Narrative role-taking in autism

A narrative sequencing and mentalizing training for adults with autism: A pilot study

Adults diagnosed with autism experience difficulties with understanding the mental states of others, or themselves (mentalizing) and with adequately sequencing personal stories (narrative coherence). Given that the posterior cerebellum is implicated in both skills, as well as in the etiology of autism, we developed a narrative sequencing and mentalizing training for autistic adults. Participants with an official autism diagnosis were randomly assigned to a Training group (n = 17) or a waiting-list Control group (n = 15). The Training group took part in six weekly sessions in groups of three participants lasting each about 60 min. During training, participants had to (re)tell stories from the perspective of the original storyteller and answer questions that required mentalizing. We found significant improvements in mentalizing about others’ beliefs and in narrative coherence for the Training group compared to the Control group immediately after the training compared to before the training. Almost all participants from the Training group expressed beneficial effects of the training on their mood and half of the participants reported positive effects on their self-confidence in social situations. All participants recommended the current training to others. Results are discussed in light of cerebellar theories on sequencing of social actions during mentalizing. Further improvements to the program are suggested. Our results highlight the potential clinical utility of adopting a neuroscience-informed approach to developing novel therapeutic interventions for autistic populations.

Combining Readers Theater, Story Mapping and Video Self-Modeling Interventions to Improve Narrative Reading Comprehension in Children with Autism Spectrum Disorder

Individuals with Autism Spectrum Disorder (ASD) demonstrate atypical development, resulting in significant deficits in perspective-taking and observational learning. Children with ASD tend to have challenges in social interactions and academic performance, such as comprehending narrative texts, which heavily rely on accurate understanding of the thoughts and feelings of others. However, the current literature provides limited information on effective interventions to address these areas. The present study expands the existing research base by combining Readers Theater, story mapping, and video self-modeling, three separate research-based interventions, into an intervention package for children with ASD. A multiple-baseline across participants design was utilized. Overall, the results indicate that the intervention package successfully improved reading comprehension. Implications and suggestions for future research are discussed.

Social Communication and Structural Language of Girls With High-Functioning Autism Spectrum Disorder

Purpose The purpose of this study was to characterize social communication and structural language of school-age girls with high-functioning autism spectrum disorder (HF-ASD) compared to a matched group of girls who are typically developing (TD). Method Participants were 37 girls between 7;5 and 15;2 (years;months)-18 HF-ASD and 19 TD. Children completed the Test of Pragmatic Language-Second Edition (TOPL-2) and Clinical Evaluation of Language Fundamentals-Fifth Edition. Parents completed the Children's Communication Checklist-2 United States Edition (CCC-2) and Receptive and Expressive Communication subdomains of the Vineland Adaptive Behavior Scales-Second Edition. Results In the area of social communication, girls with HF-ASD earned significantly lower scores and were more often classified as having an impairment on the TOPL-2 and the CCC-2. However, 28% and 33% earned average scores on the TOPL-2 and the CCC-2, respectively. In the area of structural language, no significant differences were found between groups on Clinical Evaluation of Language Fundamentals-Fifth Edition indexes. In contrast, girls with HF-ASD earned significantly lower scores and were more often classified as having an impairment on the Vineland Adaptive Behavior Scales-Second Edition. Sixty-one percent and 83% scored below average on the Receptive and Expressive Communication subdomains, respectively. Conclusions It has been argued that girls with HF-ASD, when compared to boys with HF-ASD, may have advantages for social communication and structural language that mask their impairments. However, when compared to girls who are TD, girls with HF-ASD demonstrated impaired social communication and structural language. Clinicians should include and carefully examine multiple sources of information when assessing girls with HF-ASD.

Perspective Taking Abilities among Persons with Autism: A Preliminary Study

This preliminary study examined persons with autism’s perspective taking abilities. Participants were 28 persons with autism and 27 controls. Among the persons with autism, 15 presented the Asperger Syndrome that was described in the DSM4. Scenarios in which persons were about to buy a piece of clothing were presented to participants who assessed the extent to which these persons were going to buy it as a function of suitability and price (situational factors), and what is known about their purchasing habits (the personality factor). In the same way as controls, participants with autism were able to integrate personality information into their judgments. However, only participants presenting the Asperger Syndrome described in the DSM4 were, in the same way as controls, able to vary, as a function of personality information, the importance given to situational factors during the judgment process.

The Effects of a Shared Reading Intervention on Narrative Story Comprehension and Task Engagement of Students with Autism Spectrum Disorder

The purpose of this study was to investigate the effects of a shared reading intervention on narrative story comprehension and task engagement of students with autism spectrum disorder (ASD). A single-case multiple baseline design was used, and three elementary-aged students with ASD participated in this study. The shared reading intervention included before, during, and after reading strategies (i.e., topic anticipation, dynamic reading, story retelling). Results of this study indicated that all participants demonstrated noticeable improvements in reading comprehension. Despite the longer duration of intervention sessions as compared to baseline sessions, participants showed similar or better task engagement with intervention. Improved reading outcomes were maintained at follow up for all participants. Implications for practical implementation and future research were discussed.

Responses to Vignettes Depicting Friendship Transgressions: Similarities and Differences in Children With and Without Autism Spectrum Disorder

We examined children's responses to vignettes depicting a child making one of four friendship transgressions; failing to provide validation, failing to provide help, being an unreliable partner, and betrayal. Twenty elementary students with autism spectrum disorder (ASD) and 21 typically developing (TD) students participated. Children rated emotional responses, the strategies they would use following each transgression, interpretations of transgressions, and goals of their responses. Children with ASD rated sadness lower than TD children, and rated verbal aggression strategies higher than TD children. There were several significant correlations between emotional responses and goals, strategies, and interpretations in the ASD group. Betrayal was considered the most severe transgression. These results will aid researchers aiming to support friendship maintenance in children with ASD.

Motor and verbal perspective taking in children with Autism Spectrum Disorder: Changes in social interaction with people and tools

BACKGROUND

Children with Autism Spectrum Disorder (ASD) have difficulty communicating with others nonverbally, via mechanisms such as hand gestures, eye contact and facial expression. Individuals with ASD also have marked deficits in planning future actions (Hughes, 1996), which might contribute to impairments in non-verbal communication. Perspective taking is typically assessed using verbal scenarios whereby the participant imagines how an actor would interact in a social situation (e.g., Sally Anne task; Baron-Cohen, Leslie, & Frith, 1985).

METHOD

The current project evaluated motor perspective taking in five children with ASD (8-11 years old) as they participated in a narrative intervention program over the course of about 16 weeks. The goal of the motor perspective-taking task was to facilitate the action of an experimenter either hammering with a tool or putting it away.

RESULTS

Initially, children with ASD facilitated the experimenter's action less than neurotypical control children. As the narrative intervention progressed, children with ASD exhibited increased motor facilitation that paralleled their increased use of mental state and causal language, indicating a link between verbal and motor perspective taking.

CONCLUSIONS

Motoric perspective taking provides an additional way to assess understanding and communication in children with ASD and may be a valuable tool for both early assessment and diagnosis of children with ASD.

A comparison of pragmatic language in boys with autism and fragile X syndrome

PURPOSE

Impaired pragmatic language (i.e., language use for social interaction) is a hallmark feature of both autism spectrum disorder (ASD) and fragile X syndrome (FXS), the most common known monogenic disorder associated with ASD. However, few cross-population comparisons of ASD and FXS have been conducted, and it is unclear whether pragmatic language profiles in these conditions overlap.

METHOD

The authors used seminaturalistic and standardized assessment methods to characterize pragmatic language abilities of 29 school-aged boys with idiopathic ASD, 38 with FXS and comorbid ASD, 16 with FXS without ASD, 20 with Down syndrome, and 20 with typical development.

RESULTS

Similar severity of pragmatic language deficits was observed in both of the groups with ASD (idiopathic and fragile X-associated). ASD comorbidity had a detrimental effect on the pragmatic language skills of the boys with FXS. Some different patterns emerged across the two pragmatic assessment tools, with more robust group differences observed in pragmatics assessed in a seminaturalistic conversational context.

CONCLUSION

These findings have implications for pragmatic language assessment and intervention, as well as for understanding the potential role of the fragile X gene, Fragile X Mental Retardation-1, in the pragmatic language phenotype of ASD.

Pragmatics abilities in narrative production: a cross-disorder comparison

We aimed to disentangle contributions of socio-pragmatic and structural language deficits to narrative competence by comparing the narratives of children with autism spectrum disorder (ASD; n = 25), non-autistic children with language impairments (LI; n = 23), and children with typical development (TD; n = 27). Groups were matched for age (6½ to 15 years; mean: 10;6) and non-verbal ability; ASD and TD groups were matched on standardized language scores. Despite distinct clinical presentation, children with ASD and LI produced similarly simple narratives that lacked semantic richness and omitted important story elements, when compared to TD peers. Pragmatic errors were common across groups. Within the LI group, pragmatic errors were negatively correlated with story macrostructure scores and with an index of semantic-pragmatic relevance. For the group with ASD, pragmatic errors consisted of comments that, though extraneous, did not detract from the gist of the narrative. These findings underline the importance of both language and socio-pragmatic skill for producing coherent, appropriate narratives.

Who's Missing the Point? A Commentary on Claims that Autistic Persons Have a Specific Deficit in Figurative Language Comprehension

It's become a caricature of autistic persons that they don't understand figurative language. Despite empirical evidence to the contrary, three of the four contributions to this special issue endorse this stereotype without question. And all four contributions attribute this supposed deficit to even shakier fallacies, such as the controversial claim that autistic people lack empathy or a 'theory of mind.' In this commentary, we begin by reviewing the literature more exhaustively than the other contributions, and we highlight a point that they missed: Autistic persons are likely to have difficulty comprehending figurative language if they also have difficulty comprehending language in general. There doesn't seem to be a specific deficit in figurative language unique to autism. We also tackle the claim that autistic people lack empathy. And we question the existence of a 'theory of mind area,' while demonstrating the pitfalls that ensnarl researchers when they strain to interpret differences between autistic and non-autistic brain activity as solely autistic deficits.

Narrative Skill in Boys with Fragile X Syndrome with and without Autism Spectrum Disorder

We examined recalled narratives of boys with fragile X syndrome with autism spectrum disorder (FXS-ASD; N=28) and without ASD (FXS-O; N=29), and compared them to those of boys with Down syndrome (DS; N=33) and typically developing boys (TD; N=39). Narratives were scored for mentions of macrostructural Story Grammar elements (Introduction, Relationship, Initiating Events, Internal Response, Attempts/Actions, and Ending). We found that narrative recall is predicted by short-term memory and nonverbal mental age levels in almost all groups (except TD), but not by expressive syntax or caregiver education. After adjusting for these covariates, there were no differences between the three groups with intellectual disability (ID). The FXS-ASD group, however, had significantly poorer performance than the TD group on the overall Story Grammar score, and both the FXS-O and FXS-ASD groups had lower Attempts/Actions scores than the TD group. We conclude that some form of narrative impairment may be associated with FXS, that this impairment may be shared by other forms of ID, and that the presence of ASD has a significantly detrimental effect on narrative recall.