On February 21, 2024, our study on literacy in nonspeaking autistic people was published in Autism. You can access the complete paper for free here, and you can find a EurekAlert! about the work here. Below, you’ll find responses to some frequently asked questions about the study.
FAQs
What was your motivation for the study?
Most nonspeaking autistic people are never provided access to an effective language-based alternative to speech. They communicate effectively in lots of other ways (like body language and physical proximity). But not having access to an effective language-based way to communicate dramatically limits their educational, social, and employment opportunities. Typing could be an effective alternative to speech, but someone has to be literate to communicate by typing.
Unfortunately, nonspeaking autistic people face a lot of barriers to acquiring literacy–foremost among them is the deeply entrenched assumption that because they can’t speak, they lack the capacity for language. The goal of this study was to investigate whether some nonspeaking autistic people have acquired some foundational literacy skills. We found that many in our sample have. We hope that this work helps to motivate efforts to develop and provide nonspeaking autistic people with more formal and informal opportunities to acquire literacy.
Why did you choose this particular task to measure spelling knowledge?
Our task was inspired by the “Whac-a-Mole” arcade game popular in the 80s and 90s. Remember that game where you would try to bop each mole with a mallet as it popped out of its hole, and the more moles you bopped before the game ended, the higher your score? When you play the arcade game, it seems like the moles pop out in random locations. But imagine how much faster you would be to bop the moles (and how much higher your score would be) if you had cracked the code that determined the order in which they popped out. This was what we tried to exploit in the task we designed.
On our task, before some trials, participants heard the experimenter explain that the letters would pulse in a sequence that spelled a particular sentence–for example, “On the next trial, the letters will flash in a sequence that spells, ‘I should water the backyard today.’” (See here for an example of a trial involving letters that pulse in a sequence to spell that sentence.) If participants had some knowledge of how to spell, we reasoned that they would be faster to tap letters on those trials (because they could predict the sequence of pulsing letters) than to tap targets on trials involving letters or nonsense symbols that pulsed in meaningless sequences (because it’s not possible to predict the sequences in those cases). (See here for an example of a trial involving nonsense symbols that pulse in a meaningless sequence.) This is what we found in our group data, and it was the pattern shown by 16 of the 31 nonspeaking autistic participants.
The whac-a-mole task also allowed us to look at a couple of other patterns that you would expect of literate people. First, we could look at whether the speed with which participants tapped letter pairs depended on how frequently those letter pairs appear together in printed English. Second, we could look at whether participants were slower to tap the first letter of a new word than letters within words. Both of these patterns have been documented in an extensive literature on typing in non-autistic people, and they are attributed to the cognitive processes underlying spelling. The nonspeaking autistic participants in our study also showed these two patterns.
Are there any limitations to the whac-a-mole task?
Any task is going to have limitations. For example, our whac-a-mole task involved comparing how quickly participants responded to over 550 pulsing targets in various conditions. It required a lot of attention and stamina. Someone who is easily distracted or who requires a lot of time to respond to stimuli might not be able to demonstrate their knowledge on this particular task. That doesn’t mean that they don’t have knowledge of orthographic conventions–it just means that we weren’t able to measure it using this particular task. We have a responsibility to continue to develop new tasks and measures to try to better understand nonspeaking autistic people’s abilities so that we understand how best to support them.
The study does not include information about the participants’ receptive speech abilities. Can you explain why?
I am not aware of a receptive language measure that is quick, easy to administer, and which I can be confident provides an accurate indication of a nonspeaking autistic person’s receptive language ability. For example, Helen Tager-Flusberg’s team published a study in 2016 in Autism, where they gave a number of different receptive language measures to nonspeaking autistic children–a standard vocabulary test, caregiver reports, eye-tracking, a forced-choice touchscreen task. They found “significant heterogeneity” in performance not just across their sample, but also across the different methods of assessment. In their conclusion, they urged the continued development of individualized approaches to receptive language assessment for this population (I agree!). Bottom line: We don’t yet have a reliable way to measure receptive language in nonspeaking autistic people, and it’s not clear to me what would be gained by including a measure that is not reliable.
Even though this study does not attempt to evaluate the authenticity of the rapid prompting method, some researchers have viewed it in that light. They see it as an attempt to prove message authorship without doing a message-passing test. What is your response?
I’m not sure where this interpretation of the study comes from. We said it explicitly on page 2 of the paper, and I will say it again here: This study was not about authenticating any method of communication. It was an attempt to use a reaction time task–a cornerstone of methodology in cognitive psychology–to investigate whether some nonspeaking autistic people have acquired some foundational literacy skills. We showed that many in our sample have. My hope is that our findings motivate more research about literacy in this population, including how to measure it, how to support its acquisition, and how to leverage it to provide nonspeaking autistic people with access to effective alternatives to speech.
Some researchers have also wondered why independently tapping letters on a screen is not used as a communication method, since the participants were able to do so during the task. What is your response?
There are nonspeaking autistic people who independently tap letters on a screen to communicate! Jordyn Zimmerman and Hari Srinivasan are a couple of well-known examples. They communicate by typing (and lots of other ways), and they learned to do so in different ways. All of the nonspeaking autistic people who participated in our study are working on the skills to be able to type on a keyboard. As befits a diverse group of autistic teenagers and adults with a range of experiences, they are at various points in their journeys. But if we assume that they aren’t capable of literacy because they are not yet “independently tapping letters on a screen,” then it’s unlikely that they’ll be provided opportunities to learn and practice the skills that are needed to do so.
Now that you have documented familiarity with orthographic conventions in nonspeaking autistic people, what future studies would you like to conduct?
There are so many important questions to be addressed. We are continuing to develop methods that will allow us to accurately characterize nonspeaking autistic people’s strengths and challenges in acquiring literacy. We are also collaborating with engineers at the University of Calgary to design and test how augmented reality and artificial intelligence could be used to help nonspeaking autistic people learn the skills needed to type.
What do you hope people who read your paper take away as the main idea?
It is difficult to estimate what someone who is autistic and can’t communicate effectively using speech knows or is capable of learning. In fact, the stigma against this population is so profound, we might not even try to figure out what they know or understand. This has serious consequences for the kinds of opportunities they are given. My hope is that our findings motivate more research about literacy in this population, including how to measure it, how to support its acquisition, and how to leverage it to provide nonspeaking autistic people with access to effective alternatives to speech.
How come some autistic people cannot communicate effectively using speech?
We don’t yet know. The nonspeaking autistic people we know are motivated to communicate, and most (but not all) of them express a desire to learn to be able to convey their thoughts using speech. Speech is the finest of fine motor skills, and so the most promising explanation to us involves the well-documented motor challenges that many autistic people who are not fluent speakers face (see, for example, this 2008 paper by Morton Gernsbacher and colleagues).
Jaswal Lab 