Engaging Children With Autism in Shared Book Reading

Abstract

Margot is a mother to three young children and is particularly invested in helping her children become strong readers. She makes an effort to read with her children daily, because she has been told by teachers and other professionals that reading with children is especially important in helping them develop reading skills. Sam, the youngest of her children, is a reluctant reader. He was diagnosed with autism last year when he was three years old, and he engages in challenging behaviors that make it difficult to read with him. Sam’s siblings show a natural affinity toward books and are excited to read with Margot, but when she includes Sam in book readings, he loses interest quickly and engages in behaviors that are distracting to his siblings, such as poking them or yawning loudly. When Margot asks if he would like to read a book just with her, he usually ignores her and continues playing with his trains (his favorite activity). Forceful attempts to make him read books result in screaming tantrums. Because of his challenging behaviors, Margot has stopped trying to get Sam to read with her or his siblings, but she worries that he will have difficulties reading in the future.

“A common early literacy practice valued by early childhood professionals and parents is reading aloud with children.”

The presence of a developmental disability has been associated with failures in learning to read (Landgren, Kjellman, & Gillberg, 2003). Given that children with disabilities are at higher risk for reading difficulties, it is especially important that they receive repeated opportunities to develop emergent literacy skills—particularly oral language, phonological awareness, and concepts about print—that can support later reading achievement (National Early Literacy Panel, 2008). A common early literacy practice valued by early childhood professionals and parents is reading aloud with children. Reading books with children gained popularity during the 1980s in large part, because early childhood policy makers publicized that reading aloud was an excellent, developmentally appropriate instructional practice (Bredekamp, 1986). The frequency of book reading at early ages has been related to children’s oral language ability and reading comprehension skills in elementary school (Wells, 1985). Reading aloud to children emerged as a key facet of family literacy programs and the central focus of several public library outreach efforts (e.g., the Carnegie Library’s Beginning to Read program, Reading is Fundamental, Washington Learning Systems; see Reading is Fundamental, n.d.; Segel & Friedberg, 1991; Washington Learning Systems, 2010). As a result of these efforts, parent–child shared reading (e.g., a parent reading a picture book with a toddler) gained popularity and continues to be widely recommended to promote language and other skills related to early literacy development.

The importance of reading with children at early ages is clearly understood. Yet, for the parents of many children with Autism Spectrum Disorders (ASD), reading with their children can be difficult and frustrating, because their children may lack the motivation and/or the skills that are necessary to participate in shared reading activities. A good shared book reading involves more than just the parent reading to a child. In addition to reading text, parents often make comments about the illustrations and events in the story, and invite their children to do the same by pausing and asking questions. Ideally, children initiate comments of their own, and the parent follows the child’s lead by expanding on their statements (DeBruin-Parecki, 2004; Whitehurst et al., 1988). Children with ASD may lack many of the language skills necessary to engage in such interactions, such as commenting and being able to describe events. Furthermore, shared book reading requires that children sustain social interaction around a particular topic (the book), which can be challenging for many children with ASD due to difficulties in social communication (American Psychiatric Association [APA], 2000) and joint attention (Corona, Dissanayake, Arbelle, Wellington, & Sigman, 1998; Mundy, Sigman, & Kasari, 1990). Because shared reading places social and language demands on children, as many as 40% of children with disabilities do not show an early or continued interest in book reading and actively resist storybook reading interactions (Kaderavek & Sulzby, 1998). Children may demonstrate behaviors that interfere with their parents’ attempts to engage them in book reading activities. In spite of good intentions, parents may be reluctant to read with their children if they have difficulty attending or become aggressive during book readings.

“If children with ASD are to benefit from literacy opportunities, parents must first be able to address any challenging behaviors that may interfere with their child’s engagement in the book reading act”

All children, especially those who are at risk for reading difficulties, such as children with ASD, require high-quality, frequent opportunities to interact with written and oral language to foster their early and later achievements in language and literacy (Ezell & Justice, 2005). However, merely providing literacy opportunities may not be enough to improve reading outcomes for children with ASD. If children with ASD are to benefit from literacy opportunities, parents must first be able to address any challenging behaviors that may interfere with their child’s engagement in the book reading activity. Ample evidence exists to suggest that the best ways of handling challenging behavior are indirect. In other words, it is best to have supports in place that prevent challenging behaviors from occurring rather than relying solely on reactive strategies that take place once the behavior occurs (Dunlap, Strain, & Ostryn, 2010). This article contains suggestions that parents, such as Margot in the vignette, and other caregivers can use to encourage their children to participate in book reading. These strategies can help parents indirectly address challenging behaviors that can occur during book reading by (a) creating an appropriate reading environment and routine, (b) improving compliance during reading, (c) teaching appropriate book reading behavior, and (d) encouraging children’s active participation in shared reading.

Create an Appropriate Reading Environment and Routine

The first steps toward successful book reading experiences begin long before a book is even opened. By putting some time and thought into creating an organized literacy environment and making book reading part of the daily routine, parents can set the stage for an enjoyable and productive shared book reading session.

“Experimenting with a different seating option can be an effective accommodation to help restless young children attend during shared book reading.”

Organize the Literacy Environment

The literacy environment for children with ASD should be carefully arranged so that the child is able to focus on the reading task. This involves creating a space dedicated to book reading and minimizing potential distractions (Hume, 2010). Organized spaces help children with ASD understand what is expected of them in the area (Mesibov, Shea, & Schopler, 2005), which can reduce any anxiety they might be feeling toward reading books with parents. Differentiate the reading space from other areas of the room by creating visual or physical boundaries. Parents may be able to accomplish this by dedicating a portion of their child’s play room or bedroom to book reading and physically segmenting the space by rearranging furniture, such as bookshelves or file cabinets, to act as room dividers. If it is not possible to physically segment space in the home, the same effect can be obtained by creating visual boundaries using masking tape, area rugs, or assigning special cushions or chairs for book reading.

Simple modifications to the child’s environment can help a child who is fidgety attend better during book readings. Rather than repeatedly directing a child to stay in his or her seat, parents can try out different types of seating arrangements such as a cube chair, beanbag chair, or even a therapy ball. Offering children alternative seating arrangements has been found to be effective in improving on-task engagement for children with ASD (Schilling & Schwartz, 2004). Shared book reading looks different across families depending on individual needs and preferences. Some children will be able to attend better sitting on a parent’s lap, others may prefer reading at a table or sitting on a beanbag chair. Experimenting with a different seating option can be an effective accommodation to help restless young children attend during shared book reading.

After a book reading space has been created, the next step toward creating an organized literacy environment involves minimizing any auditory or visual distractions that can detract from the reading experience. If possible, the book reading area should be located away from sources of noise. In homes, distractions may occur if a parent reads to the child near a window that overlooks a busy street, air vents, or mirrors. It may not be feasible to completely eliminate all distractions in the child’s environment, but whenever possible, attempts should be made to reduce visual and auditory stimuli by placing the distracting items out of the child’s field of vision, placing extraneous materials and supplies in cabinets or drawers, and covering open shelves and other visual distractions with fabric or butcher paper (Hume, 2010). In addition, parents can reposition themselves and their child away from potential distractions that are difficult to move or cover up. Minimizing distractions is essential for children with ASD who may be easily distracted or overstimulated when presented with too many stimuli. The literacy environment should contain only the most salient and relevant information to help children focus on book reading.

“Another strategy parents can use to prevent challenging behaviors from occurring is making book reading part of their child’s daily routine.”

Make Book Reading Part of the Daily Routine

A common characteristic exhibited by children with ASD is insistence on sameness and adherence to routines (APA, 2000). Problem behaviors can arise when children are presented with an unexpected change in their routine. Another strategy parents can use to prevent challenging behaviors from occurring is making book reading part of their child’s daily routine. The use of routines can help children with ASD better adapt to their environment by establishing consistency and predictability (Kunce & Mesibov, 1998). Parents can try to structure their child’s time after school to include daily book reading (e.g., read a book after snack or before bedtime). The routine can be effectively communicated to children using visual schedules, which indicates what activity the child should be engaged in at any given time during the day through the use of objects, photographs, icons, or words (Meadan, Ostrosky, Triplett, Michna, & Fettig, 2011). Alternatively, parents may find it easier to use an erasable whiteboard or paper with a checklist of activities or pictures representing tasks to be accomplished. Making daily book reading part of the child’s classroom schedule or home routine will add predictability to a child’s day, which can prevent the occurrence of problem behaviors that can arise from unexpected changes in the routine.

Margot has committed to making shared reading part of Sam’s evening routine. As much as possible, Sam engages in a similar series of activities every night before bed: eat dinner, take a bath, put on pajamas, watch a 30-min television program, read a book with one of his parents, and go to sleep. Margot wrote the schedule on a chalkboard that hung on a wall in the kitchen. Sam is accustomed to following schedules, so including shared reading as a part of his bedtime routine was an easy adjustment for him. After he finished his television show, Sam referred to his checklist and willingly went to his room to read a book with his mom. When he entered his room, Sam went to the reading corner which was visually separated from the rest of his bedroom by a rug and a large beanbag chair. Margot wanted to make sure that the book reading area was free of any potential distractions, so she put all of Sam’s toys in a covered toy chest and moved the mirror to a different area of the room so it would be out of Sam’s field of vision.

Improve Compliance During Book Reading

“In selecting books, parents should take advantage of children’s special interests.”

Once an appropriate literacy environment has been created, the next obstacle that many parents face is getting children to agree to sit down for shared book reading. Rather than physically forcing children to sit with them, parents should try alternative means to elicit compliance from children who may ordinarily resist book reading.

Provide Choices

Allowing children to make choices throughout the day has been shown to increase task engagement and correct responding, as well as decrease disruptive behaviors (Moes, 1998), and may be an effective strategy parents can use to improve children’s compliance with shared reading. Choices can be embedded in a number of ways during book reading. For instance, parents may decide that book reading needs to happen in the “book reading area,” but the child can choose which type of seat he or she would like to use (e.g., sitting on the floor, in a parent’s lap, on the beanbag chair). Parents may also allow the child to choose which book they will read from an assortment of preselected books. Giving children a little control over some things during their day can prove beneficial for parents and their children. A word of caution: Before allowing children to make choices, parents should ensure that all options available to children are appropriate.

Consider the Child’s Interests

Children with ASD usually have strong interests in objects or topics. In selecting books, parents should take advantage of children’s special interests. This can be especially important if a child is new to shared book reading or actively resists reading with their parents. Efforts should be made to ensure that children’s initial book reading experiences are particularly enjoyable. Books that feature favorite characters or revolve around preferred topics may be reinforcing, thereby increasing the likelihood that the child will be willing to participate in future shared book readings. After a few pleasurable book readings, the parent should gradually introduce new books to expand on the child’s interests.

If the subject of the book is not of particular interest to the child, the child’s special interests can still be used as a way for parents to reinforce participation in book reading. Parents should watch the child during free play sessions to identify his or her preferred activities. Activities that the child is likely to engage in can be used to reinforce his or her participation in less-preferred activities. Parents may be able to entice children to participate in book reading by making access to the preferred activity contingent on reading a book with a parent.

Margot knows that her son enjoys playing with Thomas the Tank Engine. When Sam comes home from school, he runs to the train bin in his playroom and arranges his favorite trains on a railroad track. At first, she allows Sam to choose among three books from the Thomas the Tank Engine book series. After 1 week, she decides to introduce some variety to their book choices. Thomas the Tank Engine was no longer an option for Sam to choose. Instead, she allowed him to choose from three more train engine books: a nonfiction book about trains, The Little Train by Lois Lenski, and Down by the Station by Will Hillenbrand. Sam has been showing some resistance to shared book reading ever since Margot started introducing new book choices during reading time. She decides to make access to building train tracks contingent on him participating in shared book reading. She tells Sam “first we’ll read one of these books together, and then you can go to the playroom to build your train track.”

“It is important that parents teach the behaviors that are expected of children during book reading.”

Read it Again, and Again

It has previously been discussed that children with ASD benefit from predictability in their daily routine. Accordingly, children may also benefit from knowing what books will be used during future book reading activities. Parents can prime their children for a book reading activity by reading the same book on several occasions, or allowing them to preview the pictures of an unfamiliar book before reading. By familiarizing the child with the book, reading becomes more predictable, which can decrease off-task and other problem behaviors (Koegel, Koegel, Frea, & Hopkins, 2003).

Teach Appropriate Book Reading Behavior

Establish Ground Rules

For children who are new to book reading, it is important that parents teach the behaviors that are expected of children during book reading. Children with ASD tend to have visual strengths and generally find it easier to follow directions that are presented to them visually rather than verbally (National Research Council, 2001). Visual supports in the form of pictures, symbols, or written words, can be used to convey the parent’s expectations (Meadan et al., 2011). Examples of appropriate book reading behavior include: sit with my bottom on chair, eyes on the book, and talk about the book. If children use visual supports, they should be placed in front of them so that they can refer to the visual supports as needed throughout the book reading.

Reinforce Appropriate Behavior

Once ground rules for appropriate book reading behavior have been established, it is important that these behaviors are reinforced. During book reading, parents should periodically give their child feedback for engaging in the desired behaviors. Many parents find it easiest (and more natural) to provide social reinforcement for behaviors, such as praise, hugs, tickles, and other signs of affection. Given the social deficits associated with ASD, it is possible that some children with ASD may not find this type of feedback enjoyable. In this case, parents may need to pair social feedback with another type of reinforcement, such as tangibles or edibles, to teach children what is expected of them during book reading. If providing tangible or edible reinforcement interrupts the pace of reading, consider implementing a token system. Token systems have been used successfully with preschool-age children to reduce disruptive behavior in home settings (Budd, Leibowitz, Riner, Mindell, & Goldfarb, 1981) and are most effective when the materials are developmentally appropriate and appeal to the child’s interests (Titus et al., 1990). Parents should try to simplify the token system to help their young child understand the system. This involves clearly defining the behavioral expectations for which the child earns tokens and identifying what the child will earn if he or she receives all the tokens. Furthermore, the token exchange should require little math skill, such as earning three stars for a reward (Filcheck & McNeil, 2004). Throughout the book reading, the child earns tokens for engaging in appropriate behavior. At the end of the session, these tokens can be exchanged for the preferred item or activity.

“The manner in which children are read with affects their engagement during book readings and what they take away from the experience.”

Although Sam willingly goes to the reading corner and selects a book, he has difficulty attending during the reading. Margot constantly redirects him to stay seated and focus on the book. She talks with Sam’s teacher who recommends that she use a visual support to communicate what Sam should be doing during book reading along with a token reinforcement system. Margot decides that she would like for Sam to (a) sit with his bottom in the chair and (b) keep his eyes on the book. She draws two pictures on an erasable whiteboard that represent these expectations.

Before the next book reading, she shows Sam the whiteboard and explains to him: “A good book reader sits with his bottom in the chair and looks at the book.” Margot asks Sam what he would like to earn if he is a “good book reader.” Sam responds that he would like to earn extra time playing with trains before bed. She tells Sam that if he earns all of his stars, he is allowed to play with his train set before bed. Throughout the book reading, Margot periodically checks if Sam is sitting on his bottom in the chair and is looking at the book. When she sees him engage in these behaviors, she praises him, and draws a star on the whiteboard.

Figure 1 provides an example of the token system Margot used with Sam. For children who are new to using a token system, parents should ensure that they are successful in receiving their reward (e.g., provide tokens frequently or start with two to three tokens and gradually increase over time). The goal of a token system is for children to view book reading as a positive experience rather than a negative experience that is focused on compliance.

Figure 1

Example of a visual support and token system for shared book reading

Encourage Active Participation in Shared Reading

Incorporating daily book readings into children’s daily routine is a great first step toward helping them develop important emergent literacy skills; however, the quantity of book reading may not be as important as the quality of book reading (Scarborough & Dobrich, 1994). The manner in which children are read with affects their engagement during book readings and what they take away from the experience. Imagine a situation in which a parent simply reads the text on the page, with little elaboration, and poses few questions. The child in this scenario is a passive listener and the reading is a performance rather than an interaction. Compare this with a book reading interaction that involves the parent describing illustrations and asking the child questions about what he or she sees and understands about the story. In this second scenario, the child has the opportunity to (and is expected to) engage with the text. The child becomes an active participant with the parent, the book, and the entire process of reading. In this scenario, the parent enhances the quality of the reading experience by encouraging the child to participate in the book reading.

“Parents can encourage children to be actively engaged by asking questions during book reading.”

Dialogic Reading

Shared book reading should involve more than just reading to children. Reading should be an interactive process in which a parent engages the child in a conversation about a book. Incorporating discussion during book reading helps children develop vocabulary, but also results in improved engagement (Dale, Crain-Thoreson, Notari-Syverson, & Cole, 1996). Many children with ASD may lack the social and verbal skills to fully engage in a conversation in a book, but parents can encourage children to be actively engaged by asking questions during book reading. In one variation of interactive reading, called dialogic reading (Whitehurst et al., 1994; Whitehurst et al., 1988), parents prompt their children to verbally participate in the reading by asking a variety of questions. Dialogic reading for young children between the ages of 2 and 3 involves the parent primarily asking simple “what” questions to encourage children to name objects pictured in the book. For older preschool-age children, the mnemonic CROWD is a way for parents to remember a set of questions that they can ask during book reading including: (C) asking the child to complete a repetitive phrase in the story, (R) recall events or details about the story, (O) open-ended questions in which the child describes what he or she sees, (W) wh-questions, and (D) distancing questions that ask the child to relate parts of the story to his or her personal experience. Once the child responds to the question, the parent expands on the child’s response by adding additional words, and asks the child to imitate the expanded phrase. By expanding on children’s responses to questions, parents provide feedback about their children’s language while modeling language that is slightly more complex that the original response. Furthermore, children have the opportunity to practice using this sophisticated language as they repeat their parents’ phrases. Parents can refer to Zevenbergen and Whitehurst (2003) for additional information about dialogic reading.

Modified dialogic reading

What happens if a child does not respond to the parent’s question? Children with ASD may lack the communication skills and/or the social motivation to respond to parent questions, so parents may need to provide additional supports to help children participate in the reading. In a recently conducted study of dialogic reading for preschoolers with ASD, the researchers changed the traditional CROWD to CROWDS in which the additional “S” stood for “special” prompts (Fleury & Schwartz, 2012). Adult readers were trained to use traditional dialogic reading prompts during book reading; however, if the child failed to answer the question, the adult would follow the unsuccessful prompt with a special prompt. Special prompts included providing response choices, yes/no questions, requests to point to answers in illustrations, and direct requests to repeat a word. A summary of CROWDS questions with examples can be found in Table 1.

Table 1

Types of Questions to Ask During Shared Reading

Question	Explanation	Example
Completion	Ask the child to complete a repetitive phrase	“Run, run as fast as you can, you can’t catch me, I’m the_____”
Recall	Ask the child to recall something about the character or the events in the book	“What did the hungry caterpillar eat?”
Open-ended	Encourage the child to respond in his or her own words	“What do you see on this page?”
Wh-questions	What, where, and why questions that target new vocabulary	“What is this called?”
Distancing	Ask the child to relate parts of the story to his or her life	“Have you ever played in the snow, like Peter?”
Special	If the child is unable to answer a question, simplify the question:
	✓ Provide choices	“Is it a ____ or a ____?”
	✓ Request the child to point	“Point to the___”
	✓ Yes/no questions	“Is that a cow?”
	✓ Direct request to repeat answer	“Say COW”

Source. Adapted from “Dialogic reading: A shared picture book reading intervention for preschoolers” by Zevenbergen and Whitehurst (2003, p. 180). Copyright 2003 by Lawrence Erlbaum Associates, Inc. Special prompts are not part of the original dialogic reading procedure.

Margot is pleased that Sam willingly joins her in book reading and is now able to sit appropriately for short books. She would like for Sam to engage more actively in the book, so she asks his preschool teacher for advice. Sam’s teacher recommends that Margot encourage Sam to talk during reading by asking him questions. She tells Margot about dialogic reading and suggests that if Sam is not able to answer a question, she should pose a different question that is easier for him to answer. That evening, she uses the teacher’s advice:

Margot points to a butterfly:

“Sam, what is that?” (ask a question)

Sam:

No response

Margot:

“Is it a CATERPILLAR or a BUTTERFLY?” (special prompt)

Sam:

“Butterfly”

Margot:

“That’s right! It’s a yellow butterfly” (expands on Sam’s response)

“Can you say yellow butterfly?” (request for imitation)

Sam:

“Yellow butterfly”

Increase the Duration of Book Reading

Children will naturally differ in the amount of time they are able to participate in seated activities. Some children can easily read an entire book with a parent, while others may get restless after a few pages. For those children who have difficulty sitting through an entire book reading, parents can teach their children to participate for longer periods of time by reinforcing successive approximations toward the goal duration. To do this, parents first need to record how long their child presently attends to a book. Second, they should decide on a target goal. Third, parents need to gradually build from the child’s current book reading duration in steps that eventually lead to the target amount of time. Recording how long children spend engaged in book reading is an easy way that parents can monitor their progress.

“The effective management of challenging behaviors enables children with ASD to more fully participate in shared book reading activities and begin developing foundational skills that will help prepare them to be successful readers.”

Margot would like to record the progress Sam is making during book reading. She hangs a calendar in the book reading area so she can write down and keep track of how long Sam reads with her. Sam currently attends to book reading for 3 to 4 min, but Margot would ideally like for Sam to be able to attend to book readings for 10 min. She decides that she will use his favorite toy, Thomas the Tank Engine, to reinforce Sam for participating in book readings for longer durations. First, she lets Sam play with the toy if he successfully reads a book for 5 min. After 3 successful days, she increases the criteria to 7 min, then 9 min, and then finally 10 min.

Final Thoughts

The development of emergent literacy skills has important implications for reading achievement. To acquire these foundational skills, children must have opportunities to engage in quality literacy experiences, such as shared book reading. Without parent support, many children with ASD may engage in behaviors that prevent them from participating in shared book reading activities, thereby limiting what they get out of the experience. The effective management of challenging behaviors enables children with ASD to more fully participate in shared book reading activities and begin developing foundational skills that will help prepare them to be successful readers. Table 2 contains a summary of all of the strategies that have been presented in this article. Parents may not need to use all of these strategies to have a successful book reading session; however, this guide is intended to be an easy reference that parents can use to select strategies that will address their children’s specific needs. By investing some time into creating a reading environment, improving compliance during reading, teaching appropriate book reading behavior, and supporting children’s active participation in shared reading, parents may be able to have successful book reading experiences that not only support their children’s literacy skills, but may also be enjoyable for parents and their children.

Table 2

Troubleshooting Guide for Shared Reading

If a child	Try these strategies
Is easily distracted	Physically or visually segment a reading space Minimize auditory and visual distractions Teach appropriate behavior (e.g., eyes on book) and reinforce the behavior
Constantly fidgets or gets out of his or her seat	Explore different seating options (e.g., table, parent’s lap, beanbag chair) Teach appropriate behavior (e.g., sit with bottom in chair) and reinforce the behavior
Resists book reading	Make reading a part of the daily routine Provide choices whenever possible (e.g., seating options, book selection) Build on the child’s interests (e.g., book selection, make access to preferred activity contingent on completing book reading) Reread familiar stories or allow the child to preview an unfamiliar book Provide praise and reinforcement for appropriate participation
Appears disengaged (or bored) during reading	Ask questions Praise and reinforce verbal (e.g., commenting, answering questions) or nonverbal (e.g., pointing, turning pages) behavior
Attends for only a short amount of time	Gradually increase the amount of time spent in shared reading Provide praise and reinforcement for appropriate participation

Footnotes

Author’s Note

You may reach Dr. Veronica P. Fleury by e-mail at veronica.fleury@unc.edu.

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