By Sara Finegan
Bobby approached my kidney-shaped conference table hesitantly, walking on tiptoe around the nearby rocking chair. He was carrying a copy of Harry Potter and the Prisoner of Azkaban. I greeted him; he did not meet my eyes.
This was the first day of the second week of school, and we had fashioned name tags, written letters for school mail, smelled Jamie’s flatulence several times, learned about Georgia O’Keefe, and made a sheet cake into a replica of the State of California. Earlier this morning we had chosen our favorite books. Now I was beginning to conduct some assessments of my new students’ reading abilities.
Bobby opened to the first chapter of the book and began to read for me:
Harry Potter was a highly unusual boy in many ways. For one
thing, he hated the summer holidays more than any other time
of year. For another, he really wanted to do his homework, but
was forced to do it in secret, in the dead of night. And he also
happened to be a wizard.
Bobby read quickly and smoothly and made no errors. I raised my eyebrows as he continued, his tongue tripping over the words and his eyes fixated on the page. This was a reader. This was a fourth grader who could read Harry Potter. I motioned for him to stop.
“So,” I said casually, “what is going on with Harry?”
Bobby looked anxious. I could almost see his mind turn inwards. He seemed absorbed in some internal sensory experience that I could not share. I pulled him back.
“Bobby? How is Harry different from other kids?”
“I don’t know.”
I did a quiet mental double-take.
“Can you find it in the text?”
He scanned the first page. Shook his head. Bobby did not understand a word he had just read. No matter what I asked, how I prompted, or where I pointed in the text, he made no meaning at all of the words.
I sent him back to his seat with a Dumb Bunny book. I sat back and watched him turn the pages, laughing vaguely and pointing at the words.
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Bobby was my first student with autism. I had just changed the focus of my work in San Diego from a middle school ED class (which stood for “emotionally disturbed” though that was rarely spoken) to a mild-moderate Special Day Class for fourth, fifth and sixth graders.
On the first day of that school year I met Bobby, who was moving to the upper level SDC class after two years in the lower grades at my new school. He was compliant, wanted to please, and was completely accepted by his classmates.
The results of that first reading conference were confirmed when I administered the Analytical Reading Inventory (ARI): Bobby could decode at the ninth grade level. His comprehension was at the primer level.
A review of his Language Arts standardized testing results for the previous year revealed that he consistently scored “Far Below Basic” on the CAT-6 test each spring. In October, the kids took the Degrees of Reading Power (DRP) test, which consists of a series of cloze exercises. Bobby scored, once again, Far Below grade level.
Hyperlexia
Bobby has hyperlexia, which is a precocious ability to decode words in text with next to no understanding of what they mean.
Children with autism tend to share some common learning characteristics, not the least of which is deficits in reading. Within the realm of reading comprehension, they generally exhibit difficulties making sense of complex sentences, struggle with figurative language, make few inferences or in any way access their background knowledge, and connect to fiction text in minimal fashion. 
When a child with autism decodes at a high level but has considerable comprehension deficits, she or he cannot learn strategies for inferring, integrating text, or making personal connections to text unless the hyperlexia is first confronted.
This blog post is the story of my next two years with Bobby, and why, as he completed the fifth grade, all standardized and authentic assessments confirmed his ability to both decode and comprehend at grade level or higher.
So what could I do to help?
Bobby not only introduced me to hyperlexia, but bore with me when I discovered that there was but one professional journal article which provided a hint about a potentially-significant intervention for this particular reading disability. By necessity, we were forced to follow up on it in our own way, on our own.
The first hundred or more times I attempted to locate information on interventions that work in cases of hyperlexia I drew a complete blank. Most of the professional literature pertaining to hyperlexia has to do with defining it and describing it. There are very few articles that describe how to fix it.
I didn’t particularly care why Bobby had hyperlexia, or how it manifested; I wanted to know what to do about it to help him make meaning when he read.
I became increasingly frustrated in my research, which was my first entrée into investigating teaching strategies for working with kids with autism. Plenty of people wanted to describe their child’s hyperlexia. Plenty of researchers wanted to discuss whether it was a part of autism or a part of language disorders. Nobody really had any useful ideas about how to handle it in the classroom.
Success! Sort of…
Finally, late one night while I was on vacation in New York, I did one last, desperate Google™ search. And up popped an abstract of an article describing a test of three different interventions: pre-questioning strategies, cloze exercises, and something called “anaphoric cuing.” Only the last intervention showed success in improving reading comprehension.
[O’Connor, I.M. & Klein, P.D. (2004). Exploration of strategies for facilitating the reading comprehension of high-functioning students with autism spectrum disorders. Journal of Autism and Developmental Disorders, 34(2): 115 -127]
Ahah! But what is anaphoric cuing and how did the researchers use it?
By yet another bit of poor luck, I was unable to obtain a good copy of the article for several months. Lacking patience, I decided to go ahead and try to figure out what anaphoric cuing was on my own. The first thing I had to do was locate the definitions of all of those big words. I learned the following from a variety of sources:
Definitions
- Hyperlexia is a reading disorder characterized by a precocious ability to decode words, usually two or more levels above the child’s age or grade, combined with significantly impaired comprehension of the same words.
- Anaphora are words, often pronouns, which refer back to reference words previously used in the text. For example: “Dan went to his locker to retrieve his jacket.” In this case, “his” is the anaphora and “Dan” is the reference word.
- Anaphoric cuing involves teaching the child to identify anaphora and to pause to relate them to their reference words while reading. In this way, the child begins to understand text as an integration of phrases and to connect the parts of the text to one another. The active engagement required to relate words to one another supports the child’s connection to the text and reduces his or her habit of passive decoding.
O’Connor and Klein’s study
Eventually I obtained their article and learned that Irene O’Connor and Perry Klein, both of the University of Western Ontario, had worked with 20 adolescent students with hyperlexia to explore the success of cloze questions, pre-reading questions, and anaphoric cuing.
While instruction using the first two techniques had little impact on the quality of reading comprehension, anaphoric cuing resulted in significant improvements.
O’Connor and Klein suggested that students with hyperlexia do not understand that anaphora refer back in the text and the researchers theorized that if such students could be coached to stop and identify the reference made by the anaphora, reading comprehension would improve.
They selected several texts in which 12 anaphora were underlined, and underneath each one provided three choices as to the reference word. Students were encouraged to pause at each underlined word and choose the correct reference word.
The students demonstrated the ability to pause and consider each underlined anaphora accurately, choosing the correct reference word 5 of 6 times. In addition, their ability to answer comprehension questions following the session of anaphoric cuing was demonstrably improved.
But in the winter of Bobby’s fourth grade year, with only an educated guess of what “anaphoric cuing” must involve, I began to work with him. What exactly did I do?
That will be the subject of my next post.
Research suggested to me that something called anaphoric cuing was the key to helping Bobby. The earlier post “Autism and hyperlexia, part 1: Anaphoric cuing?” discusses what anaphoric cuing is and how I came to discover it as a possible intervention. In this post, I will discuss exactly what I did with and for Bobby.
On Google, and on bing, we come in at number three. Not bad, we think, for a blog that began in August 2009. 
Tip: I rarely sit next to “my” student. Though I may be in a particular class only because Brandon, or Susie, or Juan is there, I do not want the other kids to know that unless it seems necessary that they know that. I watch my student from a distance, take notes, move in with advice or assistance and move back out again. Meanwhile, I’m helping other students all around the classroom. No student in the classes where I am assigned feels any stigma because I step over and talk to or assist them. Most of them couldn’t tell you why I’m there.
I worked with a sixth grader who was fascinated by Alfred Hitchcock (they often have intense interests) and wrote an essay about the filmmaker discussing several of his movies. An eighth-grade student on the spectrum was a math whiz who read ahead in his algebra book for fun (and also composed on the piano). A ninth-grader who rarely spoke required almost no help in completing earth science worksheets, finding answers from the textbook.
I
One related tip: Many kids with autism will NOT choose a partner or a group they are not assigned to. When asked to form groups of a particular size, or to choose a partner, they will stand up and wander around aimlessly until an adult asks if they have a partner or have joined a group and then assign them to it.
Don’t. Stop. And I say that to both parent and teacher.
Parents and teachers must start collecting and sharing information about the reader with autism. Relevant information includes: what kinds of movies does the child seem to like? T.V. shows? Music? Toys? Stuffed animals? Places to visit? Types of humor? Picture books? Read-aloud books? Fairy Tales? Holidays? Favorite subject in school? What’s relevant is anything that interests the child.
Make a special basket of books for the child in your classroom. Include non-fiction and fiction, and any topic that you’ve identified as of particular interest to the reader. If he’s obsessed with dinosaurs, find dino picture books, chapter books, stories, and non-fiction books. If he likes quirky, goofy characters, amass a quantity of books at all levels that you think will make him smile. 
It is not enough to simply decide that a child doesn’t comprehend text. It is never okay to stop with such a general piece of information. While the fact-finding task in the parent/teacher partnership may be directed by the parent, this next step should be led by the teacher. If your child’s teacher isn’t willing or able to lead, then it is the job of the parent to lead, or find someone who will. Don’t let this become an adversarial situation; sometimes we teachers aren’t able to lead because we don’t have enough training or experience. You can help by assisting in finding a mentor or asking a previous teacher to participate along with the current one. (You can also contact me. I’ll email with anyone who subscribes to this blog.)
When your child and the teacher are here. 
And then there’s the fact that the relationship between the reader and the text is much easier than with fiction. The reader can ask questions and get them answered without too much probing. The reader’s job is just to collect information, gather facts, and store them. This is something that many readers with autism are quite good at, and particularly enjoy. 
Are we going to try to engage in a long conversation about it? Absolutely not. If this is a child who avoids fiction like the plague, what I am going to do is heap the praise, repeat the information back, and have the child do some sort of quick exercise with me to cement the experience. This might be dictating to me a series of key words found in the text, or doing a quick entry into a graphic organizer. Five minutes. 
A child may have autism, or live with autism. She’s a child first. The autism she has is a feature, much like her hair color, sweet tooth, or athletic ability.