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Enhancing Pragmatic Abilities in Autism through Reading Intervention: Insights from fMRI
Poster Session C, Saturday, September 13, 11:00 am - 12:30 pm, Field House
Elizabeth Valles1, Sarah O´Kelly1, Rajesh Kana1; 1The University of Alabama at Birmingham
Autism Spectrum Disorder (ASD) is associated with difficulties in processing and using pragmatic language1, the use of language in social contexts2. Delayed language is an early sign of ASD3 that often leads to long-term challenges in reading comprehension. Although much of the research on reading has focused on comprehension alone, some studies suggest a relationship between pragmatics and reading skills4–6. However, the neural mechanisms underlying pragmatic language in ASD remain underexplored. The main objective of this study is to assess the engagement of pragmatic network (PN), which involves brain regions like the Inferior Frontal Gyrus (IFG), dorsomedial prefrontal cortex (dmPFC), superior temporal gyrus (STG), temporal pole, Heschl’s gyrus, among others7,8, in reading comprehension in autistic children. This functional magnetic resonance imaging (fMRI) study examines the impact of an intensive reading intervention (Visualizing and Verbalizing, V/V) on pragmatic language processing in children with ASD. The V/V program is a 10-week, 200-hour intervention designed to enhance oral and written comprehension. Participants engage in one-on-one sessions with a trained learning process clinician9,10. The sample included 21 children in the experimental group (ASD-EXP, 11.40 ± 1.84 years) and 17 children in the control group (ASD-WLC, 11.04 ± 1.40 years). Both groups completed assessments of reading comprehension (GORT11) and social communication, measure that encompasses pragmatic skills (SRS-SCI12) and underwent fMRI scans before and after the intervention. The ASD-EXP group received the intervention between pre-and-post-testing, while the ASD-WLC group received it afterward. Three analyses were conducted: (1) Paired sample t-test to evaluate changes in reading comprehension and social communication, (2) General Linear Model (GLM) analysis in FSLv6.0.313 to assess changes in brain activation, and (3) Spearman’s correlation to examine the relationship between reading comprehension, social communication, and brain activation in the PN. Results showed that the ASD-EXP group exhibited significant improvements in reading comprehension (t(18) = 4.17, p < 0.05), and a slight, though not significant, improvement in social communication (t(18) = -1.40, p = 0.19). The ASD-EXP group showed post-intervention activation in the precuneus, extending to the fusiform gyrus (FFG), right LOC, and right cerebellum VI; and the left premotor (PMA) and supplementary motor (SMA) areas, extending to the IFG, dmPFC, and frontal eye fields (FEF). No significant activation changes were seen in the ASD-WLC group. Additionally, BOLD signal change in the left STG negatively correlated with changes in social communication (rho = -0.67, p = 0.02). In conclusion, the V/V intervention improved reading comprehension in the ASD-EXP group, accompanied by increased activation in PN (precuneus, dmPFC, LOC, and IFG7,8) and in reading comprehension areas (FFG and PMA)14. These findings suggest that intensive reading interventions can promote neuroplasticity, engaging PN and reading networks. Furthermore, the negative correlation between the STG with social communication, including pragmatic skills, indicated a positive impact of reading intervention on these areas. The absence of significant changes in the ASD-WLC group highlights the intervention’s specificity. These results suggest that targeted reading interventions may enhance reading comprehension and pragmatic skills and may improve social communication in autistic children.
Topic Areas: Meaning: Discourse and Pragmatics, Disorders: Developmental