Reading Therapy (Bibliotherapy) for Kids with Autism

Researchers can now show how to improve some autism symptoms without medication or invasive procedures. Imaging shows reading therapy (bibliotherapy) improves their brain connections.

Autism spectrum disorder is a common developmental disorder, identified in about one in 68 U.S. children — and the incidence is growing, according to the Centers for Disease Control and Prevention (CDC). Autism can affect how kids communicate, interact, behave, and learn. Some youngsters with the disorder have fairly minor problems, and some need a great deal of help, especially with schoolwork.

Now, for the first time, researchers have documented there’s a way to improve some autism symptoms, and it involves literally changing the brain. The technique doesn’t involve medication or an invasive procedure. Instead, it uses reading therapy (also called bibliotherapy).

Scientists have learned the human brain has plasticity, meaning it can change in response to learning or experiencing something new. A University of Alabama at Birmingham (UAB) study found that’s what happened when 13 children with ASD, all around age 11, were given 10 weeks of intensive reading intervention.

Previous studies have shown children with autism have decreased connectivity between certain areas of their brains involved with reading, compared with normally developing children. However, using functional magnetic resonance imaging (fMRI), the UAB researchers found that, after reading therapy, youngsters with autism developed stronger activity in the loosely connected areas of their brains that interact to comprehend reading. What’s more, the ability of the kids in the study to understand what they read improved significantly, too.

“This study is the first to do reading intervention with [autistic] children using brain imaging techniques, and the findings reflect the plasticity of the brain,” said Rajesh Kana, PhD, associate professor of psychology in the UAB College of Arts and Sciences, who headed the research.

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

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

The bibliotherapy was intensive, with the autistic children receiving one-on-one instruction in a distraction-free setting, 4 hours a day, 5 days a week, for a total of 200 hours. When the research subjects’ brains were scanned with fMRIs at the end of the study and compared to fMRIs before the intervention began, the researchers found increases in brain activation and functional connectivity of two core language areas in the brain were correlated with the amount of improvement in reading comprehension each child with autism experienced.

Two other groups of children of the same age who participated in the research did not receive bibliotherapy. One group contained typically developing children, and the other was comprised of youngsters with autism. The two control groups who didn’t receive any reading therapy showed no significant changes in their brain connectivity nor in their reading comprehension at the end of the research project.

The UAB research team concluded their study, while small, supports the use of intensive reading intervention for children with autism to improve learning skills. In addition, the use of neuroimaging increases the understanding of how brain plasticity can help children with autism and suggests it could be used to develop additional targeted behavioral interventions for autism spectrum disorder in the future.

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

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