Reading Therapy (Bibliotherapy) for Kids with Autism

Research shows that reading therapy (bibliotherapy) can help improve some autism symptoms. The studies have also revealed the therapy can benefit brain connections.

Autism spectrum disorder (ASD) is a common developmental disorder, identified in about one in 44 U.S. children — and the incidence is growing, according to the Centers for Disease Control and Prevention. Autism can affect how kids communicate, interact, behave, and learn. Some youngsters with the disorder have fairly minor problems. Some need a great deal of help, especially with schoolwork.

A growing body of research has revealed a way to improve some autism symptoms that can actually change the brain. The technique doesn’t rely on medication or an invasive procedure. Instead, it uses reading therapy (also called bibliotherapy).

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Scientists have learned the human brain has plasticity, meaning it can change in response to learning or experiencing something new. Over a decade ago, researchers began trying to find ways this knowledge about our brains could help improve symptoms of autism.

A small but groundbreaking study by University of Alabama (UA) researchers found measurable improvements in 13 children with ASD, all around age 11, who had 10 weeks of intensive reading intervention.

Previous studies showed children with autism have decreased connectivity between certain areas of their brains involved with reading, compared with normally developing children.

Using functional magnetic resonance imaging (fMRI), the UA researchers found that, after reading therapy, however, youngsters with autism developed stronger activity in the areas of their brains that interact to comprehend reading. What’s more, the ability of the kids in the study to understand what they read improved significantly.

“This study was the first to do reading intervention with [autistic] children using brain imaging techniques, and the findings reflect the plasticity of the brain,” said Rajesh Kana, PhD, the director of the UA Center for Innovative Research in Autism and a professor of psychology.

Kana, who headed the study, and colleagues used the Lindamood-Bell learning process, which teaches children to form images of concepts in their minds as they read — a technique called Visualizing and Verbalizing for Language Comprehension and Thinking. The therapy can help develop and improve oral and reading comprehension and builds vocabulary and thinking skills.

“People with autism are relatively better at visual-spatial processing,” Kana explained. “The intervention facilitates the use of such strengths to ultimately improve language comprehension.”

The bibliotherapy was intensive, with the autistic children receiving one-on-one instruction in a distraction-free setting, 4 hours a day, 5 days a week, for a total of 200 hours. When the research subjects’ brains were scanned with fMRIs at the end of the study and compared to fMRIs before the intervention began, the researchers found increases in brain activation.

Increased functional connectivity of two core language areas in the brain was correlated with the amount of improvement in reading comprehension each child with autism experienced. The reading therapy resulted in positive brain changes.

Two other groups of children of the same age who participated in the research did not receive bibliotherapy. One group contained typically developing children, and the other was comprised of youngsters with autism. The two control groups who didn’t receive reading therapy showed significant changes in neither brain connectivity nor reading comprehension.

Other research has provided even more evidence backing up the UA research team’s study. In fact, Kana and UA autism research colleagues published an extensive review in Neuroscience and Biobehavioral Reviews of 15 peer-reviewed studies. The studies met strict criteria for investigating how a variety of interactive and shared reading therapies impacted all areas of autistic children’s reading skills. The criteria included comprehension, vocabulary, fluency, and phonological awareness — the ability to be aware of, and work with, sounds in spoken language.

The review reported how effectively that reading therapy improved the reading skills of youngsters with autism. Through brain imaging methods, reading therapy also increased neural activation and connectivity in parts of the brain associated with visual and language processes.

The use of neuroimaging increases the understanding of how brain plasticity can help children with autism, suggesting it could be used to develop future targeted behavioral interventions for autism spectrum disorder, according to Kana.

“Some parents think, if their child is 8 or 10 years old when diagnosed, the game is lost,” he said. “What I stress constantly is the importance of intervention and the magic of intervention, on the brain in general and brain connectivity in particular.”

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