Copyright is owned by the Author of the thesis. Permission is given for a copy to be downloaded by an individual for the purpose of research and private study only. The thesis may not be reproduced elsewhere without the permission of the Author. i Emergent Literacy Practices for Preschool Children with Autism Spectrum Disorders A thesis presented in partial fulfilment of the requirements for the degree of Master of Speech Language Therapy at Massey University, Albany NEW ZEALAND Julia Wright 2014 ii CONTENTS List of figures and tables vi Acknowledgements vii Abstract viii CHAPTER ONE Introduction 1.1 Introduction 1 1.2 Rationale for This Study 2 1.3 The Research Aims 3 1.4 The Research Context 3 1.5 The Structure of the Thesis 4 CHAPTER TWO Literature Review 2.0 Introduction 5 2.1 The Emergence of Emergent Literacy 5 2.1.1 Components of Emergent Literacy and Underlying Theoretical Framework 6 2.2 The Importance of Emergent Literacy for Later Literacy Achievement 10 2.2.1 Alphabet Knowledge 11 2.2.2 Concepts About Print 12 2.2.3 Phonological Awareness 12 2.2.4 Oral Language 13 2.3 Current Best Practice in Emergent Literacy Intervention 15 2.4 Autism Spectrum Disorders Defined 18 2.5 Challenges in Emergent Literacy Learning for Children with ASD 19 2.5.1 The Influence of Assumptions on Literacy Outcomes 20 2.5.2 Communication Differences 20 2.5.3 Special or Restricted Interests 22 2.5.4 Sensory Challenges 22 2.5.5 Movement Differences 23 2.6 Literacy Profiles in Children with ASD 24 2.6.1 Continuity Between Emergent Literacy and Conventional Literacy Profiles 25 2.7 Emergent Literacy Interventions for Children with ASD 26 2.7.1 Environmental Interventions 26 2.7.2 Shared Storybook Interventions 27 2.7.3 Dialogic Reading 28 2.7.4 Technology Based Interventions 29 2.8 The New Zealand Context 30 CHAPTER THREE Methodology 3.1 Introduction 33 iii 3.2 The Research Questions 33 3.3 Participant Recruitment 34 3.4 Methodological Approach 34 3.5 Data Collection Methods 36 3.5.1 Survey Methodology 36 3.5.2 Online Survey Methodology 37 3.5.3 Interview Methodology 37 3.5.4 Semi Structured Interviews 39 3.6 Instruments 40 3.6.1 Online Survey 40 3.6.2 Semi Structured Interview 42 3.7 Procedures 42 3.7.1 Digital Recording and Transcription 43 3.7.2 Member Checking 43 3.8 Data Analysis Framework 43 3.8.1 Data Analysis Procedures 44 3.8.2 Triangulation 45 3.9 Ethical Considerations 47 3.9.1 Informed Consent 47 3.9.2 Confidentiality 48 3.9.3 Compensation 48 3.10 Conclusion 49 CHAPTER FOUR Results 4.0 Introduction 50 4.1 Survey Results 50 4.1.2 Centre Information 50 4.1.3 Child Information 53 4.1.4 Support from External Agencies 53 4.1.5 Individual Plan Information 53 4.2 Early Childhood Teachers' Beliefs about Emergent Literacy? 54 4.2.1 Importance Placed on Components of Emergent Literacy 56 4.2.2 Availability of Emergent Literacy Artefacts 57 4.3 Engagement with Emergent Literacy 58 4.4 Teaching Practices and Strategies 59 4.4.1 Shared Storybook Reading 60 4.4.2 Independent Book Exploration 61 4.4.3 Phonological Awareness 61 4.4.4 Alphabet Knowledge 62 4.4.5 Print Concepts 63 4.4.6 Oral Language 64 4.4.7 Vocabulary Development 64 4.4.8 Emergent Writing 65 4.5 What are the challenges inherent in supporting literacy learning for preschool children with ASD? 66 iv 4.5.1 Internal challenges 66 4.5.2 External challenges 66 4.6 Professional Learning and Development Needs 67 4.6.1 Teachers Competencies in Supporting Emergent Literacy Components in Children with ASD 69 4.7 Interview Results 70 4.8 How do preschool children with ASD engage with emergent literacy opportunities and experiences within the early childhood setting? 70 4.8.1 Engagement with books 72 4.8.2 Participation at Mat Time 73 4.8.3 Influence of Restricted Interests 73 4.8.4 Technology 74 4.8.5 Engagement with Emergent Writing 74 4.8.6 Alphabet Knowledge 75 4.9 What are the practices employed to support emergent literacy learning for Preschool children with ASD? 76 4.9.1 Special Interests 76 4.9.2 Sensory Play 77 4.9.3 Technology 77 4.9.4 Taking it Slow 78 4.9.5 Collaboration 78 4.9.6 Child Specific Strategies 78 4.10 What are the challenges inherent in supporting emergent literacy learning for preschool children with ASD? 79 4.10.1 Engagement 79 4.10.2 Challenging Behaviour 79 4.10.3 Competing Demands and Needs 80 4.10.4 External supports 80 4.10.5 Time 81 4.10.6 Communication Skills 82 4.11 What are the professional learning and development needs of early childhood teachers? 82 CHAPTER FIVE Discussion 5.0 Introduction 84 5.1 What are early childhood teachers' beliefs about emergent literacy? 85 5.1.1 Teachers Understanding of Emergent Literacy 85 5.1.2 Embedded Versus Explicit Emergent Literacy Teaching 86 5.1.3 Teacher Expectations 87 5.2 How do children with ASD engage with emergent literacy opportunities and experiences within the early childhood setting? 89 5.2.1 Preference for Book Based Activities 90 5.2.2 Least Preferred Activities 91 5.3 What strategies and supports do early childhood teachers employ to facilitate emergent literacy development? 93 5.3.1 Individualised Strategies 93 v 5.3.2 General Teaching Strategies 94 5.3.3. Strategies Based on Challenges 94 5.3.4 Communication 95 5.3.5 Technology 96 5.5 What are the challenges inherent in supporting literacy learning for children with ASD? 97 5.5.1 The Paraprofessional Conundrum 97 5.6 What are the professional learning and development needs of early childhood teachers of children with ASD? 98 5.6.1 Professional Support and Collaboration 99 CHAPTER SIX Conclusion 6. 1 Introduction 101 6.2 Purpose and Design 101 6.3 Limitations 102 6.4 Implications for Practice 103 6.5 Implications for Future Research 105 6.6 Final Thoughts 106 REFERENCES References 108 APPENDICES Appendix A: Information Sheet 119 Appendix B: Interview Consent Form 122 Appendix C: Transcript Release Authority 123 Appendix D: Recruitment e-mail 124 Appendix E: Follow up Letter 125 Appendix F: Online Survey 126 Appendix G: Interview Guide Sheet 136 Appendix H: Ethics Approval Letter 138 vi LIST OF FIGURES AND TABLES List of Figures Figure 1: Focused View of the Construct of Emergent Literacy 9 Figure 2: Example of Coding and Data Analysis Process 46 List of Tables Table 1: Background Information of Survey Participants 51 Table 2: Targets of Current Individual Plan Goals 54 Table 3: Survey Respondents’ Emergent Literacy Beliefs 56 Table 4: Importance Ascribed to Various Components of Emergent Literacy 57 Table 5: Frequency of Engagement in Emergent Literacy Activities for Children with ASD 59 Table 6: Types of Professional Learning and Development 68 Table 7: Teachers’ Competencies in Supporting Emergent Literacy Components in Children with ASD 69 Table 8: Background Information of Interview Participants 71 vii ACKNOWLEDGEMENTS Firstly and foremost I would like to thank the teachers who shared their time and thoughts, as without them this study would not have been possible. To those who facilitated recruitment in particular the Auckland Kindergarten Association and North Auckland Kindergarten Association I am very grateful. I am hopeful that these contributions will facilitate wider discourse about the literacy possibilities for children with ASD and support children with ASD reaching their full literacy potential. To my supervisor and friend Dr. Sally Clendon, your enthusiasm is inspiring. I wouldn't have been able to complete this journey without your unfailing support and encouragement, not to mention your attention to detail and superior proof reading skills. A small thanks also to Jack whose bedtime routine was oft interrupted by my late night academic dilemmas. I would also like to thank my secondary supervisor Dr. Mandia Mentis for her guidance, direction and support over the past two year To my family who have supported me throughout this journey. To my pragmatic and humorous husband Doug who has encouraged me, supported me and made me laugh when I felt like crying "aisle of view". My daughters Laila and Sylvie thank you for sharing your Mum with her studies. I am so looking forward to having more time for cuddles and fun with you both. Finally to my parents John and Colleen who have lightened the load over the past four years, I am truly grateful. A final acknowledgement for the financial support received from Massey University, Kate Edger Educational Charitable Trust and the Ministry of Education. viii ABSTRACT Literacy is essential to success in education and employment, and in the modern world plays an important role in our daily communication and social participation. The value of literacy is increasingly being recognised and prioritised by government and the business sector in New Zealand. For children with autism spectrum disorders (ASD), literacy learning presents a unique set of challenges. Research suggests that children with ASD are at high risk of poor literacy outcomes, which has implications for their educational success, employment outcomes and social relationships. Given the limited research into the early years of literacy development for children with ASD, this study aimed to explore how children with ASD are engaging with emergent literacy, the strategies that teachers are using to facilitate emergent literacy and the perceived challenges teachers face in supporting emergent literacy development for this group of children. A mixed methods research design was adopted using an online survey and face-to-face interviews with preschool teachers who had recent experience teaching a child with ASD. Five key findings emerged: (1) variability in teachers’ understanding of emergent literacy with embedded literacy learning opportunities being more prevalent than explicit instruction; (2) wide variability in levels of student engagement with emergent literacy opportunities and activities (3) wide range of strategies employed by teachers to support children's emergent literacy learning with high levels of personalisation to children's individual strengths and interests; (4) children's interest level and attention were perceived as the biggest challenge to their literacy development and (5) low levels of professional learning and development (PL&D) in emergent literacy and ASD despite high levels of interest in PL&D in these areas. Participants also identified the need for greater collaboration between speech language therapists and teachers to support the communication skills and emergent literacy development of children with ASD. This study highlights the need for greater professional support for teachers to overcome the challenges identified. This support is essential in order to maximise the literacy learning for children with ASD. 1 CHAPTER ONE Introduction 1.1 Introduction The ability to read and write competently is widely regarded in society as an essential skill for success in education and employment. Moreover literacy provides a source of enjoyment and has become an integral part of the way we communicate and interact online, through the use of e-mail, social media and online communities. In an increasingly digitised and connected world, literacy has become essential to daily communication and social participation. The path to becoming literate commences well before children enter school. From birth, children acquire literacy related knowledge and skills through their interactions and experiences with print and literacy. The term emergent literacy was first used to describe this critical period in literacy development in the early 1960's (Teale & Sulzby, 1986). Research since this time has elucidated the strong links between children's emergent literacy knowledge and their later literacy development (National Early Literacy Panel, 2010). For children with autism spectrum disorders (ASD), literacy learning presents a unique set of challenges that frequently lead to low levels of literacy. Children with ASD have been shown to pass through the same stages of reading development as their peers without disabilities (Calhoon, 2001; Koppenhaver & Erickson, 2003), however as many as 1 in 5 children with ASD have been found to be unable to demonstrate an ability to read on formal reading assessments (Nation, Clarke, Wright, & Williams, 2006). Children with ASD frequently face communication, sensory, and movement challenges which impact both on their ability to access literacy activities and instruction as well as their ability to demonstrate literacy competence in the expected ways. Compounding the effects of these learning differences is the frequent assumption that they are incapable of learning to read. Assumed lack of competence leads to lowered expectations which shape the subsequent opportunities 2 available for literacy learning and instruction (Kluth & Chandler-Olcott, 2008; Koppenhaver & Erickson, 2003; Mirenda & Erickson, 2000). Teachers and speech language therapists have a pivotal role to play in developing the emergent and early literacy skills that underpin the development of conventional literacy skills in children with ASD. Despite the increasing focus on literacy achievement in New Zealand schools (Ministry of Education, 2010a), there is a paucity of evidence documenting effective interventions for this population. This presents a significant challenge to the teachers and speech language therapists supporting these children. In the absence of a strong empirical base to guide educators, there is a strong argument for children with ASD to have access to balanced literacy instruction that is guided by current best practices (Kluth & Chandler-Olcott, 2008; Lanter & Watson, 2008; Mirenda & Erickson, 2000). Indeed it has been shown that providing preschool children with ASD with access to literacy-rich environments where adults facilitate learning through naturally occurring opportunities has a positive impact on emergent literacy development (Koppenhaver & Erickson, 2003). This thesis seeks to explore the nature of emergent literacy instruction for preschool children with ASD in New Zealand early childhood centres, as well as to identify the challenges facing teachers in supporting these children. These are considered within the framework of Sénéchal, Lefevre, Smith-Chant, & Colton’s (2001) ‘focused view of emergent literacy’, as well as with reference to current best practices in emergent literacy intervention. 1.2 Rationale for This Study Despite a wealth of research into ASD there has been very little focus on the early literacy development of these children. Literature searches for "emergent literacy" and "autism" yield only 4 studies specifically investigating children with ASD. Although there are considerably more studies that have investigated emergent literacy in teenagers and adults, there appears to be only three studies (Lanter, Watson, Erickson, & Freeman, 2012; Nation et al., 3 2006; Rosenberg, 2008) that have investigated the literacy abilities of children. Intervention studies with children with ASD are more common, however, these have been restricted to small scale studies usually involving between 1 and 3 children. Typically the interventions being studied have represented highly clinical situations rather than classroom based or environmental interventions. 1.3 The Research Aims This research sought to provide some insight into what is happening for young children with ASD in terms of emergent literacy learning and supports in the New Zealand context by answering the following research questions: (1) What are early childhood teachers' beliefs about emergent literacy? (2) How do preschool children with ASD engage with emergent literacy opportunities and experiences within the early childhood setting? (3) What strategies and supports do early childhood teachers employ to facilitate emergent literacy development for preschool children with ASD? (4) What are the challenges inherent in supporting literacy learning for preschool children with ASD? (5) What are the professional learning and development needs of early childhood teachers of children with ASD? 1.4 The Research Context Two hundred and fifty three early childhood centres, in the greater Auckland region were canvassed for potential research participants. Information about the study was distributed and eligible teachers were invited to participate in either an online survey or an interview. 4 1.5 The Structure of the Thesis Chapter one has provided an overview of the research carried out for this thesis. Chapter two begins with an synopsis of emergent literacy and explores the links between emergent literacy development and later literacy achievement as well as current best practice in emergent literacy instruction. This is followed by a review of the literature on ASD and emergent literacy, with particular attention given to the challenges that children with ASD face in achieving literacy success. Chapter three outlines the survey and interview methodology underpinning the research alongside the methods used in the data collection phase of the study. Key findings from the research are presented in Chapter four. The findings are then discussed in Chapter five in relation to best practice. Chapter six presents a summary of the limitations of the study along with the final conclusions and possible directions for future research. 5 CHAPTER TWO Literature Review 2.0 Introduction The following sections provide a review of emergent literacy research conducted in the fields of Education and Autism Spectrum Disorders. First, the review examines the construct of emergent literacy, the links between the component skills of emergent literacy and later literacy acquisition, and current best practice in emergent literacy. Second, the review outlines the research examining emergent literacy in children with ASD including recent changes in the diagnostic criteria for ASD, challenges in literacy learning, emergent literacy profiles and interventions. Finally, the review explores the New Zealand context and the importance of best practice for supporting emergent literacy development for children with ASD. 2.1 The Emergence of Emergent Literacy The term emergent literacy was first used by Marie Clay (1966, 1967, 1972) who is often credited with instigating the establishment of emergent literacy as a field of research and focus of educational initiatives. Clay’s (1966) doctoral dissertation documented the early reading behaviours of 5-year-olds, providing evidence that young children are capable of engaging in important reading behaviours when exposed to literacy activities. The findings of Clay’s research called into question the doctrine of reading readiness models that dominated the first half of the 20th century. Reading readiness models proposed that children must first acquire a set of prerequisite skills and knowledge before commencing formal reading instruction (Morrow, 2009; Teale & Sulzby, 1986). Clay concluded that there were no grounds for withholding exposure to printed language forms on the basis of maturation. 6 Although Clay is largely credited with being the pioneer of the field of emergent literacy, it was the work of Teale and Sulzby (1986) which defined the key characteristics of this early period of literacy development. Their work lead to widespread acknowledgement of the new paradigm of emergent literacy in research and educational practice. Teale and Sulzby (1986) argued that the term emergent literacy should be used to describe children’s early reading and writing behaviours. They suggested the term better reflected the interrelatedness of reading and writing and marked the paradigm shift from readiness models to the understanding of literacy learning as a developmental process. Teale and Sulzby's critical hypotheses about emergent literacy continue to form the basis of our current understanding of emergent literacy (Justice, 2006; Rhyner, 2009). They hypothesized that: (1) literacy begins at birth with key literacy milestones being achieved prior to school entry, (2) literacy and language are reciprocally related, (3) children are active participants in literacy development and their development is mediated by adults in their environment, (4) literacy knowledge is largely acquired through incidental learning, and (5) children’s early literacy milestones tend to follow a developmental sequence. 2.1.1 Components of Emergent Literacy and the Underlying Theoretical Framework Modern interpretation of the concept of emergent literacy is grounded in Teale and Sulzby's (1986) definition which refers to emergent literacy as pertaining to the reading and writing behaviours that precede and develop into conventional literacy (Justice, 2006). Historically researchers have been interested in studying the materials, activities and interactions that play a prominent role in the development of children's emergent literacy (Koppenhaver & Erickson, 2003). This research has given rise to a number of different theoretical models of emergent literacy which seek to describe and organise the components into a comprehensive framework. Comprehensive models share similarities in their inclusion of the components of (i) conceptual knowledge about literacy, (ii) procedural knowledge related to reading and 7 writing, (iii) oral language, and (iv) metalinguistic skills (Mason & Stewart, 1990; Sénéchal et al., 2001; Storch & Whitehurst, 2002; Van Kleeck, 1998; Whitehurst & Lonigan, 1998). Where researchers diverge in their models, is in the component knowledge and skills they ascribe to emergent literacy and the patterns of acquisition that characterise typical development (Justice, 2006; Rhyner, 2009). There is strong support in the literature to indicate that both oral language skills and metalinguistic skills are pivotal in the development of children’s literacy skills (Bishop & Adams, 1990; Blachowicz & Fisher, 2008; Catts, Fey, Zhang, & Tomblin, 1999; Scarborough, 1989; Storch & Whitehurst, 2002; Whitehurst & Lonigan, 1998). Early models of emergent literacy (e.g. Mason & Stewart, 1990; Van Kleeck, 1998; Whitehurst & Lonigan, 1998) typically include oral language and metalinguistic knowledge as components. Sénéchal et al. (2001) proposed an alternative model of emergent literacy, which they describe as a ‘focused view of the construct of emergent literacy’ (p448). In contrast to earlier models, this view proposes that language skills, metalinguistic skills and print knowledge are distinct constructs, which are closely interrelated (see Figure 1). A further departure from earlier models is in the explicit delineation of the components of the construct of emergent literacy into two distinct sub groups: (i) children’s conceptual knowledge and (ii) children’s early procedural knowledge of reading and writing. Conceptual knowledge relates to understanding of the functions of print and perceptions of the self as a reader. Procedural knowledge pertains to children’s understanding of the mechanics of reading and writing. Although the groupings of component skills described in earlier models (Mason & Stewart, 1990; Whitehurst & Lonigan, 1998) align with the notion of conceptual and procedural skills, Sénéchal et al. (2001) were the first theorists to identify and label these distinct groups of skills. Three sources of support for this alternative view are cited from within the field of emergent literacy research. The first source is the disconnect between the underlying models used by 8 researchers and the manner in which they conduct their research. Although researchers typically include oral language and metalinguistic skills within the construct of emergent literacy, they typically analyse these as separate constructs (Sénéchal et al., 2001). There is further support in the body of research investigating the influence of environmental factors. Activities that are positively related to emergent literacy development have been shown to have varying degrees of influence over different skills. Storybook reading influences children’s oral language but not print knowledge or phonological awareness (Sénéchal, Lefevre, Thomas, & Daley, 1998). In contrast, direct teaching of letters and letter- sound knowledge is linked to children’s print knowledge but not oral language (Whitehurst, Epstein, et al., 1994). The third source of support is found in the results of empirical tests which show that emergent literacy is not a unitary construct. Models that separate print knowledge from oral language and metalinguistic skills, more accurately encapsulate children’s performance than models that combine these components (Lonigan, Burgess, & Anthony, 2000; Whitehurst, Epstein, et al., 1994). In separating the constructs of emergent literacy, oral language, and metalinguistic skills, Sénéchal et al. (2001) acknowledge a close relationship between these constructs but do not identify the strength or nature of these relationships. 9 Figure 1: Focused View of the Construct of Emergent Literacy Print / Literacy Knowledge Procedural Knowledge Preconventional spelling Letter knowledge Grapheme-phoneme correspondences Word reading Conceptual Knowledge Knowledge about the acts of reading and writing Knowledge about the functions of literacy Self perception of learning to read Emergent reading in context Metalinguistic Skills Phonological awareness Syntactic awareness Oral Language Narrative knowledge Vocabulary Knowledge of the world 10 2.2 The Importance of Emergent Literacy for Later Literacy Achievement The recognition that literacy development commences prior to the onset of formal education has led researchers to view emergent literacy development as a continuum that spans the period before children attain literacy through formal literacy instruction. This perspective recognises the importance of the literacy related behaviours and skills that develop from birth as the foundations for later acquisition of conventional literacy (Justice, 2006; National Early Literacy Panel, 2010; Rhyner, 2009). Conventional literacy refers to the literacy related skills that are typically acquired through formal instruction during the school years. Conventional literacy encompasses the component skills of decoding, oral reading fluency, reading comprehension, writing and spelling (National Early Literacy Panel, 2010). Researchers have long been interested in the relationships between the component skills of emergent literacy and their impact on later literacy development. Researchers differ in the importance they ascribe to the various emergent literacy skills that precede the development of conventional literacy. Storch and Whitehurst (2002) suggest that these differences may be related to the ages at which researchers assess children’s conventional literacy skills. There is support in the literature for the notion that different emergent literacy skills make their most significant contribution at different points in development (Speece, Roth, Cooper, & de la Paz, 1999; Whitehurst & Lonigan, 1998). Thus it is logical that the ages at which children are assessed may give rise to different findings in terms of the relationships between emergent literacy skills and later achievements. A meta-analysis conducted by the National Early Literacy Panel (National Early Literacy Panel [NELP], 2008) sought to identify interventions and environmental practices in the home and education settings which promote children’s early literacy skills. The panel reviewed over 500 published studies in order to identify the emergent literacy skills and abilities that are most strongly related to later literacy achievement. Their findings revealed 10 early literacy skills with moderate to large predictive relationships to later literacy 11 achievements in reading, writing and spelling. Skills with a large predictive relationship with at least one measure of later literacy achievement included alphabet knowledge, phonological awareness, rapid automatic naming of letters or digits, rapid automatic naming of objects or colours, writing or name writing and phonological memory. Skills with moderate predictive relationships included oral language, concepts about print, print knowledge and visual processing. Not surprisingly, four of these skills: alphabet knowledge; concepts about print; phonological awareness; and oral language are common components in models of emergent literacy. The links between these four early literacy skills and later literacy achievement are outlined in the following sections. 2.2.1 Alphabet knowledge Longitudinal research has consistently identified alphabet knowledge as a significant predictor of children's later success in reading (Catts, Fey, Zhang, & Tomblin, 2001). Letter name knowledge is often viewed as a landmark in alphabetic literacy acquisition (Whitehurst & Lonigan, 1998). This knowledge is thought to underpin a series of literacy-related skills; the most obvious being letter-sound knowledge and phonemic sensitivity skills (Foulin, 2005) These skills are fundamental to the development of the alphabetic principle, whereby a letter in print represents a phoneme in speech (Vellutino & Scanlon, 1987). This knowledge plays an important role in the foundational stages of learning to read and spell successfully (Bond & Dykstra, 1967; Mutter, Hulme, Snowling, & Taylor, 1997; Scarborough, 1998; Share, Jorm, Maclean, & Matthew, 1984). Strong support for these relationships exist in the literature. Letter name knowledge at school entry is a strong predictor of children's reading progression in the first two years of school (National Reading Panel, 2000). Letter name knowledge has been shown to be the single best predictor of children's reading achievement at the end of Year 1 (Bond & Dykstra, 1967; Scarborough, 1998; Share et al., 1984) and the second best predictor following phoneme segmentation of reading achievement at the end of Year 2 (Share et al., 1984). A 12 similar relationship exists for spelling, with letter name knowledge at school entry being a strong predictor of early spelling achievement (Mutter et al., 1997). 2.2.2 Concepts About Print Concepts about print refer to children's knowledge of print conventions and concepts. It includes awareness that print conveys a message, and awareness of print conventions such as directionality, differences between letters and words, distinctions between upper and lower case letters and features of books (Clay, 1972). This knowledge helps children to understand the arbitrary conventions that are used when spoken language is transformed into the written form (Clay, 2000). Concepts about print knowledge is strongly correlated with later measures of reading comprehension and moderately correlated with both later decoding and spelling abilities. The strength of these relationships are weakened when other variables are controlled for (National Early Literacy Panel, 2008), however, concepts about print underpin formal reading instruction. Most reading instruction assumes that children have strong concepts about print knowledge, so this knowledge supports children to navigate the early stages of learning to read. 2.2.3 Phonological Awareness Phonological awareness refers to an understanding of the units of sound that make up spoken words and includes syllable awareness, onset-rime awareness, and phoneme awareness (Gillon, 2004). These skills, are thought to be particularly important for later formal reading instruction, as awareness of the smaller units of sound enables children to map phonemes to graphemes and vice versa, supporting both word recognition and spelling (Bryant, MacLean, Bradley, & Crossland, 1990; Centre for the Improvement of Early Reading Achievement, 2006; Gillon, 2004; Gillon & Dodd, 1994; Hogan, Catts, & Little, 2005; 13 Lonigan et al., 2000; National Reading Panel, 2000; Stanovich, Cunningham, & Freeman, 1984; Wagner & Torgesen, 1987). The link between phonological awareness and reading achievement has been extensively documented by researchers interested in the links between emergent literacy skills and later reading performance. Evaluation of correlation studies has shown phonological awareness skills at school entry to be highly predictive of children's reading achievement in their first two years of schooling (National Reading Panel, 2000). Phonological awareness abilities of preschool children more accurately predict their early spelling and reading development than variables such as intelligence scores, age or socioeconomic status (Bryant et al., 1990). Research suggests that skills at the phoneme level are of particular importance (Gillon, 2004). Preschool children's phoneme analysis skills have been shown to be highly correlated with segmentation skills in Year 1. In turn, children’s segmentation skills have been shown to be highly predictive of children's reading and spelling abilities at the end of Year 2. Phonological awareness interventions have been shown to have positive effects on children's literacy skills irrespective of their age or prior literacy knowledge (National Early Literacy Panel, 2010). Given that persistent weaknesses in phonological awareness skills are frequently cited as an underlying cause of reading disabilities in older children (Catts & Kamhi, 2005), the NELP findings suggest that it is advantageous to commence phonological awareness interventions for at risk populations in the preschool years. 2.2.4 Oral Language The ability to derive or convey meaning in the written form is dependent on an understanding of spoken language. There is debate in the literature surrounding the extent to which oral language skills independently influence literacy development, however, it is widely recognized that oral language skills are crucial in the development of skilled reading. Oral 14 language skills are thought to play an important role in children’s literacy acquisition at different points in their development. Storch and Whitehurst (2002) showed the importance of oral language to literacy development reduced after kindergarten but re-emerged to significantly predict reading comprehension in third grade. Oral language skills at age 3 directly related to comprehensive vocabulary and code related skills in phonological knowledge at age 4 ½. Oral language skills at age 4 ½ related both directly and indirectly to first grade word recognition and third grade reading. Oral language processes with strong links to reading attainment include vocabulary knowledge (Cunningham, 2005; Nagy, 2005; Whitehurst & Lonigan, 1998), syntactic knowledge (Bishop & Adams, 1990; Scarborough, 2001) and oral narrative skills (Cain & Oakhill, 1996; Vernon-Feagans, Hammer, Miccio, & Manlove, 2001; Westerveld, Gillon, & Moran, 2008). Extensive vocabulary knowledge supports understanding and there is a strong relationship between early vocabulary knowledge and later reading comprehension (Cunningham & Stanovich, 1997; Nagy, 2005). As children begin the process of learning to read, their oral vocabulary helps them to link the written and oral representations. As children become more skilled readers, their vocabulary plays a pivotal role in developing reading comprehension. In the same way, children’s syntactic knowledge and oral narrative abilities support their comprehension of written text and story structure. There is evidence to suggest a language basis of some reading disabilities with oral language difficulties in the preschool years presenting as a significant risk factor for reading difficulties (Catts & Kamhi, 2005; Nagy, 2005; Scarborough, 2001). Differences in oral language and vocabulary skills upon school entry frequently persist and are thought to exacerbate the achievement gap throughout the school years (Blachowicz & Fisher, 2008; Ministry of Education, 2009). Research indicates a positive and moderate association between children’s early oral language skills and later reading abilities (Catts, Fey, Tomblin, & Zhang, 2002; Catts et al., 1999; Storch & Whitehurst, 2002). Studies have shown that 15 children with significant language difficulties at the point of school entry are more likely to become struggling readers than their peers (Bishop & Adams, 1990; Catts et al., 2002). This is of particular significance to the literacy outcomes of young children with ASD as a high proportion of children with ASD exhibit language differences that are markedly different from their peer group (Noens & Van Berckelaer-Onnes, 2005; Wilkinson, 1998) . 2.3 Current Best Practice in Emergent Literacy Intervention Acquisition of emergent literacy knowledge and skills is supported by rich literacy environments, where language, books, print, pencils and paper are embedded in everyday interactions. Snow et al. (1998) describe rich literacy environments as those where: (1) literacy has a high value; (2) there is an expectation for achievement; (3) reading materials are available and utilised for a variety of functions; (4) children are frequently read to, and (5) there are frequent and varied opportunities for verbal interaction. For the majority of children, inclusion in a literate society where they have access to rich literacy environments and naturally occurring learning opportunities, will be sufficient to develop the necessary skills that underpin conventional literacy achievement (Justice, Chow, Capellini, Flanigan, & Colton, 2003). A number of children, however, will need additional support and require further explicit instruction in specific components. Many of these children are at risk of later literacy difficulties due to factors such as language impairment (Bishop & Adams, 1990; Lonigan et al., 2000), poverty (Whitehurst, Epstein, et al., 1994), or speech impairment (Catts et al., 2001). The embedded-explicit model (Justice & Kaderavek, 2004; Kaderavek & Justice, 2004) provides a service delivery framework for speech language therapists supporting emergent literacy interventions for at-risk children. Justice and Kaderavek (2004) suggest that efficacy of intervention will be maximised through the synthesis of two different intervention modes under the umbrella of strong evidence based practice. The premise of this model is to provide children with socially embedded opportunities for meaningful, naturalistic literacy 16 experiences throughout the day, in addition to regular structured learning activities that explicitly target critical components of emergent literacy. Speech language therapists can promote high quality emergent literacy environments by encouraging and supporting early childhood educators and caregivers to provide socially embedded literacy experiences. Embedded intervention activities primarily focus on utilising literacy activities to enrich and maximise oral language input. Adults support the child's learning by providing oral language input in the context of natural literacy learning opportunities. Intervention is anchored in socially embedded literacy experiences within the home and preschool environments. Speech language therapists can also play a central role in providing explicit interventions to children at risk in the contexts that facilitate transfer of discrete skills into the context of children’s written language experiences and activities. Explicit intervention involves highly structured and sequenced instruction targeted to develop specific skills. Discrete skills that have a key role in children's later literacy acquisition are targeted via explicit instruction. Kaderavek and Justice (2004) identify the domains of phonological awareness, print concepts, alphabet knowledge, writing, narrative and literate knowledge as areas for explicit instruction. The explicit component of this approach is governed by three overarching principles. These principles are grounded in the research base and are underpinned by best practice in the field of emergent literacy (Kaderavek & Justice, 2004). The first of these principles is described as the ‘response to treatment model’. Children are identified for intensive intervention based on their response to primary interventions. Thus explicit intervention is comprised of whole class instruction that is supplemented by further small group or one to one intensive intervention for those children who do not respond to whole class learning opportunities. The second level of intervention allows for speech language therapists to be 17 involved in individualising the intervention to meet the specific needs of the children who require explicit emergent literacy intervention. The second principle of the embedded-explicit model is 'collaboration'. Within this model collaboration means that both the classroom teacher and the speech language therapist have a shared responsibility for emergent literacy intervention. Typically the classroom teacher takes the lead in delivery of the embedded component and the whole class explicit intervention. While the speech language therapist takes the lead in the delivery of the second level of targeted intervention, they also have a role in the whole class interventions both in terms of planning, delivery through co-teaching and facilitating discussions about children’s progress. The use of 'supportive technique' is the third principle underpinning the embedded-explicit model. Kaderavek and Justice (2004) identify four supportive techniques that are grounded in the language and literacy research base. These include the use of intermediate targets, context manipulation, dynamic assessment, and cycled targets. Intermediate targets refer to targets that are achievable to the child with intensive adult support. Targets should be challenging but presented in a supported environment with high levels of adult scaffolding to achieve success. Context manipulation refers to creating frequent opportunities for children to use targeted skills across a variety of social, physical and linguistic contexts. Dynamic assessment involves ongoing monitoring of the child’s ability to learn a specific skill with adult scaffolding. During this process children are actively involved in learning tasks and adults engage in ongoing monitoring of the child’s engagement, support required to completed the tasks and their knowledge of the targeted skill. Finally the goals targeted in the embedded-explicit model follow a cyclic pattern with multiple goals targeted over a period of time. 18 2.4 Autism Spectrum Disorders Defined Autism spectrum disorder (ASD) is the collective name used to refer to the group of pervasive neuro-developmental disorders that were first described in the literature in the mid 1940s. Leo Kanner and Hans Asperger both presented detailed case descriptions of children who presented with impaired communication, stereotyped behaviours, a high need for uniformity, and limited affective contact with other people. These early descriptions of autism and Asperger syndrome continue to form the basis of modern diagnostic criteria for ASD (Frith, 2003; Wing, 1996). Until very recently, ASD was an umbrella term that encompassed a cohort of distinct medical diagnoses that shared common features. These diagnoses included autistic disorder, Apserger Sydrome, childhood disintegrative disorder and pervasive developmental disorder-not otherwise specified (PDD-NOS) (American Psychiatric Association, 1994). The less well known disorders of Rett syndrome, Fragile-X and childhood disintegrative disorder have also been associated with ASD (American Psychiatric Association, 1994; Wing, 1996). The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM- 5) (American Psychiatric Association, 2013a) has seen a major shift in the way that ASD is classified. Concerns about inconsistent application of the four ASD diagnoses used in the previous edition and advances in our understanding of ASD have been the driving forces behind the criteria changes (American Psychiatric Association, 2013b; Gibbs, Aldridge, Chandler, Witzlsperger, & Smith, 2012). The DSM-5 now has one diagnosis of ‘Autism Spectrum Disorder’ with the diagnostic criteria comprising of deficits in two behavioural domains: (i) social communication and interaction and (ii) unusually restricted, repetitive behaviours and interests. A severity scale is used to reflect the spectrum nature of ASD, enabling clinicians to explain the variations in symptoms, behaviour, and functioning between individuals (American Psychiatric Association, 2013a, 2013b; Lai, Lombardo, Chakrabarti, & Baron-Cohen, 2013). Two further departures from the DSM-IV include the separation of language ability from the diagnostic criteria. Under the DSM-5 an individual 19 can have ASD with or without a language disorder. Finally the DSM-5 recognises that symptoms should present in early childhood but acknowledges that for some individuals symptoms may not be evident until social demands outstrip the individual’s coping mechanisms (American Psychiatric Association, 2013b). There is wide variability in the estimated prevalence of ASD across different studies. The age of screening and the diagnostic tool used have been found to be strongly correlated to prevalence estimates (Williams, Higgins, & Brayne, 2005). Recent data from the UK reports that autism spectrum conditions affect 1% of the population (Baron-Cohen, 2008; National Autistic Society, 2007). Official New Zealand estimates suggest that 40,000 New Zealanders are affected by ASD (Ministry of Health and Education, 2008). Early field trials of the new DSM-5 indicate high levels of reliability for individuals previously diagnosed with a specific ASD diagnosis under the DSM-IV. Prevalence rates are likely to remain the same, however the changes in the DSM-5 may support earlier diagnosis as the DSM-IV was more aligned with diagnosis in school aged children. Early field trials also suggest that the new criteria may be more sensitive to higher functioning individuals (American Psychiatric Association, 2013b; Huerta, Bishop, Duncan, Hus, & Lord, 2012). 2.5 Challenges in Emergent Literacy Learning for Children with ASD Children with ASD have been shown to pass through the same stages of reading development as their peers without ASD on the route to becoming skilled readers (Calhoon, 2001; Koppenhaver & Erickson, 2003). Despite these similar trajectories, they face a number of challenges from the earliest stages of their literacy development. These challenges frequently lead to low levels of literacy. Children with ASD can experience difficulties conforming to expected educational norms as a result of their movement, sensory, communication, and learning differences. These differences pose a challenge not only in terms of accurate assessment of an individual’s literacy profile but also in planning and 20 adapting interventions so that the learner with ASD is able to engage and demonstrate their knowledge and skills (Cain & Oakhill, 1996; Carnahan & Williamson, 2012; Kluth, 2003). 2.5.1 The Influence of Assumptions on Literacy Outcomes Children with ASD are frequently faced with the assumption that they lack the skills to engage with literacy activities and artefacts (Carnahan & Williamson, 2012; Kluth & Chandler-Olcott, 2008; Mirenda, 2003). This assumption can lead to restricted opportunities to participate in literacy experiences from a very early age. In the school years, it may be assumed children with ASD are incapable of learning to read. This assumption may be based on IQ scores as indicated on a cognitive assessment, communication difficulties, or by an inability to demonstrate knowledge and skills in the context of standard classroom activities and assessment tools. Restricted opportunities and inadequate or inappropriate literacy instruction can lead to poor literacy outcomes for children with ASD (Basil & Reyes, 2003; Kluth & Chandler-Olcott, 2008; Koppenhaver & Erickson, 2003; Mirenda, 2003; Mirenda & Erickson, 2000). 2.5.2 Communication Differences Differences in communication pose the most obvious challenge to literacy learning in terms of a child’s ability to demonstrate competence in the expected ways. Many children with ASD are unable to use speech to communicate. Those children who are able to speak often have delayed or atypical speech and expressive language (Noens & Van Berckelaer-Onnes, 2005; Wilkinson, 1998).Young children with ASD may not be able to indicate to caregivers that they wish to engage with books in the same ways that their peers do. A study by Lanter (2009) suggests that despite parental reports of high levels of literacy motivation in children with ASD, only 65% were reported to ask or gesture to their parents to read them a book. Children with ASD often need additional time to process and respond to questions used in verbal discussions. They may also have difficulties comprehending and responding to the typical question formats used in literacy interactions such as shared storybook reading. 21 Typically children with ASD will find it easier to answer identification questions (e.g. 'what is in the tree?') than other types of question formats (Lanter et al., 2012). Social aspects of communication also pose problems for literacy learning and may require adaptations to enable participation. As children progress through formal education, the ability to interact with peers becomes a more important feature of literacy instruction. Children with ASD may find it challenging to participate in pairs or small groups (Kluth & Chandler-Olcott, 2008). Communication differences can make it difficult for children with ASD to demonstrate their literacy knowledge and skills in the expected ways. Different patterns in behaviour and performance pose challenges for teachers trying to make accurate assessments of an individual's abilities, strengths and needs. In addition to differences in expressive communication, many children with ASD have impaired language comprehension which is an essential component of skilled reading (Cunningham, 1993). Language comprehension difficulties are not unique to children with ASD. They do, however, appear to have an impact on their literacy profiles. Studies consistently show that many children with ASD demonstrate significant difficulties in the area of reading comprehension (Åsberg, Dahlgren, & Dahlgren Sandberg, 2008; Asberg, Kopp, Berg-Kelly, & Gillberg, 2010; Jones et al., 2009; Nation et al., 2006). Aram (1997) suggests that language comprehension difficulties are the underlying cause of reading comprehension difficulties in children with ASD. Children with ASD typically demonstrate strengths in understanding the form of language but have more difficulty understanding language function. Differences in language development such as a propensity for learning nouns over verbs, difficulties with morphological features of language and difficulties with pronouns all impact on children's ability to understand text (Carnahan & Williamson, 2012). Studies suggest that while individuals with ASD may be able to comprehend information, they frequently have difficulties interpreting inferential information (Minshew, Goldstein, & Siegal, 1995; Rumsey & Hamburger, 1988). They experience difficulties integrating information from 22 multiple sources and rely more heavily on their own knowledge of the world (Koppenhaver, 2010). Carnahan and Williamson (2012) posit three cognitive processing styles that are common in individuals with ASD which are likely to have a strong influence on the comprehension of written text. These include theory of mind, executive functioning, and central coherence. Differences in cognitive processing for children with ASD in these three areas are thought to contribute to difficulties in inferring information, assuming the perspectives of others, applying relevant knowledge to aid comprehension, integrating new information and assimilating information within text to make sense of the text as a whole. These three difficulties, alongside differences in social communication are thought to influence the way in which children with ASD engage with literacy activities and go some way to explaining the differences in reading comprehension levels that are frequently observed in this population. 2.5.3 Special or Restricted Interests Restricted interests can negatively impact on the extent of a child’s vocabulary and world knowledge. Restricted interests are often viewed as a barrier to literacy learning rather than as a vehicle through which literacy experiences can be expanded (Mirenda, 2003). A child with a severely restricted range of interests may require a high degree of personalisation of literacy materials to enable them to engage and participate in meaningful literacy activities. Using a child’s specific interests as a conduit for developing literacy-related knowledge and skills will enable them to be able to write, draw, and communicate about their specific interest and may lead to opportunities to extend their interests and knowledge of the world (Calhoon, 2001; Kluth & Chandler-Olcott, 2008; Mirenda, 2003). 2.5.4 Sensory Challenges Sensory differences have widely been described in the literature with regards to individuals with ASD (Frith, 2003; Gillberg, 2002; Wing, 1996). Educators have described children who 23 respond in unusual ways to books such as smelling, touching, or manipulating a book in a specific way. A child may find it difficult to remain in close proximity to other children as is required when sitting on the mat for story time or working in a group for an instructional activity. An acute sense of smell may interfere with the child’s ability to concentrate on other aspects of a book or make it impossible for a child to engage with certain materials that have a particular smell (Kluth & Chandler-Olcott, 2008; Mirenda, 2003; Vacca, 2007). Similarly in a learning environment, children may experience sensory overload from the auditory or visual stimuli present making it difficult to attend to literacy activities or instruction (Carnahan & Williamson, 2012). Acknowledging atypical responses or sensory behaviours and seeking to understand how they can be accommodated for in literacy instruction is a vital step in helping a child with ASD to succeed in literacy learning. 2.5.5 Movement Differences Individuals with ASD frequently experience delays in their motor skills and development (Landa & Garrett-Mayer, 2006) and often display difficulties with movement (Provost, Lopez, & Heimerl, 2007). These difficulties can manifest in a variety of ways such as an unusual gait, excessive movements, repetitive stereotyped movements (e.g. rocking, hand flapping), difficulty imitating movement, or difficulty with physical transitions (National Institute of Mental Health, 2004; Wing, 1996). Movement difficulties can impact on a child’s ability to participate in a number of aspects of literacy instruction such as sitting for sustained periods of time, turning pages, tracking print, raising one’s hand to indicate a desire to participate or handwriting. Many children with ASD experience motor planning difficulties (Frith, 2003). Motor planning difficulties involve difficulty planning sequences of coordinated movements as well as difficulty executing motor plans even when they are known (Gowen & Hamilton, 2013). Motor planning difficulties affect children’s ability to learn through imitation, and when combined with sensory needs, can make writing challenging. In some cases children may avoid writing 24 altogether. There are many ways, however, that technology and adaptive equipment can be used to encourage emergent writing skills. Unfortunately children often do not have access to these technologies in a timely manner that enables these skills to be fostered from an early age (Breit-Smith & Justice, 2012) 2.6 Literacy Profiles in Children with ASD Over the past decade there has been a small body of research focusing on emergent literacy learning in children with ASD. Initial descriptions of emergent literacy skills in this population were the result of two doctoral studies: Rosenberg (2008) and Lanter (2009). These studies involved 32 children with ASD between the ages of 4 and 6 years and 41 children between the ages of 4;0 and 7;11 years respectively. Both groups exhibited wide variability in achievement both across and within component skills of emergent literacy with high levels of impaired oral language skills a salient feature. Assessment of emergent literacy skills was possible for all participants, however, Rosenberg reported an increased likelihood of stopping subtests prematurely in participants with more severe ASD. As a group, children with ASD perform below average on assessments of emergent literacy skills. Children are more likely to show mastery or a complete lack of skills, rather than a typical distribution across scores that is observed in children without disabilities. Studies consistently report wide heterogeneity in individual abilities. High levels of oral language impairment are common (Lanter, Freeman, & Dove, 2013; Lanter et al., 2012; Rosenberg, 2008). Children with ASD demonstrate relative strengths in print awareness and alphabet knowledge alongside relative weaknesses in oral language skills and print conventions (Lanter et al., 2012; Rosenberg, 2008). Lanter et al. (2013) suggest that for children with ASD there is a 'disassociation of procedural and conceptual print related skills' (p. 21). Collectively these studies point to the importance of oral language skills in overall emergent literacy development for children with ASD. Rosenberg (2008) reported a high correlation 25 between receptive vocabulary and overall emergent literacy for children with ASD ( >.7) as measured on the Test of Preschool Early Literacy (Lonigan, Wagner, & Torgesen, 2007) and the Phonological Awareness Literacy Screening for Preschool (Invernizzi, Meier, Swank, & Juel, 2004). Lanter et al. (2012) also acknowledged the importance of oral language for this population. Their study documented strong correlations between language abilities and total emergent literacy scores (ρ =.56, p <0.01). Moderate correlations between language abilities and other component skills were found for letter name identification (ρ =.34, p =.02), letter sound correspondence (ρ =.42, p =.00), environmental print (ρ =.40, p = 0.01), print concepts (ρ = 0.35, p =.01), emergent writing (ρ =.47, p<.01). These relationships are consistent with findings in typically developing children (National Early Literacy Panel, 2010; National Institute of Child Health and Human Development Early Child Care Research Network, 2005). 2.6.1 Continuity Between Emergent Literacy and Conventional Literacy Profiles Comparison between emergent literacy studies and those focusing on conventional literacy reveal continuity of trends. Nation et al. (2006) investigated the reading skills of 41 children with ASD ranging in age from 6 to 15 years. In order to include a broad range of participants, clinicians were asked to refer children with any level of measurable language skill. Nine of the 41 participants were unable to demonstrate an ability to read on the assessment tasks used in the study. These children were among the youngest in the study. The results of the remaining 32 participants showed wide heterogeneity of individual reading skills with standard scores ranging from floor to ceiling levels. As a group, mean scores were within the normal range for reading accuracy (word reading and non-word reading) and 1SD below the mean for reading comprehension. Impaired reading comprehension relative to strong decoding skills was the most prevalent profile and this has consistently been reported in other studies (Åsberg et al., 2008; Calhoon, 2001; Mayes & Calhoun, 2003b; Minshew, Goldstein, Taylor, & Siegal, 1994). 26 As with emergent literacy, vocabulary and oral language comprehension were found to be important, with strong correlations to reading comprehension. The link between oral language impairments and reading difficulties is widely accepted by researchers in the field of literacy (Cain & Oakhill, 2007; Catts & Kamhi, 2005). The identification of strong correlations for vocabulary and oral language skills with other component literacy skills suggests a similar relationship exists for children with ASD. That these relationships are evident in emergent and conventional studies suggests that both vocabulary and oral language play a pivotal role in the attainment of literacy skills for children with ASD irrespective of age and skill level. 2.7 Emergent Literacy Interventions for Children with ASD Research focusing on effective literacy interventions for children with ASD is in the preliminary stages. To date research has predominantly focused on interventions targeting conventional literacy skills, however there is a small but growing body of research focused on emergent literacy interventions for this population (e.g. Bellon, Ogletree, & Harn, 2000; Koppenhaver & Erickson, 2003; Koppenhaver, Erickson, Harris, et al., 2001; Koppenhaver, Erickson, & Skotko, 2001; Pamparo, 2012; Travers et al., 2011). In order to develop emergent literacy skills, children need access to quality literacy materials, and opportunities to engage with these materials in supported interactions that take place in naturally occurring situations (Sénéchal et al., 2001; Teale & Sulzby, 1986). There is emerging evidence to suggest that these children do indeed benefit from the same materials, experiences and interactions as their peers without ASD. 2.7.1 Environmental Interventions Children with ASD have been shown to benefit from literacy interventions that increase the quality of literacy materials and experiences in natural learning environments. Koppenhaver and Erickson (2003) investigated the impact of providing access to a print-rich environment and increasing natural learning opportunities for three preschool children with ASD. At the 27 beginning of the study, none of the children engaged in self-selected literacy activities due to the lack of available materials and tools. The children were allowed access to a small selection of books for a few minutes each day and were given structured writing activities 2-3 times a week. During the intervention phase, the researchers increased natural learning opportunities for emergent literacy. Text was integrated into existing routines, a range of reading and writing materials were introduced and made freely available, and natural learning opportunities were used to talk about literacy materials and events with researchers drawing attention to the form, content, and use of written language. At the completion of the 5 month intervention phase, all three children were reported to spend 30% or more of their free time engaged in literacy-related activities. The researchers also documented qualitative gains in the children’s self-selected and independent book reading, and emergent writing. These findings suggest that children with ASD can benefit from access to the same materials, tools, and adult supports that are known to underpin emergent literacy development for children without disabilities. Encouraging access to literacy rich environments and experiences by sharing information with parents and educators is an important first step in supporting children with ASD to achieve their literacy potential. 2.7.2 Shared Storybook Interventions Shared storybook reading in the preschool years is known to be beneficial to the development of children’s language, vocabulary and communication skills (Mol, Bus, de Jong, & Smeets, 2008; Sénéchal & Cornell, 1993) as well as supporting growth in emergent literacy knowledge (Teale & Sulzby, 1986). The shared experience of looking at a book with a child provides a natural platform for imitating, labelling, and expanding language and vocabulary. In addition to the benefits for children's language, shared storybook reading also supports the development of children's print concept knowledge (Stewart & Lovelace, 2006; Whitehurst & Lonigan, 1998). Through shared storybook reading, young children begin to 28 understand book conventions, (e.g. how to hold a book) print conventions (e.g. directionality of reading) and print form (e.g. words are made up of letters). To date there has been limited research investigating the efficacy of shared storybook interventions with young children with ASD. There is tentative evidence to suggest that repeated storybook reading leads to improvements in spontaneous oral language. Bellon et al. (2000) presented a single case study involving a child described as 'high functioning' and may not be applicable to individuals with more complex presentations. Older children with ASD have been found to benefit from storybook based interventions. Colasent & Griffith (1998) investigated the effects of thematic storybook reading with older children with ASD. Thematic storybook reading was an effective strategy for improving the recall of oral narratives and the quality of story writing. Research with other populations with complex communication and learning needs suggests that storybook interventions are beneficial for these populations (Aram, Most, & Mayafit, 2006; DesJardin, Ambrose, & Eisenberg, 2009; Justice, Skibbe, McGinty, Piasta, & Petrill, 2011). Studies involving girls with Rett Syndrome, a syndrome previously associated with ASD in the DSM-IV (American Psychiatric Association, 1994) demonstrated gains in communication and vocabulary use from storybook based interventions. (Koppenhaver, Erickson, Harris, et al., 2001). Individuals with Rett syndrome experience significant difficulties with communication and learning, and the findings may be applicable to children with ASD. Wide and varied reading is known to make a positive contribution to children’s vocabulary and these studies suggest that storybook reading may be beneficial in developing the literacy skills of children with ASD. 2.7.3 Dialogic Reading Whitehurst et al. (1988) hypothesised that the greatest benefits from shared storybook reading would occur when parents employed techniques that encouraged children’s active 29 participation in storybook reading. Numerous studies have trialled dialogic reading, a style of interactive reading designed to optimise parental input during shared storybook reading. In dialogic reading, adults are trained to use five types of questions that encourage children to talk about the pictures as well as a series of language stimulation prompts. Dialogic reading has been shown to have significant benefits for typically developing young children and children with language delays with gains in vocabulary and mean length of utterance (Arnold, Lonigan, Whitehurst, & Epstein, 1994; Whitehurst, Arnold, et al., 1994; Whitehurst, Epstein, et al., 1994; Whitehurst et al., 1988). There is emerging evidence to suggest that similar benefits exist for children with ASD. Two recent dissertations have studied the impact of a dialogic style reading interventions on the oral language skills of young children with ASD (Pamparo, 2012; Plattos, 2011). One of these, Pamparo, focused specifically on preschool children with ASD and involved 14 children aged between 3:0 years and 5 years 7 months. Participants were engaged in a dialogic reading intervention 3-4 times per week over the course of the 5 week intervention. Comparison of baseline and post intervention data indicated that gains in book specific vocabulary were greater for dialogic reading than for traditional book reading. Moderate improvements were also observed in the participants’ definitional vocabulary knowledge. Researchers also reported qualitative and quantitative improvements in verbal participation and gains in listening comprehension from pre to post test. Although these results have not yet been published, and so must be treated with caution, they suggest that dialogic reading is an intervention that is worthy of further investigation for its potential benefits on the oral language skills of young children with ASD. 2.7.4 Technology Based Interventions There is a cluster of research investigating the efficacy of computer based literacy interventions with older children with ASD (Basil & Reyes, 2003; Coleman-Martin, Heller, Cihak, & Irvine, 2005; Heimann, Nelson, Tjus, & Gillberg, 1995; Tjus, Heimann, & Nelson, 30 1998), however until very recently this method of intervention has not been trialed with the preschool population. Travers et al. (2011) conducted a study comparing two instructional conditions for teaching alphabetic skills to preschool children with ASD. The study compared the effects of teacher led group instruction and multimedia computer assisted instruction. Both instructional conditions were effective in developing children's letter name knowledge within a relatively short time frame. Comprehensive assessment of participants’ emergent literacy skills was not conducted so it is difficult to know if alphabet knowledge was an area of weakness. Alphabet knowledge is frequently an area of relative strength for children with ASD (Lanter et al., 2012). This makes it difficult to accurately evaluate the value of the two interventions; however the positive results tentatively suggest that preschool children with ASD benefit from explicit alphabet instruction. It is possible that other discrete emergent literacy skills may be amenable to explicit instruction. 2.8 The New Zealand Context Official New Zealand estimates suggest that 40,000 New Zealanders are affected by ASD, with as many as 8000 of these individuals participating in the early childhood and compulsory education sectors (Ministry of Health and Education, 2008). The shift in policy direction within New Zealand towards inclusive education over the past 20 years (Ministry of Education, 2010b) means the majority of children with ASD are included in mainstream settings. High rates of early childhood participation in New Zealand (Ministry of Education, 2014) mean that it would be reasonable to expect that the majority of children with ASD will have had some experience of early childhood education prior to school entry. Current educational policy in New Zealand recognises the importance that literacy plays in successful outcomes for children with a strong focus on literacy in the New Zealand Curriculum (Ministry of Education, 2007) and in National Standards (Ministry of Education, 2010a). There is currently a strong emphasis on raising literacy achievement in the compulsory school sector (Ministry of Education, 2007, 2010a) with particular emphasis on 31 priority learners such as Maori and Pasifika children (Ministry of Education, 2013; Te Tāhuhu o te Mātauranga Ministry of Education, 2013). Although there are not specific mandates relating to the early childhood sector, the New Zealand early childhood curriculum Te Whāriki, (Ministry of Education, 1996) recognises the importance of literacy development in the preschool years with emergent literacy an integral component of the communication strand. Te Whāriki promotes a socio-cultural perspective which informs emergent literacy practices within the early childhood centre. Te Whāriki states that "the languages and symbols of children's own and other cultures are promoted and protected in an environment where children; develop non- verbal communication skills for a range of purposes, develop verbal communication skills for a range of purposes, experience the stories and symbols (...)of their own and other cultures, and discover and develop different ways to be creative and expressive" (Ministry of Education, 1996: p. 16). The flexible nature of Te Whāriki allows teachers to facilitate emergent literacy through activities and interactions that are meaningful and engaging. A holistic perspective is encouraged whereby infants, toddlers and young children engage with literacy in ways that reflect their growing expertise. A report by Education Review Office (2011a) suggests that emergent literacy teaching and practices vary across centres. High quality teaching and practices were observed in centres where teachers had in-depth knowledge and understanding of emergent literacy and how children's literacy learning developed. Instances of poor quality literacy practices were accompanied by a lack of engagement of the children with literacy. There has been some criticism that the flexible nature of Te Whāriki leads to wide variation in the quality of curriculum and teaching practice (Smith, 2011; Woulfe, 2014). It has been argued that flexibility and the non-prescriptive nature allows teachers and early childhood centres the 32 freedom to implement the curriculum according to their own interpretation. This is thought to lead to less emphasis on the communication strand and focus on the oral language and emergent literacy skills that provide a strong foundation for success in the school years (Education Review Office, 2013; Smith, 2011). The challenge facing teachers of children with ASD is the lack of empirical evidence documenting effective teaching strategies and interventions specifically for this population and age group. The New Zealand Autism Spectrum Disorders Guideline (Ministry of Health and Education, 2008) is a wide-ranging guide to evidence based practice for children and adults with ASD. Although the ASD Guideline does not specifically review the evidence base for literacy intervention, a number of the recommendations are pertinent to the provision of literacy instruction for this population. Recommendation 3.2.1.9 states that “literacy instruction should be provided using multiple instructional strategies and building on the child's special interests” (p.95). Furthermore the guideline recommends that “interventions should take place in natural settings, using natural routines and natural consequences” (p.95). These recommendations guide professionals to provide dynamic literacy instruction that is grounded in the child's natural learning environment and functional to their everyday life. In the absence of a strong evidence base specific to this population, these recommendations align with the philosophy of Te Whāriki and serve to guide teachers and speech language therapists to apply principles of evidenced based interventions in ways that are functional and meaningful to children with ASD. 33 CHAPTER THREE Methodology 3.1 Introduction This chapter outlines the methodological approaches underpinning this research study. It begins by outlining the research questions and explains the rationale for adopting a mixed methods approach over a single quantitative or qualitative approach. The limitations of these approaches are explored. It continues with an explanation of the survey and interview data collection methods and the analytical framework that was used to analyse the qualitative data. Instrumentation and procedures are described in detail. It concludes with a summary of the ethical considerations relating to human participants. 3.2 The Research Questions Early childhood teachers with experience teaching preschool children with ASD were surveyed and/or interviewed to explore the following research questions: (1) What are early childhood teachers' beliefs about emergent literacy? (2) How do preschool children with ASD engage with emergent literacy opportunities and experiences within the early childhood setting? (3) What strategies and supports do early childhood teachers employ to facilitate emergent literacy development for preschool children with ASD? (4) What are the challenges inherent in supporting literacy learning for preschool children with ASD? (5) What are the professional learning and development needs of early childhood teachers of children with ASD? 34 The focus of each component of the study varied slightly. The survey covered all five research questions, while the interview focused on questions 2, 3, 4, and 5. 3.3 Participant Recruitment Participants were recruited through early childhood centres in the greater Auckland area. Eligibility criteria included: (i) currently teaching in an early childhood centre and (ii) experience of teaching at least one child with ASD within the past 3 years. Teachers were approached via their centre, or the Auckland Kindergarten Association (AKA). AKA Head teachers were emailed information (see appendix D) about the study via a representative from AKA. Information was also disseminated in one of the weekly newsletters sent out by the AKA. A total of 107 kindergartens receive this newsletter. Eligible teachers were invited to participate in the anonymous online survey and/or interview. Early childhood centres not linked to AKA in the northern Auckland region were phoned by the researcher to ascertain whether they had had children with ASD attending within the last 3 years. Forty of the 146 centres contacted met this criterion. These centres were emailed information about the study inviting eligible teachers to participate in the anonymous online survey and/or the individual interviews. A follow up letter (see appendix E) was sent one month later to remind them of the study and encourage eligible teachers to consider participating. 3.4 Methodological Approach Combining research methods can be a useful way of compensating for the limitations of individual research methodologies (Patton, 2002). This approach is commonly referred to as mixed methods research (MMR). MMR designs are a relatively young research methodology, first appearing in the literature around the early 2000's. MMR arose in response to the perceived and real limitations of both quantitative and qualitative research methods when used in isolation (Caruth, 2013). 35 The limitations of quantitative research include its reliance on the reliability and efficacy of the instruments, constraints on data through the use of tightly controlled instruments, and its de-contextualized nature whereby data is analysed in isolation rather than in the context of the whole. Qualitative research also comes with its own limitations such as selection bias influencing the quality of data, restricted generalization, and greater reliance on the skill and rigor of the researcher (Lund, 2012; Patton, 2002). Overall, quantitative research is thought to lead to greater objectivity and generalizability, while qualitative research lends itself to greater depth of understanding and contextualisation of the research data (Lund, 2012; Patton, 2002). The combination of quantitative and qualitative research methods in MMR is thought to be conducive to more robust research and offers researchers the opportunity to gain broader insights into the research hypothesis and research questions (Creswell, 2012b). Lund (2012) describes four main advantages of MMR designs: (1) the ability to answer a combination of exploratory and confirmatory questions; (2) the combination of quantitative and qualitative perspectives may enrich results and facilitate analysis; (3) the possibility for increased validity of inferences through the convergence of data across both methods and finally (4) the possibility that divergence of the data has greater potential to generate new theoretical insights. In the present study, the combination of two data collection methods, a survey and interviews, enabled both quantitative and qualitative data collection through the use of a broader range of question types. MMR design was deemed appropriate to mitigate against the possibility of low data yields. Additionally the combination of survey and interview data was felt to give wider insight into teachers’ experiences and practices. It was hoped that the use of both would help to clarify and extend the findings of each, providing a wider range of both mutual and opposing views and experiences. 36 3.5 Data Collection Methods As outlined above, two data collection methods were employed in the current study, an online survey and face to face interviews. 3.5.1 Survey methodology Survey research lends itself to gathering information from a large sample of people. As a research methodology, surveys represent a relatively quick, cost effective way of gathering data. Although surveys are widely used, Ary et al. (2008) point out that crafting a high quality survey requires careful planning and implementation in order to achieve valid and reliable results. Cresswell (2012a) outlines a number of potential problems with survey questions including questions that are unclear, multiple questions within one question, negative wording, inclusion of jargon and unbalanced response options. Instrument quality directly influences the nature and validity of data collected (Denscombe, 2010; Patton, 2002). Problems associated with instrumentation can be minimised through the use of pretesting. Pretesting of a survey prior to administration is an important part of the survey design process and involves peer and target audience evaluation, review, and feedback of the survey questions. This contributes to evaluation of the quality of the instrument and its usability (Dillman, 2007). The type and format of a survey is important to consider, particularly in relation to the population being sampled. Surveys can be delivered in a variety of ways, all of which are relatively low cost, however each method comes with its own strengths and weaknesses. For example, mail surveys are convenient to administer and non-threatening but have a tendency to be slow and experience low response rates. Directly administered surveys involve the researcher being present and this typically results in high response rates, however this comes at the cost of flexibility both in terms of delivery and the time that the survey can be completed (Dillman, 2007). In the age of the Internet, online surveys present a 37 new and growing option for survey research (Dillman, 2007). 3.5.2 Online survey methodology Web based surveys are becoming increasingly common in commercial and research activities (Buchanan & Hvizdak, 2009; Creswell, 2012a; Dillman, 2007). There are a plethora of websites such as SurveyMonkey®, QuestionPro(TM) and SoGoSurvey where researchers can quickly construct and administer an online survey. Online surveys present a time and cost efficient method of data collection, they have the benefit of allowing respondents to complete the survey at any time that is convenient to them, and significantly reduce data input time required prior to analysing the data (Dillman, 2007; Rosenberg, 2008). Online surveys are well suited to computer literate populations, are convenient for the researcher and have the potential for quicker response times. As with all research methods, this mode is not without weaknesses. These include that participants require access to technology (e.g. computer, Internet), participants' identity may not be able to be verified and difficulties getting sufficient participation from potential participants. Additionally software limitations may constrain question types or response categories (Dillman, 2007). 3.5.3 Interview methodology Interviews are a simple and widely used method in qualitative research as they enable researchers to explore perspectives by obtaining data directly from an individual (Patton, 2002). Interviews provide an opportunity to understand the meaning that individuals construct as a result of their experiences and context. The benefit of interviews over other types of qualitative methods is the opportunity to explore participants’ responses in more detail. This helps to put the data into context, assisting the researcher to make sense of people’s behaviour, opinions, beliefs and feelings. Interviews allows us to explore the perspectives of another and in terms of qualitative research, the underlying assumption is that these stories are both meaningful and valuable (Patton, 2002). 38 The inherent weakness of the interview process is that the quality of the data produced is highly reliant on the skill and technique of the interviewer. Effective technique relies on the interviewer: Providing an environment where interviewees will feel at ease and where disruptions can be kept to a minimum Getting interviewees permission to record interviews to increase accuracy of the data analysis Posing well crafted open-ended questions that keep the interview focused on the key content Creating a conversational tone through active listening Seeking clarification when the interviewee’s response is not fully understood (Denscombe, 2010; Patton, 2002) It is not only the skill of the interviewer that can influence the data collection, the researcher's own beliefs or assumptions can influence both how they act and respond in an interview situation as well as the interpretation of data. Indeed the very presence of an interviewer can impact on how participants respond, potentially leading to discrepancies between what participants report and the actual reality. Research bias can be difficult to fully exclude in a study, however, it is important for researchers to be aware of its presence and consider how they may have influenced the results (Creswell, 2012b; Patton, 2002). The advantages of using interviews as a mode of data collection include the opportunity to gain a richer understanding through exploring participants’ responses in greater depth and detail. Additionally interviews present a time-efficient way to gather data. The amount of data that can be gathered in an hour long interview surpasses what might be gathered in an observation of a similar length. 39 3.5.4 Semi structured interviews A semi structured interview allows the interviewer to gather data in a conversational format through the use of a set of basic predetermined questions that guide the interview. As is typical with most interview formats, these questions tend to be open-ended in nature (Ary, Sorensen, & Walker, 2014; Denscombe, 2010). This confers the interviewee the freedom to respond as they see fit, both in terms of the nature and amount of information that they share (Denscombe, 2010). Additionally, open ended questions typically result in less structured and uniform responses than those obtained through closed questions, leading researchers to gain a more comprehensive understanding of participants’ opinions and feelings (Patton, 2002). In contrast to a structured interview format, a semi structured interview gives the researcher more freedom to respond to information as it arises in the interview, potentially gathering a more complete picture of participants’ responses. The use of a question guide in semi structured interviews assists with obtaining consistent information from the interviewees. This standardisation ensures that a complete data set is collected for each participant, allows for comparability of their responses, and permits pretesting or peer review to be employed prior to data collection to ensure validity to the research topic and questions (Patton, 2002). At the same time, the interviewer can modify or deviate from the guide in response to unanticipated responses or issues that are raised during the interview. As described in the previous section, interviewers need to employ a range of techniques to ensure that high quality data is obtained in a semi structured interview. In addition to the points made above, the interviewer conducting a semi structured interview needs to ensure that: Vague and ambiguous language is avoided Questions are relevant and linked to the focus of the research 40 The conversational tone is used to gain further insight where necessary through the careful use of prompts and probes They are able to be flexible and respond to the content of the interviewees’ response (Ary et al., 2014; Patton, 2002) 3.6 Instruments The questions for each of the instruments were developed with reference to a number of sources. These sources included Sénéchal et al.'s, (2001) ‘focused view of emergent literacy’ and the key components of emergent literacy from the meta-analysis of emergent literacy research conducted by NELP (National Early Literacy Panel, 2004). Content was also drawn from previously published surveys exploring emergent literacy practices with young children with disabilities (Al Otaiba, Lewis, Whalon, Dyrlund, & McKenzie, 2009; Erickson, Clendon, Abraham, Poston, & Van de Carr, 2005; Murphy, Hatton, & Erickson, 2008) and a recent doctoral dissertation exploring the emergent literacy beliefs of preschool teachers in inclusive settings (Rohde, 2011). 3.6.1 Online Survey The survey instrument was specifically designed and administered using SurveyMonkey® , a web based survey program. As well as cost and time considerations on the part of the researcher, the use of an online survey in this study was felt to be convenient to participants. The survey instrument (see Appendix F) included 38 questions. These were a mix of quantitative and open ended questions. The format for the questions varied and included Likert scale ratings (n = 5), forced choice responses (n = 10), multiple choice responses (n = 9) and open ended responses (n = 14). The survey was divided into 8 sections: (1) centre information; (2) professional learning and development; (3) beliefs about emergent literacy; (4) approach to emergent literacy instruction in the centre; (5) background information on the 41 child with ASD; (6) the child's engagement with emergent literacy; (7) competencies; and (8) challenges. Sections (1) and (2) contained a series of questions pertaining to the respondent's current early childhood centre as well as their work experience, training and professional learning. Sections (3) and (4) contained questions designed to capture information about the respondent's concept of emergent literacy, teaching philosophy and the literacy materials or opportunities available in their current centre. Respondents were asked to rate a series of statements about the teaching of emergent literacy using a five point scale (strongly agree, agree, neutral, disagree, strongly disagree) to indicate their level of agreement. To complete section (5), respondents were asked to think about a child they were either currently teaching or had taught recently with a diagnosis of ASD. Background data was collected about these children including: diagnosis if known, supports received from outside agencies and mode of communication. Where respondents identified that they were currently teaching a child with ASD, they were also asked about the child's current individual plan (IP). The final three sections focused more specifically on emergent literacy and children with ASD. Section (6) included a range of questions exploring the child's engagement with emergent literacy and the strategies used by the respondents to support this. Section (7) required respondents to rate how competent they felt teaching specific components of emergent literacy using a scale of 1 - 4 (1 = no experience, 2 = novice, 3 = competent, 4 = highly competent). The final section, (8), asked respondents to consider the challenges they faced as teachers supporting emergent literacy for children with ASD, the strategies that they felt most effective for this population, and the types of support and training that would facilitate this work. 42 As is common practice in similar studies (e.g. Murphy et al., 2008; Rohde, 2011), a draft copy of the survey was sent to two experts in the literacy and/or ASD fields. The experts were asked to review and give feedback on the survey content in relation to the research questions. This draft survey instrument was then piloted with two independent teachers, again reflecting standard practice in similar studies (e.g. Al Otaiba et al., 2009; Sutherland, Gillon, & Yoder, 2005). The teachers were asked to complete the survey and provide feedback on their overall impression and to comment on the relevance and comprehensibility of the questions. This feedback was incorporated into the final instrument and included rewording of two questions to help improve their clarity. 3.6.2 Semi Structured Interview For the semi structured interview, an interview guide consisting of 15 questions was prepared (see Appendix G). The content sources for the 15 questions were the same as those outlined in Chapter 3.6. The questions were designed to elicit similar information to the survey along with some background information to give a context to participants’ responses. There was particular emphasis on research questions 2, 3, and 4 in the interview questions as it was felt that these were the areas where the opportunity to explore participants’ responses in detail would help elucidate the survey data. Prior to conducting the interviews, the interview guide was discussed with a supervisor and input sought from two experts in the literacy and/or ASD fields. The experts were asked to review and give feedback on the interview guide in relation to the research questions. 3.7 Procedures Participants were invited to participate in the study via the procedures outlined above in the recruitment section. Participants could participate in one or both components of the study. Email and written communication about the study contained a URL link to the online survey hosted on the SurveyMonkey® website. Survey participants were advised that the online 43 survey would take 30 minutes to complete at a time that was convenient to them. Due to the anonymous nature of the survey, participants were unable to exit the survey and complete at a later time. To help mitigate against data validity concerns related to eligibility, a series of questions at the start of the survey were used to screen participants. Access to the remaining part of the survey was based on respondents’ answers to these questions. Participants interested in completing the interview component of the study were asked to contact the researcher by email or phone. Arrangements were made to complete the interview in person at a time and location that was convenient. Interview participants were advised that the interview would take a maximum of 60 minutes. 3.7.1 Digital Recording and Transcription Each interview was digitally recorded using a Sony IC Recorder (model ICD PX720). The recorder was placed on the table between the interviewer and interviewee. Recordings were downloaded onto a desktop computer for analysis. Digital recordings of the interviews were transcribed by a third party with experience in interview transcription. 3.7.2 Member Checking A copy of the transcription was sent to the participant for verification of accuracy. Participants received an electronic and hard copy form of the transcription. They were asked to read and verify the accuracy of the transcription and amend any errors. Participants were free to request that specific information be omitted from the study. Any amendments in the returned transcriptions were made by the researcher and the final copy resent for verification. At this point, participants were asked to sign a transcript release authority form (see Appendix C) authorising the use of their interview transcript in the study. 3.8 Data Analysis Framework Although both survey and interview research can be conducted in a myriad of ways, there 44 are well established processes through which researchers collate, analyse, and interpret the qualitative data. The first step involves organising the data into a format that aids analysis. Survey data may already be in a format that is conducive to analysis, or it may need to be entered into a database. Interview recordings are transcribed and if necessary uploaded into an appropriate qualitative analysis software package. Once the data has been collated, the researcher reads through each interview, survey, or set of survey responses to establish a sense of the data as a whole. The next step involves coding or assigning categories to the data. This can be done manually or within a software data analysis package (Creswell, 2012a). Coding of the data helps to identify patterns, themes, and unique responses within the data and the researcher must carefully consider the types of codes in relation to their research questions. Coding systems can either be deductive or inductive. Deductive coding is