Narrative Generation in Children with ASD: The Effects of a Reading Comprehension Intervention on Mental State Use

Background:  Higher functioning children with ASD (HFASD) often exhibit well-developed word level reading skills but tend to have deficits in reading comprehension. The cognitive skills involved in narrative retelling of stories is associated with reading comprehension in HFASD students and may be an important target of intervention in schools for these children. Some research has suggested that children with ASD can increase their narrative competence through exposure to storybooks, with prompting to focus attention on characters’ cognitive and affective states. Indeed, these types of narrative interventions may contribute to more generalized social outcomes, and have been found to increase perspective-taking and social cognition in school-aged children with ASD.

Objectives:  The purpose of this preliminary study was to examine if a brief curriculum-based comprehension intervention had effects on the narrative abilities of children with ASD. The hypothesis was that children’s narratives would include more story elements and evaluative terms following the intervention, indicative of improvements in perspective-taking and social cognitive abilities.

Methods:  Participants included fifteen 7- to 12-year-old children with ASD. Children participated in an eight-week intervention program, consisting of thrice-weekly, one-hour sessions. Each session emphasized a particular comprehension skill taught explicitly with guided opportunities for practice within a children’s book. A spontaneous narrative generation task was administered pre and post intervention, using a wordless picture book to elicit narrative. The book Frog, Where Are You? (Mayer, 1969), a story about a boy who searches for his missing pet frog, was used for the pre-intervention narrative assessment, and the post-intervention book, A Boy, a Dog, and a Frog (Mayer, 1971) continues the story of the boy and the frog. Narratives were transcribed and coded for terms referring to characters' affective (e.g., “laughed”, “upset”) and cognitive states (e.g., “know,” “wondered”).

Results: A paired-samples t-test was conducted to compare pre- and post-mental state usage, and revealed a significant difference in the number of mental state terms used pre- (M = 2.67, SD = 2.89) and post- (M = 4.53, SD = 4.03) intervention; t (14) = 2.56, p< .05. Preliminary analyses also showed a significant bivariate correlation between children’s pre-intervention expressive vocabulary score and the frequency of mental state use at post-test, r (13) = .56, p< .05. The results of additional planned analyses will be conducted to include additional codes for story structure and length, and the relations between mental-state use and parent report measures of children’s social ability will also be examined.

Conclusions:  This study provided evidence for the malleability of narrative retelling ability in a sample of HFASD children. This is important because of the ease with which this type of intervention can be integrated into school curriculums and because intervention for narrative retelling may be important to support reading comprehension development in these children. Moreover, such interventions may also provide means to leverage a component of school curriculums to more systematically impact social cognitive development in school aged children with HFASD. Research is planned to more rigorously test these hypotheses with randomized experimental control group intervention study designs.