Effects of Emergent Literacy Interventions for Preschoolers with Autism Spectrum Disorder
Hudson, Roxanne F.; Sanders, Elizabeth A.; Greenway, Rosanne; Xie, Sharon; Smith, Maya; Gasamis, Colin; Martini, Jay; Schwartz, Ilene; Hackett, Jacob (2017). Exceptional Children, v84 n1 p55-75. Retrieved from: https://eric.ed.gov/?id=EJ1158175
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examining46Students, gradePK
Practice Guide
Review Details
Reviewed: March 2026
- Practice Guide (findings for Phonological awareness lessons and Road to the Code – Hudson et al. (2017))
- Randomized Controlled Trial
- Meets WWC standards without reservations because it is a randomized controlled trial with low attrition.
This review may not reflect the full body of research evidence for this intervention.
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Findings
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|---|---|---|---|---|---|---|
|
Test of Preschool Early Literacy (TOPEL; Lonigan et al., 2007): Phonological awareness subtest |
Phonological awareness lessons and Road to the Code – Hudson et al. (2017) vs. Business as usual |
0 Days |
Full sample;
|
86.87 |
79.52 |
No |
-- |
|
Test of Preschool Early Literacy (TOPEL) Print Knowledge subtest |
Phonological awareness lessons and Road to the Code – Hudson et al. (2017) vs. Business as usual |
0 Days |
Full sample;
|
97.61 |
103.52 |
No |
-- |
|
Woodcock Johnson, 3rd Edition (WJ-III): Letter-Word Identification (LWI) subtest |
Phonological awareness lessons and Road to the Code – Hudson et al. (2017) vs. Business as usual |
0 Days |
Full sample;
|
109.09 |
112.83 |
No |
-- |
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|---|---|---|---|---|---|---|
|
Woodcock Johnson, 3rd Edition (WJ-III): Oral Communication and Following Directions subtests |
Phonological awareness lessons and Road to the Code – Hudson et al. (2017) vs. Business as usual |
0 Days |
Full sample;
|
76.52 |
74.83 |
No |
-- |
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|---|---|---|---|---|---|---|
|
Peabody Picture Vocabulary Test Fourth Edition (PPVT-IV) |
Phonological awareness lessons and Road to the Code – Hudson et al. (2017) vs. Business as usual |
0 Days |
Full sample;
|
80.13 |
82.83 |
No |
-- |
|
Expressive One-Word Vocabulary Picture Test, Fourth Edition |
Phonological awareness lessons and Road to the Code – Hudson et al. (2017) vs. Business as usual |
0 Days |
Full sample;
|
85.83 |
86.39 |
No |
-- |
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Sample Characteristics
Characteristics of study sample as reported by study author.
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Female: 19%
Male: 81% -
Suburban, Urban
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West
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Race Asian 27% Black 7% Other or unknown 24% White 42% -
Ethnicity Other or unknown 100% -
Eligible for Free and Reduced Price Lunch Other or unknown 100%
Study Details
Setting
The study took place in 57 preschool classrooms in 21 schools in 8 urban and suburban school districts in one state located in the Pacific Northwest. The majority of the preschools were public and the remainder were private. The numbers of students who were typically developing and students with developmental disabilities varied across classrooms. Some classrooms included only students who received services in special education or English as a second language, or were enrolled in Head Start.
Study sample
The study randomly assigned 46 students either to the intervention or comparison group. Preschool students with autism spectrum disorder participated in the study. To be included in the study, students needed to (1) be identified as having ASD by the school district, (2) be receiving services associated with an Individualized Education Program, (3) be enrolled in their last year of preschool and with a plan to enter kindergarten, (4) have no known co-occurring neurological or genetic disorders, (5) be able to use 2-4 word phases and follow simple instructions, and (6) score a minimum of 55 on the One Word Expressive Picture Vocabulary Test. A majority of the children were male, and ages ranged from 39-69 months.
Intervention Group
In the phonological awareness condition, the intervention consisted of two sequential components delivered across sessions. In the first 30 sessions, each lesson included (a) a song with a phonological awareness element, (b) an activity that was repeated across 5–7 lessons, and (c) a novel activity targeting the same skill. Instruction progressed from word-level awareness to syllable, onset-rime, and beginning phoneme skills. Tutors modeled all skills explicitly and provided systematic corrective feedback following incorrect responses. Activities incorporated manipulatives (e.g., blocks, chips, pictures) and provided multiple opportunities for student responses. Following these initial lessons, students participated in an additional 30 sessions using the Road to the Code program (Blachman et al., 2000), which was implemented as designed without adaptation. Road to the Code is a structured phonological awareness curriculum that emphasizes phoneme segmentation and blending and introduces letter names and sounds through a consistent instructional routine with hands-on materials. The program builds on earlier phonological awareness skills by moving from sound manipulation to connections between sounds and print. Across all sessions, instruction included the use of a visual schedule and brief reinforcement at the end of each session.
Comparison Group
Students in the comparison condition engaged with literacy activities during circle time and small groups at teacher-led centers. Teachers also provided non-literacy instruction such as counting, numbers, calendar, self-regulation, transition, and play. On average, students were exposed to about 40.75 minutes per hour of non-literacy instruction, 12.63 minutes of oral language instruction, about 2 minutes each of storybook reading and print concepts, and less than one minute per hour of phonological awareness, letter identification, letter sounds, reading, and writing activities.
Support for implementation
Tutors received an in-depth 3-day training on how to deliver each intervention and were required to demonstrate that they could implement the lessons with at least 95% accuracy. Tutors were also provided with lesson plans that included suggested scripts and activities to guide instruction. In addition, research staff conducted monthly onsite coaching visits to observe sessions and provide feedback. Overall, the interventions were implemented as intended, with high levels of fidelity across sessions.
Practice Guide
Review Details
Reviewed: March 2026
- Practice Guide (findings for Interactive book reading -- Hudson et al. (2017))
- Randomized Controlled Trial
- Meets WWC standards without reservations because it is a randomized controlled trial with low attrition.
This review may not reflect the full body of research evidence for this intervention.
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Findings
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|---|---|---|---|---|---|---|
|
Woodcock Johnson, 3rd Edition (WJ-III): Oral Communication and Following Directions subtests |
Interactive book reading -- Hudson et al. (2017) vs. Business as usual |
0 Days |
Full sample;
|
86.38 |
86.67 |
No |
-- |
|
Outcome measure |
Comparison | Period | Sample |
Intervention mean |
Comparison mean |
Significant? |
Improvement index |
|---|---|---|---|---|---|---|---|
|
Expressive One Word Picture Vocabulary Test (EOWPVT-III) |
Interactive book reading -- Hudson et al. (2017) vs. Business as usual |
0 Days |
Full sample;
|
93.05 |
92.14 |
No |
-- |
|
Peabody Picture Vocabulary Test Fourth Edition (PPVT-IV) |
Interactive book reading -- Hudson et al. (2017) vs. Business as usual |
0 Days |
Full sample;
|
90.05 |
91.43 |
No |
-- |
Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.
Sample Characteristics
Characteristics of study sample as reported by study author.
-
Female: 19%
Male: 81% -
Suburban, Urban
-
- B
- A
- C
- D
- E
- F
- G
- I
- H
- J
- K
- L
- P
- M
- N
- O
- Q
- R
- S
- V
- U
- T
- W
- X
- Z
- Y
- a
- h
- i
- b
- d
- e
- f
- c
- g
- j
- k
- l
- m
- n
- o
- p
- q
- r
- s
- t
- u
- v
- x
- w
- y
West
-
Race Asian 27% Black 7% Other or unknown 24% White 42% -
Ethnicity Other or unknown 100% -
Eligible for Free and Reduced Price Lunch Other or unknown 100%
Study Details
Setting
The study took place in 57 preschool classrooms in 21 schools in 8 urban and suburban school districts in one state located in the Pacific Northwest. A majority of the preschools were public and a few were private. The composition of each classroom varied in the numbers of students who were typically developing and students with developmental disabilities. Some classrooms only had student who received services in special education, English as a Second Language, and Head Start.
Study sample
Students with autism spectrum disorder participated in the study. All students had to be identified as a) having ASD by the school district, b) have an active IEP and receive services, c) be enrolled in their last year of preschool and with a plan to enter kindergarten, d) have no known co-occurring neurological or genetic disorders, e) use 2-4 word phases and follow simple instructions, f) score a minimum of 55 on the One Word Expressive Picture Vocabulary Test. The study had a 3 cohort design, no student participated in more than one cohort. For the interactive book reading cohort (Cohort 1), 21 were assigned to the intervention group, and 21 were assigned to the comparison group. The full study included additional intervention conditions. A majority of the children were male, and ages ranged from 39-69 months.
Intervention Group
Students in the intervention condition received one-on-one instruction through either an interactive book reading (IBR) intervention or a phonological awareness (PA) intervention designed to support early literacy skills. In the IBR intervention, students engaged with books that were read multiple times (three to four readings per book) to build familiarity and comprehension. Tutors prompted students to talk about the books using Dialogic Reading procedures and followed the PEER sequence (Prompt, Evaluate, Expand, and Repeat). Tutors also provided supports such as additional wait time to allow students to process information and respond. Books varied in complexity but were selected to include clear language and engaging content. The PA intervention focused on developing students’ awareness of sounds in spoken language through structured lessons that included songs, hands-on activities, and practice with identifying and manipulating sounds. Both interventions were delivered by trained tutors in short, individualized sessions held in a quiet space at the school. Sessions occurred three to four times per week and lasted about 7 to 15 minutes. The interventions were implemented from approximately November through May during the preschool year
Comparison Group
Students in the comparison condition received business-as-usual instruction in their preschool classrooms. They participated in literacy activities during circle time and small groups at teacher-led centers, along with other typical classroom activities. Instruction included non-literacy activities such as counting, calendar routines, self-regulation, transitions, and play, as well as some oral language instruction, storybook reading, and print-related activities. On average, students were exposed to about 40.75 minutes per hour of non-literacy instruction, 12.63 minutes of oral language instruction, about 2 minutes each of storybook reading and print concepts, and less than one minute per hour of phonological awareness, letter identification, letter sounds, reading, and writing activities.
Support for implementation
Tutors received an in-depth 3-day training on how to deliver each intervention and were required to demonstrate that they could implement the lessons with at least 95% accuracy. Tutors were also provided with lesson plans that included suggested scripts and activities to guide instruction. In addition, research staff conducted monthly onsite coaching visits to observe sessions and provide feedback. Overall, the interventions were implemented as intended, with high levels of fidelity across sessions.
An indicator of the effect of the intervention, the improvement index can be interpreted as the expected change in percentile rank for an average comparison group student if that student had received the intervention.
For more, please see the WWC Glossary entry for improvement index.
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The mean score of students in the comparison group.
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