Feasibility of Wh-Question Test in NT and ASD

Background:  Children are presented with a multitude of questions encompassing all wh- question forms (e.g., what, who, when, where, why and how) in daily life.  Those who have difficulty comprehending the meaning of these questions likely encounter a significant number of communication breakdowns throughout their day. It has been observed that individuals with Autism Spectrum Disorder (ASD) have specific difficulty in comprehending and responding to wh- questions (Goodwin, Fein & Naigles, 2012; Doggett, Krasno, Koegel & Koegel, 2013; Secan, Egel & Tilley, 1989). This difficulty is potentially attributed to factors including overall language delays or difficulty regarding the pragmatics of asking and responding to questions, among many other factors. While this particular difficulty has been observed in individuals with ASD (Doggett et al., 2013, Goodwin, Fein & Naigles, 2015; Goodwin, et al., 2012; Secan, et al., 1989; Tager-Flusberg, 1999), there is a lack of engaging assessment tools to identify the wh- question forms with which a child has difficulty and the error patterns showing the strategies these children are using. The lack of a comprehensive assessment tool impinges upon Speech Language Pathologists and educators in their design of appropriate goals for intervention.

Objectives:

The study was conducted to assess 1) the feasibility of administrating a computer based Wh-Question assessment to identify language goals in NT and ASD elementary school children 2) whether error patterns were different in the two groups.

Methods:

The Wh- Question Test is a computer program that assesses the question forms of who, what, where and when with multiple-choice responses presented through verbal and visual stimuli. The test contains 10 unique contextual sentences, each with an accompanying illustration, and a corresponding who, what, where, and when question, resulting in 40 total questions. Each contextual sentence includes a subject, transitive verb, object, location and time; therefore, all information needed to answer each question form is provided in the contextual sentence.

Example item:

‘The children played with blocks in the classroom before music.’

Question: ‘What did they play with?’

a) blocks

b) before music

c) the children

d) drums

e) in the classroom

The program collects both accuracy as well as error type.

Group	Mean Age	N	SD	Minimum Age	Maximum Age
NT	6.54	41	0.977	5	8
ASD	8.81	16	1.515	6	10

Figure 2. Participants

Results:

A mixed model between group (2) within wh- question form (4) ANOVA a significant interaction was present between wh- question form accuracy and group (ASD or NT) (F=6.657, p=0.001). 'When' questions were most difficult for both groups, but especially for the ASD group.

Conclusions:

The Wh-Question test is a feasible and engaging way to assess Wh-Question comprehension in both NT and ASD elementary school age children. Both groups showed similar patterns of difficulty, but the ASD group showed more difficulty relative to the NT group especially for ‘When’ questions.