Dismantling the "Visual Ease Assumption:" A Review of Visual Narrative Processing in Clinical Populations.

Abstract

Visual narratives, such as wordless picture books and picture sequences like comics, have a long history in clinical testing, research, and intervention settings. The widespread "Visual Ease Assumption" rests on the premise that visual narratives, given their non-linguistic nature, may alleviate processing difficulties in populations that struggle with language. In this paper, I review the evidence for and against this Visual Ease Assumption in three clinical populations in which language deficits are common or diagnostic: autism spectrum disorder (ASD), specific language impairment (SLI; now known as Developmental Language Disorder, DLD), and aphasia. I first redefine the Visual Ease Assumption as two testable predictions: (a) that visual narrative processing should be unimpaired for clinical populations compared to neurotypical (NT) populations; and (b) that in clinical populations, visual narrative processing should be less impaired than linguistic narrative processing. Through a review of the limited evidence available to test these predictions in ASD, SLI, and aphasia, I show that the Visual Ease Assumption is largely unsupported in empirical studies. Furthermore, I outline three additional limitations of the Visual Ease Assumption regarding the complexity of narrative processing, visual narrative tasks, and cognitive deficits in different clinical populations. Therefore, visual narratives should not be assumed to be "easier" for clinical populations that struggle with language; instead, a more thorough consideration of the cognitive processes involved in visual narrative processing is needed.