Abstract
Purpose of Review
This review provides a critical overview of recent research on spelling and autism, highlighting developments and future research priorities.
Recent Findings
It has long been known that some children with autism have difficulty learning to spell. Recent studies have explored the reasons why these children have difficulty learning to spell and how they are best supported to learn to spell.
Summary
Spelling development has been linked to various factors in groups of autistic children, with language skills and intellectual functioning identified as key contributors to spelling achievement. Autistic and non-autistic children appear to draw on similar processes when spelling and may benefit from similar forms of instruction. Additional participatory research guided by autistic children, their parents and teachers is needed to further our understanding of spelling development and efficacious spelling instruction for autistic children. Potential avenues for future research are presented.
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Introduction
Learning to spell is a key focus in the beginning years of formal education and has implications across the lifespan. Children who are proficient spellers are better able to navigate online information sources and communicate their learning across topic areas as compared to their less-literate peers [1,2,3]. Spelling development provides a foundation for growth in other aspects of writing, such as writing quality [4, 5], and is associated with improvements in other literacy and related skills, including reading and oral language [6, 7]. In these ways, spelling supports academic participation, achievement and satisfaction [8, 9] and contributes to occupational, financial and health outcomes over the longer term [10, 11].
Learning to spell is important for all children, including those with autism for whom spelling can play an additional role in supporting communication using Augmentative and Alternative Communication (AAC) systems. AAC systems are used by people with communication disabilities to replace or clarify their speech in day-to-day interactions. Users select, write or type the words they want to say, often using a combination of spelling and pre-written messages, and present these messages using speech generating devices. It is estimated that around 30% of children with autismFootnote 1 do not develop speech and could benefit from AAC [14]. While is it not known how many minimally or non-speaking autistic children utilise text-based AAC, these systems have been shown to promote participation as well as early reading and writing skills for some users [15].
In this paper we provide a critical overview of the research on spelling and autism, aiming to highlight recent developments and future research priorities. We define spelling narrowly as the independent and intentional use of graphemes (e.g., letters in English and Spanish, characters in Chinese and Korean [16]) to represent the sounds and/or meanings of words in ways that are consistent with language-specific conventions. We consider spelling as requiring independence and intentionality on the part of the person who is spelling (i.e., the author of the written work). Importantly, our definition encompasses all intentional and independent methods of grapheme production/selection including writing, typing and gestures (e.g., to select a letter using text-based AAC). This excludes any consideration of articles discussing spelling for individuals using the facilitator-dependent and invalidated technique of Facilitated Communication [17,18,19] or Rapid Prompting Method (which is comparable to Facilitated Communication on multiple dimensions and has no validation evidence [20, 21]).
In recent years, there has been increasing interest in the spelling skills and development of children with neurodevelopmental conditions in education journals and the news media as well as among advocates and parent groups [22]. Interest in spelling development and instruction for autistic children has been an area of substantial growth, driven at least in part by moves toward inclusive education and increasing recognition of children’s support needs [23]. Spelling research to date involving children with autism has addressed three important questions. First, do children with autism have difficulty learning to spell? Second, why do some autistic children have difficulty learning to spell? Third, how are children with autism best supported when learning to spell? Each of these questions is discussed below with emphasis on recent findings.
Do Children with Autism Have Difficulty Learning to Spell?
There is long-standing research and clinical interest in whether children with autism have difficulty learning to spell. Early studies approached this question by comparing spelling accuracy in groups of autistic and non-autistic children with normal-range intellectual functioning, often as part of profiling children’s broader learning strengths and weaknesses. In one such study, Minshew et al. [24] assessed word spelling accuracy and other academic skills in a group of autistic adolescent males (n = 54, mean age 16 years) and a group of non-autistic adolescent males (n = 41, mean age 15 years) matched on full-scale IQ, age, race and socioeconomic status. The authors described the group of autistic adolescents as “high functioning” (p.216) and excluded potential participants with verbal IQ scores below 70 but did not report on whether some participants were minimally or non-speaking or used AAC. Results showed no significant differences between groups in reading or spelling accuracy. However, autistic adolescents were found to have significantly lower reading comprehension skills, leading the authors to conclude that some autistic adolescents may have a psychoeducational profile that is unlike other disability groups and characterised by intact procedural skills, including spelling.
Subsequent studies have continued to measure spelling accuracy in groups of autistic children with normal-range IQ but have not reached the same conclusions regarding children’s broader psychoeducational profiles. Much of this research is represented in a meta-analysis by Finnegan and Accardo [25] which considered studies published between 2000 and 2015 on the written expression skills of autistic and non-autistic children and adults. In this review, five included studies compared spelling accuracy in autistic and non-autistic groups of children and adults using measures of word spelling accuracy in a dictation task, error rates in connected writing and word spelling accuracy as a proportion of spelling attempts in connected writing [26,27,28,29,30]. Summary effects calculated using data from all five studies showed that spelling accuracy scores were, on average, significantly lower for autistic children and adults as compared to non-autistic children and adults; however, this difference was associated with a small effect size (g = 0.28), and heterogeneity tests indicated that results were inconsistent. This is most likely related to the fact that the five studies differed with regard to participant age range, gender, language and socioeconomic status, among other potentially important factors. Based on these findings, it is difficult to make any broad conclusions regarding the spelling proficiency of autistic children, though it is clear that spelling accuracy varies widely in this group with some autistic children having significant spelling difficulties.
Research on spelling and autism published since the Finnegan and Accardo meta-analysis has continued to draw comparisons between small groups of autistic children and adults with normal range IQ and their non-autistic peers, providing further evidence that spelling accuracy is highly variable in these groups (e.g., [31, 32]). An exception to this is a longitudinal study by Solari et al. [33••] which did not exclude children with intellectual disabilities, though children who were minimally or non-speaking were excluded. The authors followed the academic development of a large group of autistic children (n = 616) across their first year of formal education. Results on a purpose-designed measure of word spelling accuracy showed that children with autism had significantly lower spelling accuracy skills than their non-autistic peers at the beginning of their initial year of formal education and that this gap closed by the end of that school year. Further analyses revealed that means for the autism group were heavily influenced by a small subgroup of children (approx. 10%) with persistent and often severe literacy learning difficulties. The authors stress that efforts are required to better understand why these children fail to progress, highlighting intellectual functioning and access to literacy instruction as potentially important factors.
Why Do Some Autistic Children Have Difficulty Learning to Spell?
The following studies have moved beyond comparing spelling accuracy in groups of autistic and non-autistic children to consider why some children with autism have difficulty learning spell. This research has important implications for the early identification and remediation of spelling difficulties and may help inform the development of effective spelling supports [34]. The studies focus on whether spelling involves similar underlying processes for autistic and non-autistic children, and the factors associated with spelling achievement in these groups.
Processes Underlying Spelling for Autistic and Non-autistic Children
Theoretical models are used to describe the processes underlying spelling. Most contemporary models, including those cited in previous studies on spelling and autism, assert that spelling in English and some other alphabetic orthographies involve the coordination of three kinds of processing: phonological (i.e., spoken words and their phonemes), orthographic (i.e., written words and their letters) and morphological (i.e., word parts that signal meaning or grammar including base words and affixes [35, 36]). Evidence of these processes can be found in children’s spelling attempts [37, 38].
Bailey and Arciuli [39] analysed spelling attempts produced by a relatively diverse group of school-age (5–12 years) children with autism (n = 20) and non-autistic children matched on age and word spelling accuracy (n = 20) for evidence of underlying linguistic knowledge using the Computerised Spelling Sensitivity System (CSSS [40]). All children in this study were able to communicate verbally using at least single words. The CSSS was used to award points based on whether spelling attempts encoded the phonological and morphological structures of their target words using plausible letter combinations and recorded the frequency of three error types: (i) omission, (ii) illegal and (iii) legal (see Table 1 for further description and examples). Results showed no significant differences in the overall level of linguistic information encoded in the spelling attempts of autistic and non-autistic children or in the types of errors produced by these groups. Consistent with earlier studies involving spelling analysis [41, 42], Bailey and Arciuli interpreted these findings as evidence of similarities in the processes underlying spelling for autistic and non-autistic children but did not suggest that existing theoretical models can fully account for spelling development in autistic children. Rather, the authors acknowledged that findings were subject to important limitations including the use of a small sample which excluded children with very low spelling accuracy.
More recently, Peristeri and Tsimpli [43••] compared spelling errors produced by three age-, performance IQ- and socioeconomic-matched groups of bilingual Albanian-Greek children aged 9 to 12 years: a typically developing group (n = 28), a group of children with autism who had normal range verbal IQ and expressive vocabulary and no parent-reported history of language delay (n = 28) and a group of children with developmental language disorder who were not autistic (n = 28). Children’s expository texts were evaluated in terms of percentage spelling errors on content words (i.e., nouns, verbs and adjectives) and frequency of spelling error types (phonological, morphological or orthographic). Descriptive statistics showed that children with autism produced more spelling errors (46%) as compared to the typically developing group (27%), but fewer spelling errors as compared to the children with developmental language disorder (69%). Across all three groups, morphological spelling errors were the most prevalent (i.e., misspelling of inflectional ending that does not distort the phonological identity of the word), followed by orthographic errors (i.e., misspelling of word stem that does not modify the pronunciation of the word) and phonological errors (i.e., misspelling that changes the phonemic composition of the word). Autistic children did not differ from the typically developing children in their frequency of phonological or morphological errors, though orthographic errors were significantly more prevalent in the writing of autistic children. The authors interpreted these findings as evidence that autistic and non-autistic children draw on similar sources of linguistic knowledge when spelling (i.e., phonological, orthographic, morphological awareness) and that other factors, including broader language skills, may influence autistic children’s spelling performance.
Factors Associated With Spelling Achievement for Children With Autism
The following studies have considered the factors associated with academic achievement for autistic children, including and beyond those implicated in contemporary theoretical models of spelling. These tend to focus on two intrinsic child-related factors—intellectual functioning and oral language skills—while there has been relatively little research on environmental factors such as the quality and frequency of children’s literacy learning opportunities at home and school.
Intrinsic Child-Related Factors
Research on the relationship between intellectual functioning and spelling has returned mixed results. An early study by Mayes and Calhoun [44] considered the potential links between general intellectual functioning and academic achievement in a relatively large, diverse group of children with autism aged 3 to 15 years (n = 164). The researchers noted that this group included children with low verbal IQ but did not report on whether children were minimally or non-speaking or used AAC. Children completed one of three intelligence tests and assessments of letter and word spelling accuracy among other tests of academic achievement. Spelling skills were generally commensurate with children’s expected level of achievement based on IQ, suggesting a link between general intelligence and spelling accuracy. Similar findings were reported by Venter et al. [45] and Kim et al. [46••], while contrary findings were reported by Estes et al. [47]. A more recent study by Kljajevic [31] found a significant, positive association between spelling accuracy and verbal IQ for 48 children with autism aged 7 to 12 years whose verbal IQ results centred near the normative mean (it was not reported whether children were minimally or non-speaking or used AAC). Taken together, these studies indicate that there may be an association between spelling accuracy and IQ for children with autism, though it is not clear whether this is the case for all autistic children and all IQ measures, or if intellectual functioning shares a unique association with spelling once other factors are taken into account.
Dockrell et al. [48] considered the relationships between word spelling accuracy and multiple other factors, including intellectual functioning and language skills, for 50 children with autism and 77 age-matched children with language impairment aged 6 to 12 years. It was not reported whether participants in either group were minimally or non-speaking or used AAC. For children with autism, spelling accuracy was most strongly associated with handwriting fluency (r = .59), followed by receptive vocabulary (r = .50), verbal working memory (r = .48), non-verbal intellectual functioning (r = .40) and receptive grammar (r = .34). Children with autism who achieved scores more than 1.5SD below the mean on standardised language assessments were also found to have word spelling accuracy skills comparable to children with language impairment. These results suggest that multiple factors, including intellectual functioning and language skills, may contribute to spelling achievement for autistic children. However, this study did not consider the unique contributions of these factors, and approximately 20% of children recruited to take part in this study were excluded due to non-participation.
A more recent study by Åsberg Johnels et al. [49••] reported on the unique contributions of various factors to spelling accuracy for a group of 41 Swedish children with autism and normal-range intellectual functioning aged 12 years. The authors described this sample as a community-representative group but did not report whether it included participants who were minimally or non-speaking or used AAC. Children completed tests of word spelling accuracy, word reading accuracy, text reading fluency, reading comprehension, listening comprehension, rapid automatised naming (RAN), phonological awareness and nonverbal intelligence. Regression analyses showed that phonological awareness (B = .64) and listening comprehension scores (B = .25) predicted word spelling accuracy in this group. Notably, nonverbal intelligence and RAN did not predict unique variance in spelling accuracy. Secondary analyses showed that children with a history of moderate-severe language difficulties achieved significantly lower spelling accuracy scores as compared to those with either no history or a history of mild language difficulties. These results were taken as evidence that language skills contribute to spelling accuracy both concurrently and longitudinally for children with autism.
Environmental Factors
There has been very little research on the environmental factors associated with spelling achievement for autistic children. Kim et al. [46••] considered the influence of school placement (i.e., general education or special education classes) on the spelling development of 74 children and adolescences with autism aged from 9 to 18 years. Children who remained in general education classes during this time were found to achieve significantly larger improvements in word spelling accuracy as compared to those in special education classes. However, this study excluded children and adolescences with very low intellectual functioning, and participants who attended general education classes tended to be those with higher baseline intellectual and academic functioning.
Another recent study by Asaro-Saddler et al. [50] considered whether writing instruction practices in two self-contained classrooms which included children with autism aged 5 to 7 years were consistent with evidence-based approaches designed for the general population. While spelling received relatively little attention in the study, teachers were observed to use some evidence-based spelling strategies such as drawing students’ attention to the phonemic features of target words, accepting the use of invented spelling, providing error correction and encouraging self-monitoring. Teachers were also observed to tailor their teaching practices to the individual needs of students. The impact of environmental factors such as these on children’s spelling development was not directly assessed in this study and remains largely unexplored, though studies in the following section have reported on the effectiveness of specific spelling instruction protocols and strategies for children with autism under experimental conditions.
How Are Children With Autism Best Supported When Learning to Spell?
Previous reviews have considered autism and writing instruction more broadly and identified relatively few studies on spelling (e.g., in 2020, Accardo et al. [51] identified only three studies on spelling instruction involving children with autism). Most early studies on spelling instruction and autism have utilised single case designs to evaluate the effectiveness of tailored instruction targeting specific aspects of spelling for individuals with autism. These studies involved participants from a range of cultural and linguistic backgrounds, many of whom had limited spelling skills and were minimally or non-speaking or used AAC. Results provide support for various instruction protocols and strategies including cover, copy, compare [52], spell check [53], speech and visual feedback [54, 55], text to picture matching [56, 57], video modelling [58], fingerspelled self-cues [59], use of word boxes [60] and matrix training [61]. While it is outside the scope of this critique to explore these findings in detail, it is sufficient to note that instruction targeting specific aspects of spelling and carefully matched to the needs of individuals with autism has the potential to be effective in supporting spelling development and use of text-based AAC to participate in daily life.
Very few studies have considered the effects of comprehensive literacy instruction on the spelling outcomes of children with autism at the group level. In one such study, Bailey et al. [62••] evaluated the effects of ABRACADABRA, a comprehensive literacy program based on best-practice recommendations for the general population [63], on the spelling skills of children with autism aged 5 to 11 years. This study utilised a broad recruitment strategy requiring that children had a confirmed autism diagnosis, were able to point to a specified image from a choice of three, use at least single spoken words to communicate, and sustain attention to any task for 15 min. Children completed oral language, reading and word spelling accuracy assessments before being assigned to matched instruction and control groups. Children assigned to the Instruction group received 26 h of literacy instruction targeting alphabetics, reading comprehension, reading fluency and spelling skills using the ABRACADABRA program over a period of 13 weeks while children in the Control group continued their usual learning activities. All children then completed the same reading and spelling assessments administered at the outset of the study. There was no significant difference in the extent of word spelling accuracy gains achieved by children in the Instruction and Control groups. However, analysis of children’s spelling attempts using the CSSS showed a significant improvement in the level of linguistic information encoded by children in the Instruction group relative to the Control group. The authors concluded that comprehensive literacy instruction designed for the general population may be effective in improving foundational spelling skills for children with autism but acknowledged important limitations in this small-scale study and a need for further research to determine the operational elements of comprehensive literacy instruction presented using ABRACADABRA.
While literacy instruction designed for the general population may be suitable for some children with autism, we agree with Asaro-Saddler et al. [50] that instruction content and delivery that is tailored to the needs of individuals will likely be most effective for children with autism. Koutsoftas [64] offers a case study which demonstrates the potential use of spelling analysis to help guide the tailoring of literacy instruction content for children with autism. This study followed a 6th Grade classroom which included two autistic children as they planned, wrote, and revised a written narrative. Spelling errors in these stories were categorised as either phonological, orthographic or morphological as defined by Bahr et al. [65]. One autistic child was found to produce a high number of phonological errors, suggesting difficulty in perceiving and/or representing the phonological structure of target words. The authors rationalised that this information could be used to justify a focus on phonological awareness instruction for this child to improve their spelling and broader literacy development. Consideration of other factors, especially those relating to instruction delivery (e.g., use of visual scaffolds, instruction dosage and frequency), is likely important though was not addressed explicitly in this study and has not been considered in depth elsewhere as far as we are aware.
Conclusions
This article offers a critical overview of the research on spelling and autism. While some children with autism have difficulty learning to spell, the reasons for this pattern of differing abilities are not yet fully understood. Recent studies provide some evidence that autistic and non-autistic children draw on similar processes when spelling and that factors associated with spelling development in the general population also contribute to spelling achievement for children with autism. An important implication is that assessment procedures shown to be effective in mapping and predicting spelling achievement in the general population may be well-suited to some autistic children. Similarly, literacy instruction approaches shown to be effective in promoting spelling development in the general population may be effective when tailored for and used by some autistic children. Indeed, research cited in this review supports the use of comprehensive literacy instruction programs—initially designed for non-autistic children—when teaching autistic children [62••].
Recent research provides some useful insights into the nature of spelling development and effective spelling instruction for children with autism, but a great deal of work remains to be done in each of these areas. Future studies must address key methodological limitations evident in much of the previous research to achieve meaningful progress. Chief among these is the underrepresentation of autistic children with higher support needs, including those who are younger, are minimally or non-speaking, have lower literacy skills and/or intellectual disability. Future studies should also ensure that participant groups are well-defined and report on key factors including children’s spoken language skills, use of AAC, school placement and intellectual functioning to better communicate their findings and enable better comparison across study groups. We agree with Åsberg Johnels et al. [49••] that targeting of more homogeneous groups, such as children within a narrow age range, may also be advantageous. Other helpful recommendations for improving the planning, design and delivery of writing research are offered by De Smedt et al. [66] in relation to creating interventions, specifying outcomes, selecting appropriate research designs and data collection methods for both single-participant and group studies.
Beyond addressing methodological limitations, future research priorities should be established in partnership with autistic children, their parents and teachers and other supporters (see [67] for a discussion on this point and [68, 69] for practical guidance on inclusive research). One potential avenue for future research is the continued exploration of factors associated with spelling development. Intrinsic child-related factors not yet considered in the research on autism and spelling, namely writing motivation and self-efficacy, have been identified as key contributors to literacy development in the general population [70]. These may prove helpful in identifying autistic children who are at-risk of spelling difficulties and in shaping the development of holistic spelling instruction that promotes writing participation, motivation, self-efficacy and spelling skills. Environmental factors, including the home literacy environment, parents' socio-economic status and community values, could also be usefully explored given the dearth of research in this area.
Future research on spelling instruction involving autistic children could extend beyond evaluation of the effectiveness of researcher-designed protocols targeting a narrow range of skills under tightly controlled experimental conditions to consider the efficacy of co-designed, comprehensive instruction approaches under real-world conditions. Participation of autistic children, their parents, teachers and other supporters both in the design and evaluation of these approaches is likely to lead to the development of more acceptable and impactful instructional materials [67,68,69]. Based on the research on autism and reading [71], it is anticipated that future approaches to spelling instruction will need to be highly customisable and able to accommodate a wide range of preferences and abilities to be optimally efficacious. Teacher and clinician education will also be an important factor in ensuring instruction fidelity [72].
A further potential avenue for future research is the role of spelling in supporting broader writing development and participation for children with autism. While most contemporary models include spelling as an important aspect of the writing process [73, 74], some questions remain regarding the contribution of spelling to writing development in the general population [75]. Future research on the role of spelling, alongside handwriting, in supporting writing development and participation for children with autism may have important implications for whether spelling development is seen as a priority for some or all autistic children moving forward.
Data availability
Data sharing not applicable – no new data generated.
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Bailey, B., Ray, K. Spelling and Autism: a Narrative Review of Recent Developments and Directions for New Research Priorities. Curr Dev Disord Rep 11, 32–40 (2024). https://doi.org/10.1007/s40474-024-00293-z
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DOI: https://doi.org/10.1007/s40474-024-00293-z