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.

»  »  ¤  «  «

 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.

Related posts:

1. FAQs about anaphoric cuing and reading comprehension
2. Anaphoric cuing: Asking clarifying questions
3. Reader with autism and figurative language, part 1

When I met him, Bobby was a fourth grader with autism, struggling to make meaning of the words he so easily read aloud (decoded).  He had hyperlexia, a common condition with children on the autism spectrum, in which they seem to read well but comprehend little. 

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.

Weekly routine

Bobby was given one-on-one attention and instruction for 20 minute sessions, three days a week.  This took place at a kidney-shaped table in the corner of the classroom, shielded from the activity of other students. 

  There were three stages to the process: 

• Initial implementation of anaphoric cuing,
• release of responsibility, and
• gradual development of independence. 

Initial implementation of anaphoric cuing

During the first several months, Bobby met with me three mornings per week.  Each session began with a conversation about the previous day’s work, with the following questions:  (1) What did you read yesterday?  (2)What do you remember about what you read? 

Following that introductory conversation, I presented Bobby with his book and his comprehension worksheet from the previous day.  The worksheet asked him questions about the anaphora from the previous day’s text, such as: 

• Who is “he”? 
• Where is “there”? 
• When was “then”? 
• What is “it”?

Here is an example:

Pages 10 and 11:

1. Who is May?

2. What does May think about the fact that Marvin likes Rosie?

Page 12:

1. Why does Marvin think Rosie is so mean?

2. What does May think of Marvin’s theory?

Page 14:

1. Why does Mr. Brock want to sell his farm?

2. Why did May think that selling Rosie was a good idea?

If he had answered all questions correctly, he was given a new assignment.  If there were questions to be corrected, he did so under my supervision.  Prior to starting a new reading section, I asked Bobby to restate the procedure for reading: 

“First, I read a page.  Then I stop and think about it.  Then I answer the questions for that page.  I don’t turn the page of the book until I have answered all the questions for that page.” 

(I did mention, didn’t I, how compliant Bobby was?)  Only then did I let him begin reading that day’s text.

 During the next 15 minutes, I observed Bobby’s reading behaviors and completed a checklist.  (See Exhibit 1: Retell Checklist, below) If he was off-task or not following the stated procedures, (i.e. reading ahead before answering questions) he was gently redirected by the question “Bobby, what are you supposed to be doing now?”

 At the end of each session, I evaluated his worksheet and tabulated the results.  At the end of each week, the checklists were compiled and the data recorded.

Release of Responsibility 

Bobby's Bookmark

Once Bobby had progressed up several levels of narrative fiction text and built his stamina to 20 minutes at a time, I released some of the responsibility for addressing anaphora to him.  Bobby was taught what anaphora are, and the types of words they might be. (For example, he, them, it, there, that, then.)

I made for him a laminated bookmark listing many of the words to look for.

  He was instructed to pause before reading each paragraph and to scan and underline any anaphora he saw.  He was then told to to stop as he read at every underlined anaphora and identify the reference word (the word to which the anaphora refer). 

His reading comprehension worksheets were redesigned to focus on a summary or restatement of each paragraph using different words.

Gradual development of independence

 When Bobby moved up three grade levels to books at the fourth grade level, I decided to nudge him into a new phase of independence and responsibility for his own work.    The comprehension worksheets were removed entirely and he was asked to create his own questions to prompt identification of anaphora and reference words.   

When he exhibited some reluctance to assume this responsibility, I taught him the types of question words he might use for each anaphor:  pronouns generally lead to “who” inquiries; whereas “there” might lead to a “where” question. 

Once he had practice in identifying the types of questions he might ask based on the nature of the anaphora, he was encouraged to work more independently. Supervision was limited to observation of his reading behaviors and once weekly conferences when I asked him to retell what he’d been reading. 

Evaluation of process

 The process I followed involved ongoing and consistent collection of data, which was used not only to monitor levels of improvement in reading comprehension, but to identify problems and design solutions. 

For example, observations led me to conclude that Bobby needed to build reading stamina before he could proceed into more complex types of narrative fiction text, and accommodations were made that allowed him to gradually increase the amount of text read in each session. 

Tip:  Constant and careful observation and recording of various reading behaviors is necessary if the teacher is going to customize reading instruction in anaphoric cuing, adapt to the resulting improvement in comprehension, and resolve related issues which invariably arise.  No two students are alike. 

 One-on-one instruction and guided practice proved to be a key to the consistency of Bobby’s progress.  Direct instruction was provided in small chunks in a step-by-step basis over time.  All instruction was assessment-based, building on observations from the previous session.  

The result was Bobby’s gradual movement from dependence on comprehension checklists and worksheets to independent habits of reading.

You can do this!

 This particular classroom intervention can be performed by any teacher or paraprofessional with minimal training.  Each part of the daily work session routine is simple to implement and the student will quickly learn what to do and expect.  Gradual release of responsibility for thinking and working occurs after the child has become comfortable with anaphoric cuing.  

If a paraprofessional performs the daily conference tasks with the student, the teacher must regularly review the results to gage when to move to a new phase or how to resolve issues that arise. 

Because the involvement of instructional staff is limited in anaphoric cuing, the child quickly understands that the staff is not going to answer questions or do the work for him or her.  This teaches independence and responsibility for the thinking without much struggle.

But back to Bobby…

 The anaphoric cuing method used with Bobby was an evolving process of ongoing assessments to consider how to promote independent reading behaviors.  In the middle phase, Bobby was required to slow his reading and limit reading stints to but a few sentences at a time.  He was encouraged to identify reference words and retell each passage using those reference words to cement and demonstrate his understanding. 

Later, Bobby was asked to assume more responsibility, first to identify the anaphora in text; then to ask himself questions that connected the anaphora to the reference words.  Both standardized and my informal assessments (for example, Exhibit 2: Bobby and the Doughnut Store, below) revealed striking improvements in Bobby’s ability to read and comprehend text.

Epilogue

One cold and rainy day in January of 2008, I looked across my classroom and saw Bobby, now a sixth grader,  building a fort out of pillows.    He was once again holding a copy of  Harry Potter and The Prisoner of Azkaban in one hand while elbowing pillows into place with the other. 

I watched as he nested into his fort, opened his book, and began to read.  Two years before, while he could fluently read this book aloud, he comprehended almost none of it.  After awhile, I went over to him.

“What’s happening in the book?” I asked. 

“Oh!  I think Harry Potter is different from other kids,” said Bobby.

“How so?”  I asked.

“ Oh!  He hates vacations and he likes homework,” said Bobby.  “Also, he’s a wizard.  Wizards aren’t like normal people.  Oh!  And he does his homework with a feather pen.  I do mine with pencil.”

Exhibit 2: Bobby and the Doughnut Store

Exhibit 1: Retell Checklist

 

Related posts:

1. The problem of the read-aloud
2. Reader with autism and figurative language, part 1
3. Autism and hyperlexia, part 1: Anaphoric cuing?

This blog is a collaborative effort between my wife Sara and me.  She does most of the writing.  I do all of the editing, formatting, illustrating (mostly clip art), layout, etc.  Since neither of us had ever blogged or had a website before, it has been a new and rewarding experience.

I am a Special Education Tech in a large Southern California school district where I have worked for several  years, usually assigned in general education classrooms working one-on-one with students on the autism spectrum.  My assignments have included one elementary, two middle, and two high schools and even the school to which  they remove students  for zero-tolerance violations.

I have a degree in journalism, a law degree, and am only a few hours short of being certified as a mild-moderate special education teacher.   So why am I working as a para-educator/classroom aide?

Because I like being able to focus on the students.  Only on the students.  Not grading 150 of yesterday’s five-paragraph essays, or preparing tomorrow’s lessons, and especially not tolerating all that frustrating, annoying administrative stuff that teachers are expected to deal with.  (As an hourly classified employee, I rarely even have to attend staff meetings!)

The role of para-educator

Helping the teachers, of course, is part of our job description but we are not there for the teacher’s benefit (to make copies, or grade homework, or mop the floor, though I’ve done all those things).  We are there only because one or more of the kids in that class has an IEP that says they need extra classroom support.

Don’t be shy about telling the teacher when and why you can’t do something they ask you to do if you truly feel  it intereferes with something one of your students needs from you.

So what is the role of the special education classroom aide in a general education classroom?

To help the child with an IEP become more independent.

When a child no longer needs me, I have succeeded.  When a child continues to depend on me for something other children do without assistance, I have failed.  I have asked in the past not to continue  with a particular student because I thought they had progressed as far as they needed to go with me.

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.

Children on the autism spectrum can be great to work with as an aide.

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.

Yet all of these students, capable as they were in certain areas, had difficulty following even simple plots when reading fiction.  I don’t know that they had hyperlexia, but I would think it highly likely.  Often this particular reading deficit is not specifically identified.

What can you do to help a child who understands the vocabulary but still can’t follow the story?

Well, you can read Sara’s two posts on this blog about Autism and Hyperlexia.   And whether or not your teachers know about or focus on anaphoric cuing, you can use what you learn about it to help any student comprehend narratives, particularly fiction.

Simply put, anaphora are words that refer to other words.  Most of us know almost instinctively who “his” refers to when we read:

“Bob slung the backpack over his shoulder and followed Julio.”

A child with autism will often be unsure who is carrying the backpack.

So first, we have to identify the anaphora that may confuse a child.  These include more than just the obvious pronouns :

• I
• we
• us
• ours
• you
• yours
• he
• his
• she
• hers
• they
• theirs
• them
• it
• its

but also such words as:

• there
• then
• can
• do

When the child encounters these words in reading, we can ask (and teach them to ask themselves)

• Where is “there”?
• When was “then”?
• What is “it”?
• Who is “he”?
• Whose is “theirs”?
• “Can” what?
• “Do” what?

Reading connections that most of us make almost automatically the child with autism may need coaching and repeated practice to learn how to make accurately and regularly.

If you, the para-educator, can help a struggling reader learn this seemingly simple reading strategy, you may just open the door to a lifetime of reading enjoyment.  It is worth the effort.

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PS: I love this slogan “When children can not learn…It’s time to change the way we TEACH” They offer more than 40 products with this alone, and have dozens more autism-related designs.  We make not a dime off this endorsement, by the way.    http://shop.cafepress.com/design/17338377

Our Goal:  Providing help for struggling readers on the autism spectrum.

Related posts:

1. FAQs about anaphoric cuing and reading comprehension
2. The child in the IEP: Can we really see him as described?
3. Hearing the story in your head: The role of expressive reading