Purpose of Review
Modern communication requires written expression for work, academic, and personal purposes. Using meta-analysis, this study compares the written expression of individuals with autism with that of their non-diagnosed peers.
In the last five years, there has been an increase in studies that examine holistic elements of written expression. The current study identified 25 studies and the results of these studies showed individuals with autism perform at a rate comparable to their peers in syntax and spelling yet perform significantly lower in scores related to overall quality, structure, and cohesiveness.
Individuals with autism display a wide range of written skills. This study indicates that in general, individuals with autism perform well in the mechanics of writing but may need additional support in the organization and structure of writing. Since researchers tend to study written expression within clinical contexts, further research is needed to determine how individuals with autism use written expression in real-life contexts.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Berninger VW, Amtmann D. Preventing written expression disabilities through early and continuing assessment and intervention for handwriting and/or spelling problems: research into practice. In: Swanson HL, Harris KR, Graham S, editors. Handbook of learning disabilities. New York City: The Guilford Press; 2003. p. 345–63.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders V. 5th ed. New York City: American Psychiatric Association; 2013. p. 50–1.
Brown HM, Klein PD. Writing, Asperger syndrome and theory of mind. J Autism Dev Disord. 2011;41:1464–74. https://doi.org/10.1007/s10803-010-1168-7.
Capps L, Losh M, Thurber C. “The frog ate the bug and made his mouth sad”: Narrative competence in children with autism. J Abnorm Child Psychol. 2000;28:193–204. https://doi.org/10.1023/A:1005126915631.
• Gillespie-Lynch K, Hotez E, Zajic M, Riccio A, DeNigris D, Kofner B, et al. Comparing the writing skills of autistic and nonautistic university students: a collaboration with autistic university students. Autism. 2020;24:1898–912. https://doi.org/10.1177/1362361320929453. Participatory research which includes autistic researchers in developing its assessment tools.
Salas N, Silvente S. The role of executive functions and transcription skills in writing: a cross-sectional study across 7 years of schooling. Read Writ. 2020;33:877–905. https://doi.org/10.1007/s11145-019-09979-y.
Finnegan E, Accardo AL. Written expression in individuals with autism spectrum disorder: a meta-analysis. J Autism Dev Disord. 2018;48:68–82. https://doi.org/10.1007/s10803-017-3385-9.
LaValle CL, Chenausky K, Tager-Flusberg H. How do minimally verbal children and adolescents with autism spectrum disorder use communicative gestures to complement their spoken language abilities? Autism Dev Lang Impair. 2021;6:1–16. https://doi.org/10.1177/23969415211035065.
• Tomlinson E, Newman S. Valuing writers from a neurodiversity perspective: integrating new research on autism spectrum disorder into composition pedagogy. Compos Studies. 2017;45(2):91–112. A qualitative study describing how individuals with autism approach writing.
Naigles LR, Tek S. ‘Form is easy, meaning is hard’ revisited:(re) characterizing the strengths and weaknesses of language in children with autism spectrum disorder. Wiley Interdisc Rev: Cogn Sci [Internet]. 2017;8:e1438. https://doi.org/10.1002/wcs.1438.
•• Zajic MC, Wilson SE. Writing research involving children with autism spectrum disorder without a co-occurring intellectual disability: a systematic review using a language domains and mediational systems framework. Res Autism Spectr Disord [Internet]. 2020;70:101471. https://doi.org/10.1016/j.rasd.2019.101471. A comprehensive review of studies which describes both the writing characteristics of individuals with autism and effectiveness of interventions supporting writing.
• Pennington RC, Carpenter M. Teaching written expression to students with autism spectrum disorder and complex communication needs. Top Lang Disord. 2019;39:191–207. https://doi.org/10.1097/TLD.0000000000000181. Addresses the needs of students with complex communication needs.
Hume K, Steinbrenner JR, Odom SL, Morin KL, Nowell SW, Tomaszewski B, et al. Evidence-based practices for children, youth, and young adults with autism: third generation review. J Autism Dev Disord. 2021;51:4013–32. https://doi.org/10.1007/s10803-020-04844-2.
Accardo AL, Finnegan EG, Kuder SJ, Bomgardner EM. Writing interventions for individuals with autism spectrum disorder: a research synthesis. J Autism Dev Disord. 2020;50:1988–2006. https://doi.org/10.1007/s10803-019-03955-9.
Pennington RC, Delano ME. Writing instruction for students with autism spectrum disorders: a review of literature. Focus Autism Other Dev Disabil. 2012;27:158–67. https://doi.org/10.1177/1088357612451318.
•• Zajic MC, Brown HM. Measuring autistic writing skills: combining perspectives from neurodiversity advocates, autism researchers, and writing theories. Hum Dev. 2022;66:128–48. https://doi.org/10.1159/000524015. Discusses autism as a neurodiversity construct with the Writer(s)-within-Community model, highlighting the complexities involved in understanding the interactions of identity, context for writing, and assessment of written products.
Asaro-Saddler K, Ellis-Robinson T, Eacker H. Exploring the effects of a biopoem writing intervention on middle school students with autism spectrum disorder. Top in Lang Disord. 2019;39:155–90. https://doi.org/10.1097/TLD.0000000000000179.
Kushki A, Chau T, Anagnostou E. Handwriting difficulties in children with autism spectrum disorders: a scoping review. J Autism Dev Disord. 2011;41:1706–16. https://doi.org/10.1007/s10803-011-1206-0.
Grace N, Enticott PG, Johnson BP, Rinehart NJ. Do handwriting difficulties correlate with core symptomology, motor proficiency and attentional behaviours? J Autism Dev Disord. 2017;47:1006–17. https://doi.org/10.1007/s10803-016-3019-7.
Grace N, Rinehart NJ, Enticott PG, Johnson BP. Do children with ASD have difficulty handwriting under time pressure? Res Autism Spectr Disord. 2017;1:21–30. https://doi.org/10.1016/j.rasd.2017.02.001.
Grace N, Johnson BP, Rinehart NJ, Enticott PG. Are motor control and regulation problems part of the ASD motor profile? A handwriting study Dev Neuropsychol. 2018;43:581–94. https://doi.org/10.1080/87565641.2018.1504948.
Troyb E, Orinstein A, Tyson K, Helt M, Eigsti IM, Stevens M, et al. Academic abilities in children and adolescents with a history of autism spectrum disorders who have achieved optimal outcomes. Autism. 2014;8:233–43. https://doi.org/10.1177/1362361312473519.
Tyson K, Kelley E, Fein D, Orinstein A, Troyb E, Barton M, et al. Language and verbal memory in individuals with a history of autism spectrum disorders who have achieved optimal outcomes. J Autism Dev Disord. 2014;44:648–63. https://doi.org/10.1007/s10803-013-1921-9.
Zajic MC, Solari EJ, McIntyre NS, Lerro L, Mundy PC. Task engagement during narrative writing in school-age children with autism spectrum disorder compared to peers with and without attentional difficulties. Res Autism Spectr Disord [Internet]. 2020;76:101590. https://doi.org/10.1016/j.rasd.2020.101590.
Zajic MC, Solari EJ, McIntyre NS, Lerro L, Mundy PC. Overt planning behaviors during writing in school-age children with autism spectrum disorder and attention-deficit/hyperactivity disorder. Res Dev Disabil [Internet]. 2020;100:103631. https://doi.org/10.1016/j.ridd.2020.103631.
Zajic MC, Solari EJ, McIntyre NS, Lerro L, Mundy PC. Observing visual attention and writing behaviors during a writing assessment: comparing children with autism spectrum disorder to peers with Attention-Deficit/Hyperactivity Disorder and typically developing peers. Autism Res. 2021;14:356–68. https://doi.org/10.1002/aur.2383.
Kmet LM, Cook LS, Lee RC. Standard quality assessment criteria for evaluating primary research papers from a variety of fields. Edmonton, Canada: Alberta Heritage Foundation for Medical Research; 2004. https://doi.org/10.7939/R37M04F16.
Borenstein M. Comprehensive Meta-Analysis Version 3. Englewood, NJ: Biostat; 2022. https://www.meta-analysis.com/index.php?cart=B2XM7315514
• Price JR, Martin GE, Chen K, Jones JR. A preliminary study of writing skills in adolescents with autism across persuasive, expository, and narrative genres. J Autism Dev Disord. 2020;50:319–32. https://doi.org/10.1007/s10803-019-04254-z. Study analyzes writing samples from the same cohort across genres that reflect writing expectations in K-12 schools.
Myles BS, Huggins A, Rome-Lake M, Hagiwara T, Barnhill GP, Griswold DE. Written language profile of children and youth with Asperger syndrome: from research to practice. Educa Train Dev Disabil. 2003;38:362–9. https://www.jstor.org/stable/23879912
Zajic MC, McIntyre N, Swain-Lerro L, Novotny S, Oswald T, Mundy P. Attention and written expression in school-age, high-functioning children with autism spectrum disorders. Autism. 2018;22:245–58. https://doi.org/10.1177/1362361316675121.
Brown HM, Johnson AM, Smyth RE, Cardy JO. Exploring the persuasive writing skills of students with high-functioning autism spectrum disorder. Res Autism Spectr Disord. 2014;8:1482–99. https://doi.org/10.1016/j.rasd.2014.07.017.
Hilvert E, Davidson D, Scott CM. An in-depth analysis of expository writing in children with and without autism spectrum disorder. J Autism Dev Disord. 2019;49:3412–25. https://doi.org/10.1007/s10803-019-04057-2.
Bourke L, Marriott-Fellows M, Jones A, Humphreys L, Davies SJ, Zuffiano A, et al. Writing with imagination: the influence of hot and cold executive functions in children with autism characteristics and typically developing peers. Read Writ. 2020;33:935–61. https://doi.org/10.1007/s11145-019-09989-w.
Dillon G, Underwood J. Computer mediated imaginative storytelling in children with autism. Int J Hum Comput Stud. 2012;70:169–78. https://doi.org/10.1016/j.ijhcs.2011.10.002.
Hammill DD, Larsen SC. Test of written language-(TOWL-4). Austin, TX: Pro-Ed; 2009.
Semel EM, Wiig EH, Secord W. CELF3: clinical evaluation of language fundamentals. San Diago, CA: Harcourt Brace; 1995.
Hilvert E, Davidson D, Gámez PB. Assessment of personal narrative writing in children with and without autism spectrum disorder. Res Autism Spectr Disord [Internet]. 2020;69:101453. https://doi.org/10.1016/j.rasd.2019.101453.
Bailey B, Arciuli J. Subskills associated with spelling ability in children with and without autism spectrum disorders. Autism Dev Lang Impair [Internet]. 2018;3:2396941518803807. https://doi.org/10.1177/2396941518803807.
Cartmill L, Rodger S, Ziviani J. Handwriting of eight-year-old children with autistic spectrum disorder: an exploration. J Occup Ther, Sch, Early Interv. 2009;2:103–18. https://doi.org/10.1080/19411240903146426.
Alaniz ML, Galit E, Necesito CI, Rosario ER. Hand strength, handwriting, and functional skills in children with autism. Am J Occup Ther [Internet]. 2015;69:6904220030. https://doi.org/10.5014/ajot.2015.016022.
Beversdorf DQ, Anderson JM, Manning SE, Anderson SL, Nordgren RE, Felopulos GJ, et al. Brief report: Macrographia in high-functioning adults with autism spectrum disorder. J Autism Dev Disord. 2001;31:97–101. https://doi.org/10.1023/A:1005622031943.
• Li-Tsang CW, Li TM, Ho CH, Lau MS, Leung HW. The relationship between sensorimotor and handwriting performance in Chinese adolescents with autism spectrum disorder. J Autism Dev Disord. 2018;48:3093–100. https://doi.org/10.1007/s10803-018-3580-3. Examines writing samples from bilingual students and compares their performance in Chinese characters and European letters.
Lanter E, Freeman D, Dove S. Procedural and conceptual print-related achievements in young children with autism spectrum disorders. Focus Autism Other Dev Disabil. 2013;28:14–25. https://doi.org/10.1177/1088357612459270.
Johnson BP, Phillips JG, Papadopoulos N, Fielding J, Tonge B, Rinehart NJ. Do children with autism and Asperger’s disorder have difficulty controlling handwriting size? A kinematic evaluation. Res Autism Spectr Disord. 2015;11:20–6. https://doi.org/10.1016/j.rasd.2014.11.001.
Conflict of Interest
The authors declare no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Communication Disorders
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Finnegan, E.G., Accardo, A.L. Written Expression in Individuals with Autism: a Meta-analysis. Curr Dev Disord Rep 9, 178–186 (2022). https://doi.org/10.1007/s40474-022-00262-4
- Written language
- Written communication