Teaching Personal Narrative Skills to Enhance Social Conversation in Children with Autism Spectrum Disorders

Background:  The literature suggests that pervasive and persistent symptoms related to social communication are a hallmark of autism spectrum disorders (ASD). In addition to being core diagnostic symptoms of ASD, these symptoms relate to the extent to which children can engage in interactions that rely on social conversation skills. These pragmatic difficulties are commonly expressed in conversational exchanges that either lack the incorporation of personal narratives or incorporate personal narratives that are deficient or impoverished in nature. This is in contrast to neurotypically developing children who acquire personal narrative skills in early childhood, and use these skills as an essential tool in their social interactions. The literature indicates that self-management strategies are effective in improving a range of social communication skills.

Objectives:  Given the current body of literature, pervasive nature of social communication impairments, and the documented impact of conversational competence on later outcomes, the objective of the current study was to examine whether self-management procedures targeting increased responsiveness to conversational bids for personal narratives led to improvements in conversational skills in children with ASD. Further, this study assessed the extent to which the improvements resulted in meaningful outcomes in ratings of overall verbal pragmatic ratings during conversation.

Methods:  A non-concurrent multiple baseline across participants experimental design was used to evaluate the effectiveness of the self-management intervention. Three children diagnosed with ASD between the ages of 5 to 8 participated in this study. Five dependent measures were used to assess the effects of self-management in ameliorating social communication deficits by targeting the integration of personal narratives during reciprocal social conversation. The dependent measures were: (a) percent of responses to conversational bids with personal narratives, (b) mean number of personal narrative details, (c) percent of synchronous responses, (d) quantitative measures of overall language production, and (e) global pragmatic ratings of verbal conversational behaviors as measured by the Pragmatic Protocol (Prutting & Kirchner, 1987). Effect sizes were also calculated. Data were analyzed using representative five-minute videotaped probes collected throughout all phases of the study.

Results:  The results of this study indicate that social communication deficits in children with ASD can be ameliorated with self-management procedures. Specifically, the intervention improved their conversational competence by (a) increasing responsiveness to conversational bids for personal narratives or stories, (b) improving the quality of the personal narratives through greater narrative detail, (c) increasing synchronous discourse, and (d) increasing linguistic productivity. Furthermore, the sustained treatment gains observed at follow-up with novel conversational partners and improvements in global verbal pragmatic ratings suggest that the intervention may have led to meaningful outcomes.

Conclusions:  Results from the current study suggest that self-management procedures are effective in improving personal narrative skills during social conversation. These new skills were associated with positive gains in narrative details, synchronous responding, linguistic productivity, and pragmatic ratings. Overall, the findings suggest that social communication interventions focusing on personal narrative skills may contribute to meaningful positive outcomes in children with ASD and should be incorporated as part of a comprehensive intervention program.