the issues which can cause these traits.

Developmental Dyslexia has three cognitive subtypes : auditory, visual and attentional. Which means that an auditory processing disorder, a visual processing disorder, an attention disorder, or any combination of the three can cause the dyslexic symptom.
So ADHD would be considered a cause of dyslexia.
Otitis Media with Effusion (Glue Ear) is initially a hearing impairment, which later causes Auditory Processing Disorder (APD) which is a listening disability, and and part of the auditory subtype of dyslexia. Having a listening disability, means that both children and adults who have APD will have problems processing and understanding speech, conversations and multiple verbal instructions, and can easily loose the plot as to what is being said, Reading is about decoding and recoding the visual notation of speech, or the graphic symbols society chooses to represent speech. So if children have problems comprehending speech they will also have problems comprehending any notation of speech visual or otherwise.

you could have a look at these CiteULike research paper sharing collections
Reading: Acquiring and Developing the Skills and Abilities
Developmental Dyslexia
Attention Deficit Hyperactivity Disorder (ADHD)
Autism
and maybe some of my own PubMed research paper collections regarding
Joint Hypermobility Syndrome
Ehlers-Danlos syndrome (EDS)
Marfan?s syndrome
and Dyslexia and Attention
Dyslexia and Auditory Processing
Speech and Language Pathology

I hope this helps understanding some the underlying issues

Nibledbyducks

I forgot one of the CiteUlike groups, the one which relates to Otitis Media (Glue Ear) issues
Audiology and Auditory Processing Disorder

It is my understand that there is a difference between word reading and reading comprehension.

Word reading is recognising single words, possibly with or without understanding what they mean.

Reading comprehension is reading lots of words and understanding the concept. It is quite common for children with ASD not to understand what they read, in SALT report, he calls it difficulty in 'central coherence' ie logically deducing the whole picture from fragments of information.

Non verbal reasoning, ds was assessed - Matrices ie selecting the figure that correctly completes the matrix. Quantitative reasoning ie linking the sides of two presented dominoes and apply that relationship to complete a third domino.

He scored very highly in the non verbal reasoning, but very low in 'mathematical reasoning'. The reason he scored so highly in non verbal reasoning is becasue of his spatial ability ie recall of designs and patterns. Designs and patterns are his 'thing', his obsession.

So non verbal reasoning and math, reading etc ability are almost two seperate things iyswim.

Claw - it's interesting that you mention patterns - DS2 recognises number patterns. He's 5 and can rattle off multiples of any number 1-12 all the way from the base number to over 100 without even blinking an eye. I stopped him from going further (13+) as my blasted brain is rubbish at mental math and the look he gave me (much like "what do you mean you have to think about it?") was frankly a bit embarrassing!

But even if he sees the same sequence of actual events, he cannot put them in order. It's quite an odd combination of skills and such, isn't it? I know I am forever being forced to alter my stance on what he does and doesn't understand, as often there seems to be no rhyme or reason to it, however, I've found that if I dig deeper, all those "absolutes" or "facts" seem to be easier for him to comprehend than "interpretations" such as social situations, emotions, etc. He deals much better in the concrete than perception or prediction. I guess that points at issues with imagination as well.

This might explain reading comprehension a bit better, from ds's SALT report (ds's reading age was about 11 years old, when he was assessed when 6 1/2) but as you will see his comprehension is way below that.

The expression, reception and recall of narrative instrument. The Errni tests a childs ability to relate a story with picture clues, comprehend it and recall it without picture clues after 30 minutes are over. It also explores theory of mind, as the central character has a false belief, so the child is questioned to ascertain if they can imagine what the charcter might be thinking.

Whilst ds spoke at length, using complex sentence structures and can describe pictures in detail, ds struggled to grasp the underlying meaning of a situation. Ds was aided by visual sequence of pictures but his narrative did not describe the main ideas of the story. Ds spoke at length about irrelevant details and did not get the gist of the storyine. He was not able to understand the relationships of the charcters or to understand the emotions the characters were feeling.

Ds did not demonstrate theory of mind ie the ability to see a situation from another perspective. Ds may give the impression of understanding as he is keen to comply by using visual clues, but as was observed in class ds may miss the key issue and give tangential responses.

I have this issue and am battling with the school at the mo, ds can read and spell well - when we do spelling I ask him to make a sentence with the word and does no probs. When I read with him he understands and answers the questions correctly and does the same with his lsa - he also is very expressive and the expression is in context. My problem is the senco assesses him and he has limited contact with her and so he won't answer her questions - so she put him on the lowest rating for reading. Have now asked for reassessment with lsa and senco observing to try and get a clearer picture

Triggles, ds is obsessed with patterns and designs, all his lining up of things of cars, sweets, anything, very symmetrical, colour coordinated, as is his lego building. He loves maps and puzzles, he was doing complicated jigsaw puzzles at a very early age, without looking at the box. Oh and 'wheres wally' he finds him, before my eyes have even had time to adjust to the confusing thing! But he cannot get the pattern in numbers, he finds numbers very confusing. He has great difficulty with concepts such as first and last, before or after etc.

I agree, it is all very confusing and conflicting. Im just looking through my box of reports now and trying to make sense of them all. For example EP assessment verbal comprehension 79th centile. Yet SALT writes "severe difficulty in understanding word meaning and sementic links 0.04 centile, so how does he verbally comprehend on the 79th centile!

Yes i think so, abstract as oppose to concrete requires a great deal of imagining and seeing another perspective other than your own.

Wow, Claw, DS2 does all that too - the lining up, the puzzles. I set up the box on a 100pc puzzle so he could see the picture and kept moving it, as the box was in his way - he didn't need it. He still likes to line crayons up on their flat end, all along the windowsill. (chaos, as DS3 likes to knock them over! )

Triggles, how old is your ds? Ds spatial ability is on the 99th centile, im betting your ds would score highly too. Ds also scored 99th centile for visual closure, copying, position in space and eye hand coodination. So it suggests that he is extremely visual. His drawing are amazing. I sure this is how he hides some of his other difficulties, SALT identified that he searches for visual 'clues' to help him conform. So half the time he doesnt understand what he should be doing, he just copies what everyone else is doing, giving the impression, he has understood.

NAS put me in touch with some research, they are researching 'special abilities' in certain areas of children with a dx of autism, apparently ds is too young at the moment, but they would like include him in future research. I have asked for a copy of the research findings when they have completed it, should be interesting.

Oh yes, under no circumstances do you disturb the lines

DS2 is 5yo. He struggles with writing or drawing, as he has problems with fine motor skills as well as hypermobility. He is extremely visual, however. We just bought a laminator last week and are trying to put together some visual aids to use at home, as he seems to respond well to them.

Disturb the lines? God forbid! You might as well tilt the earth off it's axis!!

Claw3, Triggles

Communication is about understanding or comprehending the signs, or signals made by another party, to share mutual understanding of the meaning of the attempted communication.

As humans have evolved we have moved from scent based communication, to gesture communication, to picture communication, and currently we prefer sound based forms of communication such as speech or text. These different forms of communication are still part of how we communicate, and required different sets of cognitive skills and abilities to enable effective use.

Unfortunately some of us are not best able, may have a cognitive skill or ability deficit, to use all of various methods of communication used by others to gain mutual comprehension and understanding of the communication methods used by others.

So to use speech, or a sound based communication system, both parties need to first to be able to hear the different sounds, and then be able to process of comprehend the meaning of the sounds. part of the process is to remember the sounds and the sound prompts, much like a parrot, but understanding the meaning of the sounds is a different cognitive set of cognitive skills and abilities.

Those whom have goods decoding and recoding skills but poor comprehension abilities have been described as having Hyperlexia which can be associated with ASD.

Oooh how interesting - I am just about to start a research project on this so I will let you know what we find (in 5 years or so...). There are quite a number of (non-ASD) children who read accurately and quickly but don't understand what they read. And of course it makes sense that children with ASD would also have this problem, especially when inferences are needed.

Haven't read whole thread, will go back now

Dolfrog, im in the process of sorting through assessments of ds and trying to make sense of the conflicting centile scores, i hope Nibledbyducks, doesnt mind the slight hi jack as its all kind of relating to what she was asking and thought it might help others too. Scores as follows:-

When ds was 5.9 word reading 6.10, spelling 6.4
When ds was 6.5 word reading 8.3, spelling 7.4
When ds was 6.10 word reading 7, spelling 6.8

When ds was 5.9 verbal comp 84th centile
When ds was 6.10 verbal comp 74th centile

When ds was 6.5 reading comp 93rd centile
When ds was 7 reading comp 37th centile

In september 2010 position in space was 91st centile
In Feb 2011 position in space was 25th centile.

To name just a few of the ones i have found so far.

Is he just having bad/good days? Is it 'normal' for such a big drop, is he losing skills that he once had?

Admittedly these centilles are not a true reflection of ds, as these do not describe his 'functional' ability. Would be interested in your views?

Triggles ds's writing, letter formation etc is terrible, he also has hypermobility and poor fine motor skills, doesnt seem to affect his drawings though, they are extremely detailed and very busy, lots going on in them (thats another story, CAMHS think, he expresses his confusion through his drawing)

skidd the research has only just started so it will probably be a good few months before they send me the results, you are more than welcome to have a copy.

that's interesting claw3. DS2 has difficulty with his pencil grip which affects any writing or drawing, and he has yet to choose which hand he wants to use, which complicates it further, as he tends to switch back and forth

I was told that you use different muscles and skills for writing, than you do for drawing (another conflict ds has!!). "Ds has a 'immature grasp' and weakness within his intrinsic hand muscles, which prevent him from controlling the pencil by moving his fingers. Ds moves his wrist to direct the pencil, which is an inefficient use of larger groups muscles in his forearm and uses additional energy" is what OT wrote, its handy having all these reports spread out in front on me, she explains it so much better than me!!) Light pressure, poor control, poor letter formation, very slow, reverses letters. He always uses felt pens for drawing (all lined up in colour group, as you do of course ), they dont require as much pressure as a pencil. Ds is left handed.

"Claw3"

When we set up APDUK back in 2002 one of the team was better versed in these types of tests and the in depth meaning of the various centile levels. So I never really got too deeply involved. And back then the real issue was getting APD recognised.

Having said that, we all have good and bad days, and sometimes during these types of tests we can try that extra bit harder and have a better day than average.

Reading and spelling can be very hit and miss and can vary from day to day, we are not able to switch the coping strategies we need to perform these tasks ON and OFF when we need them, as like all humans we control our working memories subconsciously, and there can a wide range of reasons why a specific coping strategy was not available to us when we needed it.

For each new task or variation of a task, for some a new coping strategy or variation of an existing coping strategy needs to be created, in order to enable us to perform a specific task. All of these coping strategies also need to be integrated wit one another so that we can perform various tasks may be one after the other. This integration of coping strategies can take some time. So on one day we may appear to be able to perform a specific task, but not be able to perform the same task the next or on some following days. We can not control or select when we have a good day or when we have a bad day, or when one turns into the other. Can be very annoying and frustrating, but that is what life is about when living with these types of disabilities.

Thanks Dolfrog, it just seemed strange to me that every assessment, all assessments by different experts, on different days, over a period of time, got 'worse' and there is no mixture of good days, in with the bad days. Just all bad days, which made me think of regression.

Anyhow, its almost irrelevant what his centiles are, centiles do not describe his functional ability. Its just the LA, school etc only seem interested in centiles and this 'proves' progress, i have been arguing with them for years about 'functional ability'. Still if they are insisting that centiles prove progress, then surely a drop in centiles has to prove lack of progress?