Evidence-based practices: using the touch points strategy to teach single-digit addition to students with ASD

Saudi Arabia is advancing inclusive education for students with ASD, partnering with national organizations to support special education. Despite these efforts, there is a need for evidence-based mathematics instruction for children with ASD. Students with ASD often struggle with abstract mathematical concepts, organization, place value, memory for operations, and visual–spatial representations, which are linked to higher-order math performance (Mohn, 2010). This study focuses on an evidence-based, practical strategy—touch points—for teaching single-digit addition to address these challenges. Research problem: Students with ASD in Saudi Arabia are expected to meet academic standards comparable to their peers, yet they lag significantly in mathematics (e.g., average of 5 years behind in middle school; Wagner et al., 2003), and there is a scarcity of evidence-based academic interventions specifically for ASD. Touch-point strategies have shown promise but their use and effectiveness in Saudi classrooms are underexplored. Research objectives: Using a single-subject (A-B-A-B) design, the study evaluates whether the touch-point strategy improves accuracy and acquisition rate for single-digit addition among second-grade students with ASD, and explores teacher perceptions and implementation challenges. Research questions: (1) Does using the touch-point strategy affect the ability of students with ASD to solve single-digit addition problems? (2) Does it increase the acquisition rate of basic math skills? (3) What are teacher perceptions regarding its use in ASD classrooms?

The review highlights mandates and initiatives (IDEA, NCLB; Saudi equivalents) driving inclusive education and the need for effective strategies for ASD. Number lines and touch points: Cihak and Foust (2008) compared number lines vs. touch points with three elementary students with ASD, finding touch points more effective for single-digit addition and preferred by students. Yikmis (2016) corroborated touch points’ effectiveness, aligned with the concrete-to-abstract principle. A meta-analysis (Kot et al., 2018) found touch math effective for addition skill acquisition in children with special needs. CRA (Concrete-Representational-Abstract): CRA supports students with LD/ASD in progressing from manipulatives to pictorials to abstract notation, improving performance and engagement (Witzel et al., 2008). Self-monitoring: Legge et al. (2010) showed that self-monitoring with a tactile prompt (MotivAider) increased on-task behavior in students with ASD during independent math work. TOUCHMATH: Developed in 1975, it uses counted dots on numerals to provide multisensory input. Fletcher et al. (2010) found TOUCHMATH superior to number line strategies for middle school students with moderate intellectual disabilities; Kot et al. (2018) meta-analysis supports effectiveness. Overall, literature supports touch-point approaches as effective for teaching basic addition to students with ASD and other disabilities, though generalization and classroom-scale implementation need further study.

Design: Single-subject multiple baseline A-B-A-B reversal design over 5 weeks to evaluate the effect of the touch-point strategy on single-digit addition accuracy and acquisition among three second-grade students with ASD. Sessions were ~40 minutes, twice per day, 2 days per week; baseline and intervention stability criteria used to transition phases. Participants: Three second-grade students with ASD from an elementary school in Jeddah, Saudi Arabia, identified per DSM-5 and receiving special education services. Inclusion criteria included prerequisite skills (writing, attending to board, identifying problems, recalling numbers, engaging for 5–15 min, counting 1–15). Observer: A 35-year-old special education teacher experienced with touch points received a 2-hour orientation (strategy explanation, modeling videos, live demonstration); provided task-specific instructions and post-session reliability checks. Variables: Independent variable—touch-point strategy. Dependent variable—accuracy on single-digit addition facts (two-step problem-solving to produce single-digit sums). Instructional setting: Resource classroom with a kidney-shaped table and whiteboard; sessions recorded; small-group instruction with all three students, maintaining a 1:3 instructor-to-student ratio. Procedures: Baseline (A)—three sessions/week, 10–15 min; worksheets with ten single-digit facts to establish stable pre-intervention performance. Intervention (B)—explicit instruction on dot positions for numerals 1–9; teacher modeling on whiteboard, guided practice using “count all” and emphasizing starting with the larger number then counting forward; verbal corrective feedback; minimum 10 practice problems per session; students independently solved at least 4 problems per session using touch points; reinforcement provided for correct responding. Phases were sequenced A→B→A→B, each until data stability. Maintenance/generalization: In a 1-week maintenance phase, worksheets omitted touch-point visuals; students expected to apply learned steps; at least one maintenance probe daily for four days (12–16 minutes per session). Materials: Individualized worksheets with single-digit addition items; two assessment worksheets with reversed addend order (e.g., 2+3 vs. 3+2); teaching sheets with dots on numerals (top-to-bottom placement); in later generalization, dots on the first addend were faded; reinforcers identified via parent preference forms; sessions recorded with an FDR-AX100E camera. Data collection: End-of-session independent assessment (5 problems, 20 minutes) capturing accuracy and efficiency; worksheets collected and scored each session. Qualitative component: Semi-structured, 30–40 minute, face-to-face interview with the math teacher post-intervention; audio recorded; inductive thematic analysis conducted to identify themes concerning implementation facilitators and barriers.

• Overall effect: Introduction of the touch-point strategy produced immediate and notable increases in correct single-digit addition responses across participants, demonstrating a positive functional relation between the intervention and accuracy. Gains were observed again upon reintroduction (B) after withdrawal (A).
• Participant 1: Baseline average ~2/10 correct (never exceeding 4/10). During intervention, increased to as high as 9/10 correct; faster problem completion noted. Upon return to baseline, performance remained improved relative to initial baseline; reintroduction maintained elevated accuracy.
• Participant 2: Baseline 1/10 correct; intervention increased to 5/10; after withdrawal, maintained ~5/10; final intervention rose to 8/10 correct.
• Participant 3: Baseline 1/10 correct; intervention average ~4/10 (rapid improvement from baseline to intervention). After withdrawal, performance exceeded initial baseline; final intervention yielded 4/10 correct.
• Retention/maintenance: Evidence of maintained use of the strategy across sessions; students were observed using finger counting of ‘invisible’ dots during post-tests, suggesting internalization of the procedure.
• Teacher interview themes: (1) Resource constraints and staffing (lack of teacher’s assistant; need for materials/funding) hinder implementation; (2) Classroom-level challenges given heterogeneity of ASD severity and class size—strategy perceived as more feasible one-on-one or in very small groups; concerns about dividing attention among students.
• Efficiency: Reduced time-to-solution was reported (Participant 1), indicating improved computational fluency with the strategy.

The touch-point strategy supports students with ASD by coupling visual, tactile, and verbal counting cues, facilitating the processing of linguistic and numerical information and bridging concrete representations to more abstract mathematical thinking. Findings align with prior literature (Cihak & Foust; Yikmis; Kot et al.) showing touch points’ effectiveness for single-digit addition. The approach is simple to teach and potentially beneficial for a broader student population beyond ASD, enhancing visual problem-solving and long-term retention. The strategy also complements CRA progression, enabling simultaneous engagement at concrete, pictorial, and abstract levels, which matches learning preferences of many students with ASD. Implementation barriers highlighted by the teacher—time, class size, lack of a TA, and limited materials—suggest that successful classroom adoption may require professional development on small-group management and institutional support (staffing, resources, and a balanced focus on academics alongside behavioral/social goals). Shifting school paradigms to address academic challenges could reduce behavior issues linked to academic frustration and ensure equitable access to evidence-based instruction.

This single-subject A-B-A-B study demonstrates that the touch-point strategy can substantially improve accuracy and efficiency in single-digit addition for second-grade students with ASD in Saudi Arabia. Students showed rapid acquisition, improved performance upon reintroduction of the strategy, and indications of maintenance/generalization (e.g., counting invisible dots). Practical implications include adopting touch points as a structured, multisensory scaffold that aligns with CRA and supports progression toward abstract skills. For broader impact, schools should ensure adequate staffing and resources, and provide teacher training for small-group implementation. Future research should: (1) scale to larger and more diverse samples (varying ASD severity); (2) extend duration to assess long-term retention and generalization; (3) compare group-based vs. individualized implementation; (4) examine transfer to other operations (subtraction, multi-digit computation, word problems) and to general education settings.

• Small sample size (n=3) of second graders with mild ASD limits generalizability.
• Narrow skill focus restricted to single-digit addition; results may not transfer to other mathematical domains.
• Short study duration (5 weeks) precludes conclusions about long-term maintenance and generalization.
• Classroom implementation constraints (e.g., class size, staffing) may affect external validity and scalability.