Use of Computer Based Interventions to Teach Communication and Literacy Skills to Children with Autism Spectrum Disorders: A Systematic Review

Background: Children with autism spectrum disorders (ASD) frequently experience challenges regarding development of communication and literacy skills. Overcoming such challenges often requires special and intensive instruction and support. Computer-based instruction (CBI) represents a potential method for teaching communication and literacy skills and meeting the unique learning needs of students with ASD.  Given that a moderately large number of studies have been conducted on the use of CBI with students with ASD for the development of communication and literacy skills, a systematic review of the research is warranted.

Objectives: The purpose of this review is to provide a systematic analysis of studies involving the use of CBI to teach communication and/ or literacy skills to children with ASD. This review has three main aims: a) to evaluate the evidence-base regarding CBI, b) to inform and guide practitioners interested in using CBI, and c) to stimulate and guide future research aimed at improving the efficiency and effectiveness of CBI for development of communication and literacy skills in students with ASD. 

Methods: Systematic search of four comprehensive databases, along with hand searches of major, relevant journals, were conducted to find peer-reviewed intervention studies that were published between January 1990 and June 2010. This review summarizes, synthesizes, and evaluates intervention outcomes, appraises the certainty of evidence, and describes software and system requirements for each included study. 

Results: The systematic search yielded 16 studies involving the use of CBI to teach communication and literacy skills to a total of 119 individuals with autism.  Studies that measured the effectiveness of CBI on communication skills reported varying degrees of improvement for all participants. Studies that measured the effectiveness of CBI on literacy skills reported inconsistent results across studies. 

Conclusions: The variations in the effects of CBI appear to be due to (a) differences in software characteristics, (b) differences participant characteristics, and (c) differences in study designs, sampling procedures, and measurement tools. However, the existing literature does not allow for statistical testing of relationships between study variables and participant outcomes. Possible directions for future research include evaluation of the effects of various types of feedback, functional literacy approaches to instruction, and strategies for addressing unusual reinforcer hierarchies.