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Child Language Teaching and Therapy
2014, Vol. 30(3) 273 –288
© The Author(s) 2013
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DOI: 10.1177/0265659013514069
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Promoting active participation in
book reading for preschoolers with
Autism Spectrum Disorder:
A preliminary study
Veronica P Fleury
University of Washington, USA; University of North Carolina at Chapel Hill, USA
Shane Herriott Miramontez, Roxanne F Hudson
and Ilene S Schwartz
University of Washington, USA
Abstract
A common literacy practice in early childhood classrooms is reading aloud to children. Little is
known, however, about the quality of engagement in shared reading activities for young children
with Autism Spectrum Disorders (ASD). Dialogic reading is one method of shared reading in
which adults encourage children to actively participate in the reading process by asking them a
variety of questions while reading a book. The current study used a multiple baseline design across
participants to examine the effect of a dialogic reading intervention on book reading participation
for three preschool boys with ASD. Compared to baseline book readings, dialogic book reading
resulted in increased rates of child verbal participation and longer duration spent engaged with
printed materials. Based on these preliminary findings we suggest that this reading strategy may be
a promising practice for early childhood educators that warrants further exploration.
Keywords
Autism spectrum disorder, dialogic reading, emergent literacy, intervention, preschool
I Introduction
Before children begin formal reading instruction in elementary school, they develop important skills
that are related to reading success through their interaction with literacy-rich environments.
‘Emergent literacy’ is the term used to describe the knowledge that children have about literacy
Corresponding author:
Veronica P Fleury, Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, CB
#8040, Chapel Hill, NC 27599-8040, USA.
Email: veronica.fleury@unc.edu
514069CLT30310.1177/0265659013514069Child Language Teaching and TherapyFleury et al.
research-article2013
Article
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274 Child Language Teaching and Therapy 30(3)
before they receive formal literacy instruction in school (Whitehurst et al., 1988). This includes
knowledge about conventions of print, letter identification, vocabulary and story skills, and an
awareness of the conventions and purpose of book reading (Reese et al., 2003; Snow and Dickinson,
1991). One activity that is highly valued by teachers, early childhood professionals, and parents is
reading aloud to children. In fact, Anderson et al. (1985) claim that shared book reading is ‘the sin-
gle most important activity for building knowledge required for eventual success in reading’ (p. 23).
Reading to children at early ages gives them opportunities to develop emergent literacy skills that
support later reading achievement. Previous research has shown that the frequency of book reading
between the ages 1–3 is significantly correlated with teacher ratings of child literacy and oral lan-
guage outcomes at age 5, and reading comprehension at age 7 (Wells, 1985). Dickinson et al. (1992)
suggest several reasons why children’s participation in early book reading activities supports later
literacy, including accelerating language development (Whitehurst et al., 1988), familiarizing chil-
dren with print (Mason, 1992) and language found in books (Pappas and Brown, 1987; Purcell-
Gates, 1988), developing vocabulary (Whitehurst et al., 1988), and introducing children to ways of
talking about books (Dickinson and Smith, 1991; Heath, 1982, 1983). Many of the benefits associ-
ated with book reading focus on oral language as it has been found to be a strong predictor for later
reading ability and academic achievement (Aram et al., 1984; Catts et al., 2002; Justice et al., 2005).
Simply reading to children does not ensure adequate emergent literacy skill development. Research
conducted in the past few decades has stressed that the quality of book reading is more important than
the quantity of book reading (Scarborough and Dobrich, 1994). The manner in which children are
read to affects their engagement during book readings and what they take away from the experience.
Several researchers have found that adults dramatically differ in their reading styles, and these varia-
tions have an influence on children’s language development (Haden et al., 1996; Heath, 1982;
Pellegrini et al., 1985; Whitehurst et al., 1988). In line with previous research, Reese and colleagues’
(2003) analysis of teachers’ book reading interactions revealed three main clusters of reading styles:
‘describers’ who primarily focus on description and labels, ‘comprehenders’ who employ more infer-
ences and predictions, and the ‘performance oriented’ readers who do not involve children much
during reading but encourage children’s participation prior to book reading by asking for predictions
and after reading as they evaluate the story. Interestingly, their analyses did not identify one style of
reading to be superior for all children; rather, they found that children with lower initial vocabulary
levels benefited most from the describer style, while children with higher initial vocabulary benefited
most from the performance-oriented style. This interaction effect was reversed for print skills. While
no one style of book reading may be best for all children, researchers stress that engaging children in
active participation is almost always better than the passive listening that can occur when adults sim-
ply read the text (Reese et al., 2003; Senechal et al., 1995).
1 Dialogic reading
Shared story reading (also called read alouds, repeated storybook reading, story-based lesson,
interactive reading) is a broad term used to describe the act of adults reading aloud to children,
while encouraging interaction through asking questions or engaging in a discussion about the book
(Hudson and Test, 2011). Dialogic reading is a particular method of shared story reading in which
the adult uses specific question prompts to encourage children to talk during book readings.
Because the prompts that are used in dialogic reading tend to primarily elicit information about
picture description and character labels, it has been conceptualized by some researchers (Reese
et al., 2003) as a describer-style book reading intervention.
The dialogic reading model is formulaic making it easy for educators to learn the strategy
(Teale, 2003). Initially developed by Whitehurst and colleagues (e.g. Lonigan and Whitehurst,
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Fleury et al. 275
1998, Whitehurst et al., 1988, 1994), parents and educators were taught to use the mnemonics
‘PEER’ and ‘CROWD’ to remember dialogic reading steps and specific question prompts, respec-
tively. While reading to a child, the adult periodically prompts a child to verbally participate in the
reading. Once the child responds to the adult prompt, the adult evaluates the accuracy of that
response and expands on the child’s utterance. Lastly, the adult repeats the prompt. The specific
types of prompts used in dialogic reading include completion, recall, open-ended, wh-, and dis-
tancing (CROWD) questions. This approach to reading is believed to be effective in improving
language and emergent literacy skills in young children because children are actively engaged in
book readings, receive reinforcement for their participation, and adult feedback serves as a model
of appropriate language. The efficacy of dialogic reading on expressive language has been repeat-
edly documented across studies and has been identified as an intervention strategy that works for
young children by the What Works Clearinghouse (2007, US Department of Education).
2 Children with ASD
Despite common areas of impairment in social and communication skills that define autism as a
condition, individuals with Autism Spectrum Disorders (ASD) show great variability in the expres-
sion and severity of their behavioral symptoms (Jones and Klin, 2009). As such, it is extremely
difficult to make general conclusions about reading skills in the population as a whole. Studies
indicate marked differences across individual’s ability to learn the mechanics of reading, or decod-
ing skills, ranging from poor to average or above average skill level (Nation et al., 2006), however
most individuals with ASD, including those who have mastered word decoding, have difficulty
understanding what they read (Huemer and Mann, 2010; Mayes and Calhoun, 2003; Nation et al.,
2006). This research focused on conventional literacy skills for individuals with ASD; even less is
known about emergent literacy skills and practices for the population. This should be a concern of
early childhood professionals because it is well understood that the foundation for learning to read
begins early in life (Whitehurst et al., 1988) and that children’s early experiences contribute to their
literacy accomplishments (Dunst et al., 2006). In one study of home literacy experiences for chil-
dren with ASD, caregivers of young children with ASD reported that their children are less likely
to request or enjoy shared reading compared to their language-matched peers (Lanter et al., 2012).
Moreover, when children with ASD do participate in shared reading, they attend to the activity for
less time as compared to their peers (Watson et al., 1996).
Children with ASD may have difficulty participating in shared book reading, in part, because of
social and communication demands of the activity. Children with ASD generally have difficulty
with social interactions and exhibit low rates of initiating and responding to peers and adults,
which is especially marked in interactions for the purpose of sharing experiences and establishing
joint attention (Mundy et al., 1987, 1990). Furthermore, many young children with ASD exhibit
delays in their receptive and expressive language development (Tager-Flusberg et al., 2005), and
have difficulties understanding others’ language and gestures (Wetherby, 2006). While the majority
of children with ASD eventually develop speech (estimates of 75%–90%; Rogers, 2006), all chil-
dren with ASD regardless of language ability, continue to have problems with pragmatics, the
social aspects of language (Leekam, 2007; Tager-Flusberg and Joseph, 2003). This means that
many children with ASD will lack many of the communication and social skills necessary to
engage in such social interactions associated with book reading. In particular, shared book reading
requires that children are able to sustain social interaction regarding a particular topic (the book),
including asking questions or making comments about what they notice, which can be challenging
for many children with ASD due to their difficulties with social communication and joint attention
(Dawson et al., 2004; Tager-Flusberg and Joseph, 2003). Because the design of many literacy
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276 Child Language Teaching and Therapy 30(3)
activities relies heavily on social and communication ability, children who lack basic skills in these
areas will have difficulty participating in, and benefiting from, these activities without instructional
support (Kluth and Chandler-Olcott, 2008). These characteristics can discourage adults from read-
ing to children with ASD, or when they do read to the children, the reading often becomes ritual-
ized and focuses on a few highly preferred books.
Children and adolescents with ASD, however, have been able to successfully participate in
shared story reading when adaptations are made to the activity. Adaptations for young children
include the inclusion of visual cues (Mucchetti, 2013), music (Carnahan et al., 2009), and scaffold-
ing strategies (cloze procedures, binary choices, wh-questions, and expansions; Bellon et al.,
2000). Shared story reading has also been adapted for older students with ASD, which include
simplifying text (Browder et al., 2007), explicit prompting procedures, and rereads of key portion
of texts combined with rules to help students answer wh-questions (Mims et al., 2012). These
researchers demonstrate that shared book reading, when appropriately adapted to support the needs
of individuals with ASD, result in positive outcomes in participation, ranging from basic improve-
ments in on-task behavior (Carnahan et al., 2009) and decreased echoics (Bellon et al., 2000) to
improved rates of responding to questions and story comprehension (Browder et al., 2007; Mims
et al., 2012; Mucchetti, 2013).
3 Focus of the present study
In order to develop emergent literacy skills, children must have frequent opportunities to engage in
quality literacy experiences. Most typically developing young children develop emergent literacy
skills, not through formal didactic instruction, but by observing others and participating in informal
literacy activities that occur in most homes and early learning environments (Smith and Dickinson,
2002). The same factors that place children with ASD at risk for future reading difficulties make it
unlikely that children with ASD will naturally develop emergent literacy skills simply through
observation. It is important, therefore, that research efforts focus on developing instructional strat-
egies that will facilitate meaningful engagement in early literacy activities for all young children.
Although the positive effects of dialogic reading for children with language delays and those from
at-risk populations have been well established in the research (e.g. Dale et al. 1996; Valdez-
Menchaca and Whitehurst, 1992), it is unknown whether dialogic reading strategies can be
extended to children with ASD with similar outcomes. The purpose of this study is to evaluate the
use of dialogic reading strategies for preschool children with ASD. Specifically, the following
research questions are addressed:
1. Is there a difference in how much time children with ASD participate in dialogic book read-
ings compared to standard book readings? How engaged are children with ASD in the book
reading task?
2. Are there differences in children’s verbal participation during standard book reading com-
pared to dialogic reading?
3. Are dialogic reading prompts effective in eliciting verbal responses from children with
ASD?
II Method
1 Participants
Participants were recruited from a university affiliated comprehensive early childhood program.
Classroom teachers nominated students based on the following eligibility criteria: (1) clinical
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Fleury et al. 277
diagnosis of ASD; (2) able to sit and attend to activities lasting five minutes; (3) communicate
verbally using phrase speech consisting of at least 2–3 words or better. The three male children
who participated in the study were enrolled in a half-day integrated preschool five days per week,
with additional small group instruction three days per week in an extended day classroom. The
children received a total of 25 hours a week of comprehensive educational services at school. All
participants had received a diagnosis of ASD from agencies not related to the preschool program;
these diagnoses were not independently verified by the research team.
a Alan. Alan (age 4 years, 4 months) was diagnosed with Autism at the age 2 years, 10 months.
Alan primarily communicates through verbal speech, and is able to speak using complete sen-
tences. According to his Individual Education Program (IEP) at the time of study, Alan received a
standard score of 69 on the Vineland Adaptive Behavior Scales – Communication Subtest indicat-
ing a delay in both expressive and receptive language. Upon preschool entry, Alan’s social devel-
opment was assessed using the Vineland Adaptive Behavior Scales indicating a delay in social
abilities at a standard deviation of −1.93.
b Nick. Nick (age 5 years, 11 months) was diagnosed with Pervasive Development Disorder –
Not Otherwise Specified at the age of 2 years, 11 months. Nick primarily communicates through
verbal speech, and is able to speak using complete sentences. His teacher reported that Nick dem-
onstrates great variability in his communication performance depending on his level of interest, the
number and type of distractions around him, and his communicative partner.
c Frances. Frances (age 3 years, 4 months) received a diagnosis of Autism at the age of 1 year, 7
months. He has limited verbal ability, and communicates through both verbal speech (2–3 word
phrases) and Picture Exchange Communication System (PECS; Frost and Bondy, 2002). According to
his most current IEP, Frances’s receptive and expressive language scores were significantly below that
of chronologically aged peers (–1.80 SD) based on the Vineland. Although Frances uses some verbal
speech, his teacher reported that he does not readily use it to initiate communication with adults.
2 Settings and materials
All baseline and dialogic reading sessions were conducted in a treatment room (approximately 3m
× 4.5m) located adjacent to the children’s classroom at their school. The room contained a table
and four chairs. At the start of each session, the child was given the choice of reading at the table
or on the floor. Throughout the study, five books were read with the participants:
The very busy spider (Carle, 1989)
What do you know? (Cauley, 2001)
Sheep out to eat (Shaw and Apple, 1992)
One giant splash (Dahl and Ouren, 2004)
Lunch (Fleming, 1993).
Books were selected according to criteria used by Hargrave and Senechal (2000):
colored illustrations on every page;
potentially new vocabulary that appear in the illustrations or the text;
texts limited to 30 or fewer pages;
book topics were appropriate for preschool-age children;
subject matter was not specific to certain holidays.
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278 Child Language Teaching and Therapy 30(3)
Additionally, the books included in this study were ones that the classroom teachers reported that
they had not used in their classroom.
3 Measures
a Session duration. The duration of each session was recorded using a stopwatch. Timing started
once the child and reader were seated and began reading the book. Timing stopped once the last
page of the book was read, or when the last statement was made about the book. Alternatively,
reading sessions could end early if the child requested to be finished or engaged in challenging
behavior. No reading sessions, however, were terminated due to child requests or challenging
behavior in the present study.
b On-task behavior. Children’s on-task behavior was measured using momentary time sampling
at 10-second intervals. On-task behavior was defined as: (1) sitting upright in a chair or on the
floor; (2) body oriented towards the book and/or adult reader; and (3) eyes directed toward the
book or the adult reader.
c Verbal participation. The number of verbal utterances made by children during book reading was
measured using a frequency count. A verbalization made by the child was counted if the utterance
was: (1) on topic, and (2) contained one or more intelligible words. These verbalizations could
consist of spontaneous initiations (e.g. questions, comments about the picture) or responses to
adult questions. In order to take into account session differences in duration, a rate of verbaliza-
tions per minute was calculated.
d Response to prompt type. Data were taken on the type of adult prompts given during the book
reading and whether specific prompts elicited a verbal response from the child.
4 Experimental design and procedure
The effects of dialogic reading prompts on child participation were assessed using a multiple base-
line design across participants. This design allows researchers to demonstrate changes in target
behaviors through: active manipulation of the independent variable (i.e. reading style), incorporat-
ing basic effects of behavior change across three individuals, and staggering the onset of the inde-
pendent variable across three different points in time (Kratochwill et al., 2013). A total of nine
reading sessions were conducted across a 5-week period. Because the start of the intervention
phase was staggered across three children, the length of baseline varied from 3–5 sessions. At the
start of each session, the child chose a book from an array of three choices. Children were allowed
to pick the same book up to three times during the study. In all reading sessions, the first or second
author read the book with the child while a research assistant collected data on the target
variables.
a Baseline. During baseline, the adult read the text from the books and refrained from elaborating
or posing questions to the child. If the child made a comment or asked a question, the reader
responded to the child and returned to reading the text. The adult did not redirect the child if he
became disengaged from the book reading.
b Dialogic reading intervention. During book reading, the adult would prompt the child to speak by
asking a question about the characters or events in the story. Prompts were given at least once every
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Fleury et al. 279
2–3 pages. Specifically, adults would ask the following types of prompting questions (for more
description, see Zevenbergen and Whitehurst, 2003):
Completion: The adult reads the initial part of a repetitive phrase and allows the child to
finish the phrase.
Recall: The adult asks questions about the characters or previous events in the story.
Open-ended: The adult encourages the child to tell what is happening in a picture.
wh-questions: The adult asks wh-questions (what, where, who) about a picture.
Distancing: The adult asks questions that relate elements of the story to the child’s personal
experiences.
Lesson plans were created for each book selection that indicated when the adult could use specific
dialogic reading prompts. The child was given five seconds to respond to a prompt. Contingent
upon providing a response, the adult would evaluate the response, provide praise or correction, and
expand on the child’s verbalization (e.g. ‘The mouse is eating red strawberries!’). If the child failed
to respond to the prompt within five seconds, the reader continued to read the book.
c Inter-observer agreement. Inter-observer reliability was calculated on 20% of reading sessions
using the point-by-point method in which the number of agreements was divided by total (agree-
ments plus disagreements), and multiplied by 100. Reliability for child engagement was 100%.
The researchers reached 100% agreement on the types of dialogic reading prompts asked, and
reached 91% agreement on child responses.
d Fidelity of implementation. Data collected on the types of reading prompts used by the reader
during dialogic book reading sessions provided a measure of treatment fidelity. To be considered
dialogic reading, the reader had to use at least two of each prompt type during any given book read-
ing. All intervention sessions met the criteria to be included in the analysis.
III Results
1 On-task behavior and duration of book reading
Visual analyses reveal that dialogic reading (DR) had little effect on children’s on-task behavior,
largely because all three boys demonstrated high rates of engagement during baseline book reading
sessions, leaving little room for improvement. Baseline observations show overall high levels of
on-task for Nick (M = 100%), Alan (M = 70.5%, range = 43%–81%), and Frances (M = 76.4%;
range = 52%–100%). During the DR condition, average engagement levels remained high for Nick
(M = 92%, range = 63%–100%), with more variability due to one outlier session. Levels of on-task
behavior during DR was higher and less variable for both Alan (M = 91.2%; range = 74%–96%)
and Frances (M = 91.3%; range = 76%–98%). No differences in trend were observed across phases
for any of the children. Improvement rate difference (IRD; Parker et al., 2009) scores were calcu-
lated as a measure of the difference in behavioral improvement between sessions. IRD calculations
indicate that DR was not effective in improving on-task behavior for Nick (IRD = .50) or Frances
(IRD = .55), and moderately effective for Alan (IRD = .80).
Data on the length of book reading indicate that the DR sessions lasted longer than baseline
reading sessions for all three participants. Baseline reading conditions lasted an average of 2.75
minutes (range 2.30–4.17 minutes) compared to an average duration of 4.48 minutes (range 2.83–
6.67 minutes) in DR sessions. Taken together with the time on-task data, these results indicate that
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280 Child Language Teaching and Therapy 30(3)
children participated in longer book readings while maintaining high levels of engagement during
dialogic reading sessions. For graphic representation of on-task behavior across children, see
Figure 1.
Figure 1. Percentage of time children spent on-task across reading conditions.
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Fleury et al. 281
2 Verbal participation
To ensure that the length of the reading session did not impact the measurement of child verbal
behavior, the frequency of child verbalizations made during book reading was converted to a rate
of verbal participation (number of verbalizations/minute). This allowed the researchers to compare
behavior change across sessions that differed in duration. Presenting these data as rate was neces-
sary since the DR sessions were longer than the baseline sessions. Baseline observations show low
levels of verbal participation for Nick (M = .95, range = 0.00–2.00), Alan (M = .11, range = 0.00–
0.43), and Frances (M = .32, range = 0.00–0.96) followed by increased levels of verbal participa-
tion during DR conditions for Nick (M = 3.18, range = 1.25–4.20), Alan (M = 2.45, range =
1.16–3.33) and Frances (M = 1.56, range = 1.35–1.77). This change in level was observed imme-
diately once the intervention was introduced for all three children. Measures of trend were consist-
ent across phases for Nick and Frances. Alan, however, showed stable verbal participation with no
systematic trend in the baseline phase followed by a systematic trend with verbal participation
improving during the DR phase. IRD (Parker et al., 2009) calculations of the rate of verbal partici-
pation improvement across phases indicate that DR was moderately effective for Nick (IRD = .83)
and highly effective for both Alan and Frances (IRD = 1.0). For complete rate of verbal participa-
tion data across participants, see Figure 2.
3 Response to specific prompt types
Data were collected on the percentage of prompts responded to by children, and analysed accord-
ing to prompt type. Nick responded relatively equally to all prompt types. Alan responded most
frequently to distancing and recall prompts (100% and 93%, respectively), but did not respond as
consistently to completion prompts (43%). Frances responded most often to completion prompts
(50%), but showed a lower propensity to respond to all other prompt types, particularly open-
ended (8%) distancing (0%) prompts, For response to prompt type data, see Figure 3.
IV Discussion
The development of language skills, specifically oral language ability, has important implications
for future reading success (Aram et al., 1984; Catts et al., 2002; Justice et al., 2005). Given that
difficulties in social communication are a defining characteristic of ASD, it is critical that children
with ASD be given opportunities to improve their oral language skills by hearing and using lan-
guage. In dialogic reading, children are both exposed to the language presented in the text and are
expected to answer questions posed by adults. In other words, children have the opportunity to hear
language and practice using language. All of the children in the present study demonstrated varied
oral language ability ranging from limited 2–3 word phrases to the ability to speak in full sen-
tences. Despite these differences in communication skills, all of the children were observed to talk
more when an adult read to them using dialogic reading strategies compared to when they were
read to in baseline sessions that involved minimal interaction procedures.
Compared to baseline book reading, the richness of children’s literacy experiences with dialogic
reading is enhanced not only because the prompts elicit more language but also because children
spend more time engaged with books. This result is significant given that social skills impairments,
a defining characteristic of ASD, are believed to impede children’s ability to participate in literacy
activities. Consistent with the behavioral profile of ASD, all children in the present study showed
significant delays in social skills according to their recent school evaluations. Despite deficits in
social skills, all children participated in the dialogic reading sessions for more time than in baseline
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282 Child Language Teaching and Therapy 30(3)
Figure 2. Rate of children’s verbal participation across baseline and dialogic reading conditions.
Notes. Verbal participation includes initiations and responses to adult prompts. Adult prompts were only presented in
DR condition.
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Fleury et al. 283
book reading sessions. Taking into account duration and engagement data together, dialogic read-
ing sessions exposed children to language, print, and illustrations for longer periods without sacri-
ficing child engagement.
Although all children were engaged during dialogic reading, observational data reveal that each
child responded to specific dialogic reading prompts differently. Whereas Nick responded equally
well to all types of dialogic reading prompts, Frances had difficulty responding to some adult
prompts, particularly open-ended and distancing questions. This finding indicates that traditional
dialogic reading procedures that were used in the present study may work well for some children,
but may need to be modified for other children. In the event that children have difficulty respond-
ing to the traditional reading prompts, the adult will need to provide additional support (e.g. sim-
plify the question, provide answer choices) in order to elicit more verbal participation from their
children.
1 Instructional implications
Book reading is a common practice in early childhood settings. Unfortunately, children with disa-
bilities do not have as many opportunities to engage in meaningful literacy activities compared to
typically developing peers (Light and Smith, 1993; Marvin, 1994). We believe that children with
ASD may be further at risk for experiencing reading difficulties due to deficits that characterize the
disorder, specifically communication and social difficulties. If we expect to improve literacy
achievement in children with ASD, we must begin by developing strategies to support children’
active engagement in early literacy activities, such as shared book reading. Simply reading the text
to the children is not sufficient in eliciting verbal participation during book readings. It is evident
that the adults who work with children with ASD will need to be more intentional in their reading
style as children are more likely to require higher levels of support to verbally engage with the
reading material. Consistent with previous research in which elements of shared book reading were
Figure 3. Children’s rate of responding to different types of dialogic reading prompts.
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284 Child Language Teaching and Therapy 30(3)
adapted for individuals with ASD (Bellon et al., 2000; Carnahan et al., 2009; Mucchetti, 2013), the
findings of the present study suggest that dialogic reading may be a simple way that adults can
modify the way they read with children that results in improvements in children’s active participa-
tion in book reading. Through dialogic reading, adults makes slight changes to their reading behav-
ior in order to provide children with more opportunities to verbally participate in book readings,
thereby enriching their book reading experiences. The steps in dialogic reading are easy for practi-
tioners to learn and the outcome measures used in the present study (number of verbalizations, time
on task, response to adult questions) may serve as appropriate instructional objectives for other
children.
Encouraging active participation from young children with ASD during book reading may
require that adults occasionally deviate from the standard dialogic reading prompts. Children who
are younger, or who demonstrate severe language deficits, may not be able to respond to the tradi-
tional dialogic reading prompts. The youngest participant in this study, Frances, had difficulty
responding to recall, open-ended, and distancing prompts. We would suggest that adults who read
with Frances in the future ask predominately completion and wh-questions, to encourage his par-
ticipation, while providing additional support or scaffolding in order to respond to other prompts
that he was not able to answer independently. Asking yes/no questions, providing choices of pos-
sible answers, requests to point to target words, or even requesting the child repeat a target vocabu-
lary word are methods of encouraging children to engage in book reading when a traditional
dialogic reading prompt may be too difficult for them to answer. While the goal of interactive book
reading is to encourage rich verbal participation, any form of participation is better than passive
listening (Reese et al., 2003; Senechal et al., 1995).
2 Study limitations and direction for future research
The methodology of the present study allows us to draw some preliminary conclusions, but limits
the claims that we can make about the effectiveness of dialogic reading for children with ASD.
First, all information about children’s diagnoses and skills were taken from student records. No
assessments were conducted by the research team to confirm diagnoses or to characterize their
abilities. Second, measures of verbal participation included both spontaneous language and
responses to adult prompts. While it is apparent that all children verbally participated more during
dialogic reading compared to traditional baseline readings, the data does not allow us to determine
whether dialogic reading impacted spontaneous language, or if the increase in language is largely
accounted for by children’s responses to adult prompts. Third, all children in the study demon-
strated unexpected high levels of on-task engagement during baseline book reading, leaving little
room for improvement. Based on the operational definition used in this study, it appears that inter-
vention is not needed to improve on-task behavior during book reading. The use of a different
measure of engagement in future studies, such as an observational measure of joint attention
(Adamson et al., 2004; Wong and Kasari, 2012) may be a more appropriate method of capturing
changes in children’s level of engagement during reading activities. Fourth, and perhaps most
important, are problems around internal validity. The multiple baseline design in this study only
allows us to document a basic pattern of low levels of verbal participation during traditional read
alouds, followed by immediate increases in verbal participation during dialogic reading. This basic
effect was demonstrated across all three participants; however, questions around experimental con-
trol arise because there is only one data point that separates the onset of the intervention phase
across participants, rather than three data points as recommended by the What Works Clearinghouse
design standards (Kratochwill et al., 2013). We are, therefore, unable to make definitive claims
about the effectiveness of dialogic reading on children’s verbal participation. Furthermore, because
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Fleury et al. 285
the children who participated in the study represent a highly heterogeneous group, our ability to
claim that these findings will generalize to all children with ASD is limited.
Given both the findings and limitations of this study, we suggest that dialogic reading has the
potential of improving the richness of literacy experiences for some children with autism by
increasing verbal participation and the amount of time engaged with the print material. Although
these outcomes are not trivial, they are limited. Improvement in other areas of early literacy skill
development, such as expressive vocabulary and print knowledge were not measured in the pre-
sent study. Future studies that examine the effectiveness of dialogic reading interventions for
children with ASD and other severe disabilities should include a broader range of early literacy
outcome measures. In light of the preliminary outcomes in this study, we suggest that dialogic
reading techniques may be a promising practice that can be incorporated in early intervention
programming for children with ASD pending further rigorous study that replicate and extend
these findings.
Acknowledgements
We wish to express our appreciation for participating teachers, schools, and families who supported this pro-
ject. In addition, assistance from Melissa McGraw is gratefully acknowledged.
Declaration of conflicting interest
The authors declare that there is no conflict of interest.
Funding
The work reported here was supported by the Institute of Education Sciences, US Department of Education
through grant #R324B090005 awarded to University of North Carolina at Chapel Hill. The opinions expressed
represent those of the authors and do not represent views of the Institute or the US Department of Education.
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