Abstract
Narrative impairments are common in autism spectrum disorders (ASDs). The Autism Diagnostic Observation Schedule (ADOS) battery includes a story-telling activity using a picture book called Tuesday. The current study aimed to identify differences between children with ASD and children with typical development (TD) on the production of Tuesday narratives, with a special focus on semantic-pragmatic aspects. Participants were 48 cognitively-able boys, in the age range of 4;10–7;0 years. Twenty-four participants were boys with ASD and 24 participants were TD boys. The semantic-pragmatic analysis included measures of: story details (characters setting, objects, and actions), central ideas, evaluative comments, and unrelated text. Results showed that the narratives produced by children with ASD included fewer central ideas, and fewer settings, characters, and actions, but not objects, as compared with the narratives produced by their TD peers. The number of evaluative comments and utterances that were unrelated to the story did not differ between the groups. A negative correlation was found between the autism severity level and the number of central ideas and number of characters mentioned in the narratives of the ASD participants. Taken together, as a group, these findings point to a semantic-pragmatic impairment in ASD. However, individual analysis revealed heterogeneity within the ASD group in this area. Some of the results may be explained by cognitive deficits in maintaining central coherence (the Weak Central Coherence account). This study has important clinical implications. Defining the specific differentiating measures can maximize the use of the ADOS story-telling activity by clinicians. The association found between the autism severity level and some of the semantic measures can be used in evaluating the severity of the ASD symptoms.
Highlights
Autism spectrum disorder (ASD) describes a wide range of symptoms
This study examined the narrative ability of cognitively-able children with and without ASD using the Tuesday picture book from the ADOS diagnostic battery
Analysis of additional narrative variables revealed that the TD group was more talkative as they produced generally more utterances than the ASD group, but the percentage of complex sentences in the narratives was higher for the ASD group
Summary
Autism spectrum disorder (ASD) describes a wide range of symptoms. The core symptoms in ASD are defined as a difficulty with social-communication skills and restricted interests and repetitive behaviors (RRBs) (American Psychiatric Association [APA], 2013). In addition to the core symptoms, some individuals with ASD show specific deficits in cognition (Grzadzinski et al, 2013) and language (Harper-Hill et al, 2013). In both domains, children with ASD comprise a highly heterogeneous group with great variability. With respect to verbal ability in ASD, a wide range of linguistic competence is described in the literature, from a total lack of verbal language to fluent and even advanced language skills (Harper-Hill et al, 2013). Even among individuals with ASD whose cognitive and language achievements in standardized assessments are within normal limits, pragmatic and semantic impairments are still commonly reported (Tager-Flusberg et al, 2005)
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