Narrative competence and internal state language of children with Asperger Syndrome and ADHD

Speech and language patterns in autism: Towards natural language processing as a research and clinical tool

Speech and language differences have long been described as important characteristics of autism spectrum disorder (ASD). Linguistic abnormalities range from prosodic differences in pitch, intensity, and rate of speech, to language idiosyncrasies and difficulties with pragmatics and reciprocal conversation. Heterogeneity of findings and a reliance on qualitative, subjective ratings, however, limit a full understanding of linguistic phenotypes in autism. This review summarizes evidence of both speech and language differences in ASD. We also describe recent advances in linguistic research, aided by automated methods and software like natural language processing (NLP) and speech analytic software. Such approaches allow for objective, quantitative measurement of speech and language patterns that may be more tractable and unbiased. Future research integrating both speech and language features and capturing "natural language" samples may yield a more comprehensive understanding of language differences in autism, offering potential implications for diagnosis, intervention, and research.

The Neural Bases of Language Processing During Social and Non-Social Contexts: A fNIRS Study of Autistic and Neurotypical Preschool-Aged Children

Background

Little is known about how the brains of autistic children process language during real-world "social contexts," despite the fact that challenges with language, communication, and social interaction are core features of Autism Spectrum Disorder (ASD).

Methods

We investigated the neural bases of language processing during social and non-social contexts in a sample of N=20 autistic and N=20 neurotypical (NT) preschool-aged children, 3 to 6 years old. Functional near-infrared spectroscopy (fNIRS) was used to measure children's brain response to "live language" spoken by a live experimenter during an in-person social context (i.e., book reading), and "recorded language" played via an audio recording during a non-social context (i.e., screen time). We examined within-group and between-group differences in the strength and localization of brain response to live language and recorded language, as well as correlations between children's brain response and language skills measured by the Preschool Language Scales.

Results

In the NT group, brain response to live language was greater than brain response to recorded language in the right temporal parietal junction (TPJ). In the ASD group, the strength of brain response did not differ between conditions. The ASD group showed greater brain response to recorded language than the NT group in the right inferior and middle frontal gyrus (IMFG). Across groups, children's language skills were negatively associated with brain response to recorded language in the right IMFG, suggesting that processing recorded language required more cognitive effort for children with lower language skills. Children's language skills were also positively associated with the difference in brain response between conditions in the right TPJ, demonstrating that children who showed a greater difference in brain response to live language versus recorded language had higher language skills.

Limitations

Findings should be considered preliminary until they are replicated in a larger sample.

Conclusions

Findings suggest that the brains of NT children, but not autistic children, process language differently during social and non-social contexts. Individual differences in how the brain processes language during social and non-social contexts may help to explain why language skills are so variable across children with and without autism.

Effect of Emotional Valence on Emotion Recognition in Adolescents with Autism Spectrum Disorder

This study investigated how emotional valence of a perceived emotional state impacted performance on the Reading the Mind in the Eyes task (RMET) in adolescents with autism spectrum disorder (ASD) and typically developing (TD) controls. Valence of items on the RMET, Adult (RMET-A) and Child (RMET-C) versions, was first classified in a survey of 113 medical students. Adolescents with ASD (N = 33) and TD adolescents (N = 30) were administered both RMET versions. Individuals with ASD made more errors than TD controls on positive and negative, but not neutral, valence items. The difference in performance was accentuated on the RMET-A compared to the RMET-C. Both emotional valence and complexity of language contribute to RMET performance in individuals with ASD.

Internal state language factor structure and development in toddlerhood: Insights from WordBank

Internal state language (ISL) research contains knowledge gaps, including dimensionality and predictors of growth, addressed here in a two-aim study. Parent-reported expressive language from N = 6,373 monolingual, English-speaking toddlers (Mage = 23.5mos, 46% male, 57% white) was collected using cross-sectional and longitudinal data in WordBank. Exploratory and confirmatory factor analyses suggested a best-fitting one-factor model of ISL. The single-factor model of ISL was then submitted to hierarchical linear modeling to evaluate predictors of ISL development. Age 2 ISL production was predicted by child sex, wherein females outperform males, and maternal education, wherein higher education contributes to higher ISL. Only maternal education emerged as a significant predictor of ISL growth. These results provide support to theory suggesting a unitary construct of ISL, as opposed to considering ISL as categorical, and further illustrate linear growth through the second postnatal year that varies as a function of child sex and maternal education.

Developmental differences in reported speech and internal state language in preschoolers' personal narratives

The present study explored developmental differences in preschoolers' use of reported speech and internal state language in personal narratives. Three-, four-, and five-year-olds attending a laboratory preschool shared 204 stories about 'a time when you were happy/sad'. Stories were audio-recorded, transcribed, and coded for reported speech (direct, indirect, narrativized) and internal state language (cognitive states, total emotion terms, unique emotion terms). Personal narratives told by five-year-olds included more cognitive states and more narrativized speech than those told by three- and four-year-olds, even when accounting for children's vocabulary skills, and that reported speech (narrativized, direct) were positively correlated with cognitive state talk. These findings highlight distinct shifts in children's use of cognitive state talk and reported speech in personal narratives told at age five. Associations between reported speech and internal state language are both informed by and support Vygotsky's (1978) fundamental claim that psychological processes are socially mediated by language.

A systematic review on the use of technology to enhance the academic achievements of children with attention deficit hyperactivity disorder in language learning

This review investigates the use of technology for children and adolescents with Attention Deficit Hyperactivity Disorder and their academic achievements in language learning, as well as their attitudes towards technology use. The goal is to integrate this information in order to learn how technology is provided to this population regarding first and second language learning, and also how effective and appropriate its use is and how it is perceived by stakeholders in the learning process. A systematic review was conducted, and after the final screening process, 15 studies were analysed, the majority of which were about first language learning (n = 11). Most studies found that technology use has a positive impact on students' language skills and that students tend to find it more motivating and engaging. While these technologies seem to be promising tools for improving skills, further studies must be conducted, especially in the field of second language learning.

Defining the Characteristics of Story Production of Autistic Children: A Multilevel Analysis

Several studies suggest that a valuable tool to examine linguistic skills in communication disorders is offered by procedures of narrative discourse assessment. Following this line of research, we present an exploratory study aimed to investigate storytelling abilities of autistic children to better define the characteristics of their story production. Participants included 41 autistic children and 41 children with typical development aged between 7.02 and 11.03 years matched on age, gender, level of formal education, intelligence quotient, working memory, attention skills, theory of mind, and phonological short-term memory. Narrative production was assessed by analysing the language samples obtained through the "Nest Story" description task. A multilevel analysis including micro- and macro-linguistic variables was adopted for narrative assessment. Group differences emerged on both micro- and macro-linguistic dimensions: autistic children produced narratives with more phonological errors and semantic paraphasias (microlinguistic variables) as well as more errors of global coherence and a fewer number of visible events and inferred events (macrolinguistic variables) than the control group.This study shows that even autistic children with adequate cognitive skills display several limitations in their narrative competence and that such weaknesses affect both micro- and macrolinguistic aspects of story production.

Here's the Story: Narrative Ability and Executive Function in Autism Spectrum Disorder

Background

Difficulties with narrative have been reported in individuals diagnosed with autism spectrum disorder (ASD), but the role of executive function on narrative ability has not been examined in ASD. In this study, we aimed to (1) examine whether narrative abilities of ASD children differed from neurotypical (NT) children who did not differ in age, sex, and IQ; and (2) investigate relations between executive function and narrative ability in ASD children.

Method

Narratives were elicited from 64 ASD children and 26 NT children using a wordless picture book and coded to derive several aspects of narrative ability such as propositions, evaluative devices, and self-repairs. Executive functions (specifically, inhibition and working memory) were measured using both experimenter-administered assessment and parent-report measures.

Results

Compared to NT children, ASD children produced fewer propositions but did not differ in their use of evaluative devices and self-repairs during narrative production. Greater inhibitory challenges related to more self-repairs involving repetition of story elements, whereas working memory did not relate to any of the measures of narrative ability among ASD children.

Conclusions

This study revealed that narratives by verbally fluent ASD children were shorter and less complex than those by NT children but did not differ in the specific features of narratives. Furthermore, although ASD children did not make more self-repairs than NT children, difficulty with inhibition was related to more self-repairs, indicating more dysfluent narrative production in ASD children, which has implications for intervention.

Linguistic markers of autism spectrum conditions in narratives: A comprehensive analysis

Background & Aims: Narratives are regularly elicited as part of standardized assessments for autism spectrum conditions (ASC) such as the ADOS, but have rarely been utilized as linguistic data in their own right. We here aimed for a specific and comprehensive quantitative linguistic profile of such narratives across nominal, verbal, and clausal domains of grammatical organization, and error patterns. Methods: We manually transcribed and annotated narratives elicited from the ADOS from a sample of bilingual autistic Spanish-Catalan children (n = 18), matched with typically developing controls (n = 18) on vocabulary-based verbal IQ. Results: Results revealed fewer relative clauses and more frequent errors in referential specificity and non-relational content-word choice in ASC. Frequent error types are also discussed qualitatively. Conclusions & Implications: These findings, based on more finegrained linguistically defined variables, help to disentangle previous inconsistencies in the literature, and to better situate language changes in the spectrum of neurocognitive changes in this population.

A Systematic Review and Meta-analysis of Narrative Language Abilities in Children with Attention-Deficit/Hyperactivity Disorder

While children with ADHD are reported to have language problems, it is less clear if their ability to use language to tell a story (i.e., form a narrative) is impaired. Therefore, a systematic review and meta-analysis of studies examining the oral production of fictional stories in children with ADHD was conducted. Databases were systematically searched in January 2019 and December 2020 (follow-up). Studies comparing children (≤ 18 years) with ADHD to a control group of typically developing children were included. The meta-analysis adhered to PRISMA guidelines and was preregistered with PROSPERO [CRD42019122040]. Sixteen studies were retained. Results indicated that compared to typically developing children, children with ADHD produced less coherent narratives (Hedges' g = 0.58 p < .001), gave more ambiguous references (Hedges' g = 0.52, p < .001), made more disruptive errors (Hedges' g = 0.41, p < .001), and produced language that was less syntactically complex (Hedges' g = 0.39, p < .05). Children with ADHD also produced less language overall (Hedges' g = 0.27, p < .05), although this result appeared to be an artefact of publication bias. Two studies investigated internal state language and both found children with ADHD to produce narratives with less internal state language. Children with ADHD did not produce less fluent narratives (Hedges' g = 0.23, p = .47), although a scarcity of studies [K = 4] preclude firm conclusions. In conclusion, children with ADHD were impaired in several areas of oral narrative production and screening for narrative language problems should be considered when assessing language and communicative abilities in children with ADHD.

A Subtle Profile With a Significant Impact: Language and Communication Difficulties for Autistic Females Without Intellectual Disability

The presentation of autism in females is poorly understood, which is thought to contribute to missed or later- age diagnosis, especially for those without intellectual disability. Dedicated research into social and behavioral differences has indicated a specific female phenotype of autism. However, less has been done to explore language and communication profiles, despite known sex/gender differences in typically developing populations. This article provides a synthesis of recent work from this small but emerging field. It focuses on a series of four preliminary and explorative studies conducted by the authors and embeds this within the wider literature. Findings suggest a specific profile of language and communication strengths and weaknesses for autistic females without intellectual disability (compared to autistic males and typically developing females). Furthermore, despite the relatively subtle presentation of difficulties (compared to autistic males), the impact on functionality, social inter-relations and emotional well-being, appears to be equitable and significant. The discussion highlights the need for further empirical research and proposes areas for investigation. Implications for clinical practice include the need for better recognition, testing and provision of interventions dedicated to the language and communication difficulties for autistic females. This has relevance for diagnostic, mental health and speech and language therapy services.

Capacity of the CCC-2 to Discriminate ASD from Other Neurodevelopmental Disorders

The Children’s Communication Checklist (CCC-2) has demonstrated its usefulness as an instrument to assess discrepancies between the use of structural dimensions of language and the pragmatic and sociointeractive uses of language. The aims of the present paper are: (1) to test the capacity of the Galician adaptation of the CCC-2 to discriminate the linguistic profiles of children with different disorders and (2) to test whether the capacity of the CCC-2 to discriminate the linguistic abilities of children with different disorders is the same at different ages: earlier development and later development. The sample is of 117 children previously diagnosed with different disorders: autism spectrum disorder (ASD), developmental language disorder (DLD), attention deficit with hyperactivity disorder (ADHD), Down syndrome children (DS) and typically developing children (TD). The children were divided into two different age groups: from 4 to 6 and from 7 to 16 years of age. The results indicate that the Galician CCC-2 (1) accurately identified children with and without communicative impairments, (2) distinguished between profiles with a predominance of pragmatic (ASD and ADHD) and structural disorders (DS and DLD) and (3) distinguished between different profiles of pragmatic impairment. The CCC-2 equally identified these profiles at both earlier and later ages. The Galician CCC-2 seems to be a useful instrument for differentiating among different clinical groups and for assessing pragmatic disorders from an early age, which can be valuable for planning early intervention.

Conversation During a Virtual Reality Task Reveals New Structural Language Profiles of Children with ASD, ADHD, and Comorbid Symptoms of Both

Many studies have utilized standardized measures and storybook narratives to characterize language profiles of children with Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD). They report that structural language of these children is on par with mental-age-matched typically developing (TD) peers. Few studies have looked at structural language profiles in conversational contexts. This study examines conversational speech produced in a virtual reality (VR) paradigm to investigate the strengths and weaknesses of structural language abilities of these children. The VR paradigm introduced varying social and cognitive demands across phases. Our results indicate that children from these diagnostic groups produced less complex structural language than TD children. Moreover, language complexity decreased in all groups across phases, suggesting a cross-etiology sensitivity to conversational contexts.

The effect of picture support on narrative retells in Swedish adolescents with ADHD

ADHD is characterized by executive functioning (EF) deficits, which in turn may affect language, and therefore EF demands in language assessment tasks are important to consider. This study aims to inform clinical practice by 1) comparing and describing narrative retells in Swedish adolescents with and without ADHD, and 2) investigating the effects of picture support on narration in the two groups. Fifteen adolescents with ADHD and 31 with typical development (TD) participated. Two carefully matched narratives for retelling, one with and one without picture support were administered, transcribed, and analyzed regarding content and linguistic complexity (macro- and microlevel measures). The results showed that the ADHD group included less content than the TD group in both tasks, measured in fewer story grammar units and details. Both groups included more story grammar units in the task without picture support. The TD group had shorter retells with higher syntactic complexity in the task with picture support compared to the task without picture support. Compared to TD peers, retells without picture support from the ADHD group were significantly shorter and had a higher proportion of grammatical errors. These results show different strengths and weaknesses in the two groups and indicate that the narrative task without picture support, which places higher demands on EF, captured a linguistic vulnerability in the ADHD group. In conclusion, the choice of narrative task is important to consider in clinical practice to enable accurate descriptions of linguistic strengths and weaknesses in individuals with ADHD, and aid in differential diagnosis.

The profile of pragmatic language impairments in children with ADHD: A systematic review

This systematic review synthesizes the empirical literature examining pragmatic language in children diagnosed with attention-deficit/hyperactivity disorder (ADHD). Using a taxonomy of pragmatic language, we compared the pragmatic language profiles of children with ADHD to those of typically developing (TD) children and children with autism. Three databases were searched up to October 2019: PsychInfo; PubMed; and CSA Linguistics and Language Behavior Abstracts. We included 34 studies reporting on 2,845 children (ADHD = 1,407; TD = 1,058; autism = 380). Quality and risk of bias assessments included sample size and representativeness; measure reliability and validity; and missing data management. Children with ADHD were found to have higher rates of pragmatic difficulties than their TD peers. Specific difficulties were identified with inappropriate initiation, presupposition, social discourse, and narrative coherence. Children with ADHD appear to differ from those with autism in the degree of their pragmatic language impairments. General language skills contribute to, but do not explain, pragmatic difficulties in samples of children with ADHD. Though the extant evidence is limited, a preliminary profile of the pragmatic language impairments in children with ADHD is indicated. This supports a call for evidence-based interventions that include pragmatic language skills training.

Structural and Contextual Cues in Third-Person Pronoun Interpretation by Children with Autism Spectrum Disorder and Their Neurotypical Peers

This study investigates the use of structural and discourse contextual cues in the interpretation of third-person pronouns by children and adolescents with autism and their neurotypical peers. Results show that referent-biasing contextual information influences pronominal interpretation and modulates looking patterns in both groups compared to a context-neutral condition. These results go against the predictions of Weak Central Coherence and the notion that pragmatics in general is impaired in ASD, since the ASD group was able to use details in discourse context to influence the pronominal interpretation process. However, although discourse context influenced looking patterns in both groups, the groups nevertheless diverged in the nature of these patterns, suggesting that behavioral differences may emerge in more complicated discourse tasks.

The impact of bilingualism on the narrative ability and the executive functions of children with autism spectrum disorders

While there is ample evidence that monolingual children with Autism Spectrum Disorders (ASD) face difficulties with narrative story-telling and executive functions (EF), there is considerable uncertainty about how bilingualism impacts these skills in autism. The current study explores the effect of bilingualism on the narrative and EF skills of forty 7-to-12-year-old bilingual and monolingual children with ASD, as well as forty age-matched bilingual and monolingual children of typical development (TD). Narrative production data were elicited using the Edmonton Narrative Norms Instrument (ENNI; Schneider et al., 2005), which was developed to measure narrative production at a microstructural and macrostructural level. The same children were administered two EF tasks, namely, a global-local visual attention task and a 2-back working memory task. In story-telling, bilingual children with ASD achieved higher scores than monolingual children with ASD on story structure complexity and use of adverbial clauses, and they tended to use significantly fewer ambiguous referential forms than their monolingual peers with ASD. In the global-local task, bilingual children with ASD were faster and more accurate in global trials than monolingual children with ASD, who tended to be more susceptible to interference from locally presented information than the other experimental groups. Higher accuracy and faster response times were also observed for bilingual children with ASD in the 2-back task. Further correlation analyses between the story-telling and EF tasks revealed that bilingual children with ASD drew on a broader range of EF in narrative production than their monolingual peers. The overall findings reveal that bilingual children with ASD outperformed their monolingual peers with ASD in both the microstructure and macrostructure of their narrative production, as well as in their visual attention and working memory skills.

Semantic-Pragmatic Impairment in the Narratives of Children With Autism Spectrum Disorders

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.

Mental health literacy for autism spectrum disorder and depression

In this study, three hundred and sixty-eight participants answered a questionnaire consisting of three vignettes describing a person with depression, severe Autism Spectrum Disorder (ASD), and high-functioning Autism Spectrum Disorder/Asperger's Syndrome (AS). Each vignette was followed by thirteen questions concerning the participant's knowledge about diagnosis, treatment, and prognosis. Participants demonstrated good mental health literacy (MHL) for depression, but were poor at diagnosing ASD. Drug therapy was rated as the least effective treatment and 'talking to a family member of friend' was rated as the most effective for each disorder. The highest prognosis ratings were given to depression, and the lowest given to ASD. Participants demonstrated better MHL than expected, possibly due to the availability of information on the Internet and the increase in prevalence of mental illnesses such as depression and ASD among the general population.

The influence of narrative competence on mental state talk in kindergarten and primary school children

This study investigates the relationships between narrative competence and mental state talk at different age levels. Specifically, we explored whether a higher level of structure in narratives is associated with children's mental state talk, and whether this effect is moderated by age (kindergarten, lower and upper primary school). The participants in the study were 172 Italian children. The children were asked to tell a story and their productions were coded for narrative structural level and mental state talk. Data showed higher levels of narrative structure were associated with a higher frequency of emotional, cognitive, moral, and socio-relational terms. Results of the present study contributed to improve our understanding about how mental state talk and narrative competence are associated in different ways at different ages. This result suggests that children may develop in the ability to coordinate mental state talk and narrative structure as an effect of both, age and schooling. Statement of contribution What is already known on this subject? Theory of mind and language are interconnected. Theory of mind can be assessed through mental state talk. Mental state talk is elicited through narrative tasks. What does this study add? Narrative competence is associated with mental state talk. The first years of primary school seem to represent an important transition in children's development in narrative competence and MST. Children may develop in the ability to coordinate mental state talk and narrative structure as an effect of both, age and schooling.

Gender Differences in Pragmatic Communication in School-Aged Children with Autism Spectrum Disorder (ASD)

Possible gender differences in manifestations of autism spectrum disorder (ASD) were examined using data on production of narratives. The Expression, Reception and Recall of Narrative Instrument (ERRNI; Bishop, Expression, Reception and Recall of Narrative Instrument, Harcourt assessment, London, 2004) was administered to a sample of matched 8-year-old intellectually able boys and girls with ASD (13M, 13F), who had been selected from a large, longitudinal study. In addition, transcripts of the narratives were analyzed in detail. Significant gender differences were found in narrative production. Girls included more salient story elements than boys. On detailed language analysis, girls were also shown to tell richer stories, including more descriptors of planning or intention. Overall, our findings suggest that subtle differences in social communication may exist between intellectually able boys and girls with ASD. If reliably identifiable in young children, such gender differences may contribute to differential diagnosis of ASD. In addition, such differences may pave the way for differential approaches to intervention when the target is effective communication in sophisticated discourse contexts.

Linguistic markers of autism in girls: evidence of a "blended phenotype" during storytelling

Background

Narrative abilities are linked to social impairment in autism spectrum disorder (ASD), such that reductions in words about cognitive processes (e.g., think, know) are thought to reflect underlying deficits in social cognition, including Theory of Mind. However, research suggests that typically developing (TD) boys and girls tell narratives in sex-specific ways, including differential reliance on cognitive process words. Given that most studies of narration in ASD have been conducted in predominantly male samples, it is possible that prior results showing reduced cognitive processing language in ASD may not generalize to autistic girls. To answer this question, we measured the relative frequency of two kinds of words in stories told by autistic girls and boys: nouns (words that indicate object-oriented storytelling) and cognitive process words (words like think and know that indicate mentalizing or attention to other peoples' internal states).

Methods

One hundred two verbally fluent school-aged children [girls with ASD (N = 21) and TD (N = 19), and boys with ASD (N = 41) and TD (N = 21)] were matched on age, IQ, and maternal education. Children told a story from a sequence of pictures, and word frequencies (nouns, cognitive process words) were compared.

Results

Autistic children of both sexes consistently produced a greater number of nouns than TD controls, indicating object-focused storytelling. There were no sex differences in cognitive process word use in the TD group, but autistic girls produced significantly more cognitive process words than autistic boys, despite comparable autism symptom severity. Thus, autistic girls showed a unique narrative profile that overlapped with autistic boys and typical girls/boys. Noun use correlated significantly with parent reports of social symptom severity in all groups, but cognitive process word use correlated with social ability in boys only.

Conclusion

This study extends prior research on autistic children's storytelling by measuring sex differences in the narratives of a relatively large, well-matched sample of children with and without ASD. Importantly, prior research showing that autistic children use fewer cognitive process words is true for boys only, while object-focused language is a sex-neutral linguistic marker of ASD. These findings suggest that sex-sensitive screening and diagnostic methods-preferably using objective metrics like natural language processing-may be helpful for identifying autistic girls, and could guide the development of future personalized treatment strategies.

Estrutura e coerência da narrativa oral de crianças com transtorno de déficit de atenção e hiperatividade

RESUMO Objetivo O objetivo do estudo foi caracterizar e comparar o uso de elementos típicos da gramática de história e o nível de coerência global na narrativa oral de crianças com Transtorno de Déficit de Atenção e Hiperatividade à narrativa de crianças sem o transtorno e com desenvolvimento típico. Método Participaram 40 crianças com idade entre 5 e 10 anos, de ambos os sexos, que frequentavam o ensino fundamental, sendo 20 com diagnóstico de Transtorno de Déficit de Atenção e Hiperatividade (Grupo TDAH) e 20 com desenvolvimento típico (Grupo TD). Os participantes de cada grupo eram semelhantes quanto ao sexo, idade cronológica, escolaridade e nível socioeconômico. O livro “Frog Where Are You?” foi utilizado para eliciar a narrativa oral de história, que foi analisada quanto à presença dos principais elementos típicos do esquema de história (personagem, tema/tópico, evento/trama e desfecho) e posteriormente classificada dentre quatro diferentes níveis crescentes de organização, correspondendo ao nível de coerência global da história. Resultados O grupo TDAH apresentou menor pontuação nos elementos estruturais “tema/tópico” e “desfecho” e narrativa com grau de coerência inferior quando comparado ao grupo TD. Conclusão As crianças com TDAH deste estudo apresentaram dificuldades no uso de elementos típicos da gramática de história, principalmente relacionados com a manutenção do tema central e desfecho da história. Tais elementos são considerados fundamentais para a construção do sentido da narrativa, o que justifica os níveis inferiores de coerência encontrados na narrativa oral do grupo TDAH.

The effects of narrative-based language intervention (NBLI) on spoken narrative structures in Persian-speaking cochlear implanted children: A prospective randomized control trial

BACKGROUND

Previous research has shown that narrative-based language intervention (NBLI) is a feasible approach increasing the narrative skills of hearing-impaired children.

OBJECTIVE

In the present study, the efficacy of NBLI on the macrostructure and microstructure components of the spoken narrative of children with cochlear implants (CI) was evaluated in an experimental study.

MATERIALS AND METHODS

Thirty-six CI children between the ages of 5.5 and 7 years were randomly divided in three groups of equal size. Group 1 attended 24 1-h sessions of NBLI group therapy. Group 2 participants each attended 24 1-h private sessions of NBLI instruction. Group 3 attended 24 1-h conventional speech therapy (CST) sessions. The subjects' storytelling skills were prompted using pictures from the Persian version of the Language Sample Analysis test. The results were assessed before treatment (T0), after treatment (T1) and two months after treatment (T2) as follow-up.

RESULTS

Groups 1 and 2 showed significantly better results over Group 3 on all microstructure components of spoken narrative at the T1 (p ≤ 0.04) and T2 (p ≤ 0.04) levels in comparison with T0, but no differences were observed between the NBLI approaches (p > 0.05). All three intervention programs significantly improved the macrostructure of the spoken narrative in CI children.

CONCLUSION

Improvements in spoken narrative structures were observed in CI children that support the efficacy of NBLI over CST for the hearing-impaired population.

Do Patients With Depression Prefer Literal or Metaphorical Expressions for Internal States? Evidence From Sentence Completion and Elicited Production

In everyday communication metaphoric expressions are frequently used to refer to abstract concepts, such as feelings or mental states. Patients with depression are said to prefer literal over figurative language, i.e. they may show a concreteness bias. Given that both emotional functioning and the processing of figurative language may be altered in this clinical population, our study aims at investigating whether and how these dysfunctions are reflected in the understanding and production of metaphorical expressions for internal states. We used two behavioral approaches: a sentence completion task and elicited speech production. In the first experiment, patients with ICD 10 depression (n = 26) and healthy controls (n = 32) were asked to complete sentences by selecting an appropriate word out of four alternatives (metaphorical expression, literal expression, concrete distractor, abstract distractor). All participants–irrespective of the presence of depression–chose more literal (60%) than metaphorical (40%) expressions. In the second experiment, patients with depression (n = 44) and healthy controls (n = 36) described pictures showing emotive events. The descriptions were transcribed and coded for type of expression (non-figurative words for internal states vs. metaphorical expressions, valence, type of metaphor, source and target domain of metaphor). In addition, the Thought and Language Index was applied to assess formal thought disorder. When talking about internal states, both groups used more literal than metaphorical expressions. The groups did not differ with respect to the composition of internal state language, but patients with depression tended to verbalize positive content to a lesser extent. Correlation analyses within the patients' group revealed that signs of disorganization in their speech were related to a higher use of internal state expressions, whereas a negative correlation was found with dysregulation phenomena. Taken together, results indicate that people with and without depression prefer literal means in order to verbalize internal states, but they additionally make use of figurative language. Since patients with depression were able to understand and produce metaphors for internal states similar to controls, the concreteness bias cannot be confirmed by the present study. The results contribute to existing research by demonstrating associations between symptoms of formal thought disorder and internal state language.

Executive function predicts the visuospatial working memory in autism spectrum disorder and attention-deficit/hyperactivity disorder

Children with autism spectrum disorder (ASD) and those with attention deficit/hyperactivity disorder (ADHD) always show working memory deficits. However, research findings on the factors that affected the working memory in ASD and ADHD were inconsistent. Thus, we developed the present study to investigate the association of executive function (EF) with the visuospatial working memory (VSWM) in ASD and ADHD. Three groups of participants were examined: 21 children with ASD, 28 children with ADHD and 28 typically developing (TD) children as the controls. All participants completed two tests: the Wisconsin Card Sorting Test (WCST) and the Corsi Block Tapping Test for measuring EF and VSWM, respectively. The WCST included four domains: categories achieved (CA), perseverative errors (PE), failures to maintain set (FMS), and total errors (TE). The findings indicated that (1) the ASD group showed poorer performance in VSWM than the ADHD and TD groups; (2) for the ASD group, VSWM was positively correlated with CA, and was negatively correlated with PE and TE; (3) for the ADHD group, FMS showed a negative relationship with VSWM; and (4) TE predicted the performance of VSWM in ASD group, while FMS predicted VSWM in ADHD group. The study results suggested that VSWM was impaired in ASD but not in ADHD. Also, the EF domains were differently correlated with the VSWM performance in ASD and ADHD. Our study suggests that we should consider different intervention targets of working memory and EF contributions in improving the cognitive capacity of ASD and ADHD. Autism Res 2018, 11: 1148-1156. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The present study compared the visuospatial working memory (VSWM) in three groups of children: autism (ASD), attention deficit/hyperactivity disorder (ADHD), and typically developed children (TD). The ASD group showed poorer VSWM than the ADHD and TD groups. The total error of executive function predicted the performance of VSWM in ASD, while failures to maintain set predicted VSWM in ADHD . These findings suggested that we should consider the different working memory and executive function training targets to increase cognitive capacity of ASD and ADHD.

Spoken and Written Narrative in Persian-Speaking Students Who Received Cochlear Implant and/or Hearing Aid

OBJECTIVES

To compare narrative skills between fourth and fifth grades of Persian-speaking students with hearing impairments and typical hearing students of the same grade and also to evaluate the effects of group, sex, hearing age, and educational grade of the students on their spoken/written narrative performance.

METHODS

The subjects were 174 students aged 10-13 years, 54 of whom wore cochlear implants, 60 suffered from moderate to severe hearing losses and wore hearing aids, with the remaining 60 students being typical hearing in terms of the sense of hearing. The micro- and macrostructure components of spoken and written narrative were elicited from a pictorial story (The Playful Little Elephant) and then scored by raters.

RESULTS

Compared to the typical hearing, the students with hearing impairments had significantly lower scores in all of the microstructure components of narratives. However, the findings showed no significant difference among different groups in macrostructure components of narratives. It was also revealed that the students had equal performance in spoken and written narrative. Finally, factor analysis manifested that group, sex, hearing age, and educational level of children might alter the outcome measures in various interactions.

CONCLUSION

Although cochlear implantation was more effective than hearing aid on spoken and written narrative skills, the Persian-speaking students with hearing impairments were seen to need additional trainings on microstructure components of spoken/written narrative.

Learning and Using Abstract Words: Evidence from Clinical Populations

It has been shown that abstract concepts are more difficult to process and are acquired later than concrete concepts. We analysed the percentage of concrete words in the narrative lexicon of individuals with Williams Syndrome (WS) as compared to individuals with Down Syndrome (DS) and typically developing (TD) peers. The cognitive profile of WS is characterized by visual-spatial difficulties, while DS presents with predominant impairments in linguistic abilities. We predicted that if linguistic abilities are crucial to the development and use of an abstract vocabulary, DS participants should display a higher concreteness index than both Williams Syndrome and typically developing individuals. Results confirm this prediction, thus supporting the hypothesis of a crucial role of linguistic processes in abstract language acquisition. Correlation analyses suggest that a maturational link exists between the level of abstractness in narrative production and syntactic comprehension.

Pragmatic competence of children with autism spectrum disorder. Impact of theory of mind, verbal working memory, ADHD symptoms, and structural language

The primary aim of this study is to increase the existing knowledge about the pragmatic skills of children with autism spectrum disorders (ASD). Specifically, the study has two objectives. The first is to provide a profile of characteristics based on The Children's Communication Checklist (CCC-2) pragmatics scales (inappropriate initiation, stereotyped language, use of context, nonverbal communication, and general pragmatics) and narrative task indicators. To this end, children with ASD will be compared to children with typical development (TD), controlling the effects of sex and structural language (speech, syntax, semantics, coherence). The second objective is to analyze whether theory of mind (ToM), verbal working memory, ADHD symptoms, and structural language can predict pragmatic competence in children with ASD without intellectual disability (ID). The results showed worse performance in the group with ASD on the majority of the pragmatic aspects evaluated. In addition, the application of ToM skills and structural language were significant predictors of the pragmatic skills of the children with ASD. These findings reinforce the importance of focusing intervention programs on mentalist abilities through experiences in real social scenarios, along with strengthening structural language components.

Syntactic and Story Structure Complexity in the Narratives of High- and Low-Language Ability Children with Autism Spectrum Disorder

Although language impairment is commonly associated with the autism spectrum disorder (ASD), the Diagnostic Statistical Manual no longer includes language impairment as a necessary component of an ASD diagnosis (American Psychiatric Association, 2013). However, children with ASD and no comorbid intellectual disability struggle with some aspects of language whose precise nature is still outstanding. Narratives have been extensively used as a tool to examine lexical and syntactic abilities, as well as pragmatic skills in children with ASD. This study contributes to this literature by investigating the narrative skills of 30 Greek-speaking children with ASD and normal non-verbal IQ, 16 with language skills in the upper end of the normal range (ASD-HL), and 14 in the lower end of the normal range (ASD-LL). The control group consisted of 15 age-matched typically-developing (TD) children. Narrative performance was measured in terms of both microstructural and macrostructural properties. Microstructural properties included lexical and syntactic measures of complexity such as subordinate vs. coordinate clauses and types of subordinate clauses. Macrostructure was measured in terms of the diversity in the use of internal state terms (ISTs) and story structure complexity, i.e., children's ability to produce important units of information that involve the setting, characters, events, and outcomes of the story, as well as the characters' thoughts and feelings. The findings demonstrate that high language ability and syntactic complexity pattern together in ASD children's narrative performance and that language ability compensates for autistic children's pragmatic deficit associated with the production of Theory of Mind-related ISTs. Nevertheless, both groups of children with ASD (high and low language ability) scored lower than the TD controls in the production of Theory of Mind-unrelated ISTs, modifier clauses and story structure complexity.

Severity of Autism Symptoms and Degree of Attentional Difficulties Predicts Emotional and Behavioral Problems in Children with High-Functioning Autism; a Two-Year Follow-up Study

Children with autism often struggle with emotional and behavioral problems (EBP). This study investigated whether level of autism symptoms, attention problems or verbal IQ at baseline can predict EBP 2 years later in children with High-Functioning Autism (HFA). Thirty-four participants with HFA and 45 typically developing children (TD) (ages 9-16) were assessed with parent ratings of EBP, autism symptoms, attention problems, and a test of verbal IQ. The amount of autism symptoms and degree of attention problems at baseline significantly predicted EBP at follow-up, whereas verbal IQ did not. The findings from this study emphasize the importance of assessing and understanding the consequences of autism symptoms and attention problems when treating EBP in children with HFA. Furthermore, interventions aimed at improving ASD symptoms may positively affect the prevalence of EBP in children with HFA.

Mental states and activities in Danish narratives: children with autism and children with language impairment

This study focuses on the relationship between content elements and mental-state language in narratives from twenty-seven children with autism (ASD), twelve children with language impairment (LI), and thirty typically developing children (TD). The groups did not differ on chronological age (10;6-14;0) and non-verbal cognitive skills, and the groups with ASD and TD did not differ on language measures. The children with ASD and LI had fewer content elements of the storyline than the TD children. Compared with the TD children, the children with ASD used fewer subordinate clauses about the characters' thoughts, and preferred talking about mental states as reported speech, especially in the form of direct speech. The children with LI did not differ from the TD children on these measures. The results are discussed in the context of difficulties with socio-cognition in children with ASD and of language difficulties in children with LI.

Beyond Sentences: Using the Expression, Reception, and Recall of Narratives Instrument to Assess Communication in School-Aged Children With Autism Spectrum Disorder

PURPOSE

Impairments in the social use of language are universal in autism spectrum disorder (ASD), but few standardized measures evaluate communication skills above the level of individual words or sentences. This study evaluated the Expression, Reception, and Recall of Narrative Instrument (ERRNI; Bishop, 2004) to determine its contribution to assessing language and communicative impairment beyond the sentence level in children with ASD.

METHOD

A battery of assessments, including measures of cognition, language, pragmatics, severity of autism symptoms, and adaptive functioning, was administered to 74 8- to 9-year-old intellectually able children with ASD.

RESULTS

Average performance on the ERRNI was significantly poorer than on the Clinical Evaluation of Language Fundamentals-Fourth Edition (CELF-4). In addition, ERRNI scores reflecting the number and quality of relevant story components included in the participants' narratives were significantly positively related to scores on measures of nonverbal cognitive skill, language, and everyday adaptive communication, and significantly negatively correlated with the severity of affective autism symptoms.

CONCLUSION

Results suggest that the ERRNI reveals discourse impairments that may not be identified by measures that focus on individual words and sentences. Overall, the ERRNI provides a useful measure of communicative skill beyond the sentence level in school-aged children with ASD.

Influencia del riesgo social en la teoría de la mente y funciones ejecutivas de adolescentes colombianos

El objetivo del presente estudio fue determinar la relación que existe entre las Funciones Ejecutivas (FE) y la Teoría de la Mente (ToM) en población colombiana en condición de riesgo social. Participaron 78 adolescentes (41 en riesgo social y 37 controles) entre los 13 y 16 años. Se administraron el Test de Palabras y Colores de Stroop, el Test de la Pirámide de México y el Test de Falso Paso para evaluar Control Inhibitorio, Planificación y ToM, respectivamente. A pesar de que no se encontraron diferencias significativas en los procesos ejecutivos de control inhibitorio y planificación, los controles mostraron tener mejor desempeño en la prueba de ToM (p<0,05). Adicionalmente, mientras que al interior del grupo sin riesgo social se observó una relación entre la ToM y los procesos ejecutivos evaluados (ps<0,05), sin embargo, al interior del grupo en riesgo social estos procesos no están relacionados. Se concluye que el entorno de riesgo social parece no afectar las habilidades ejecutivas de control inhibitorio y planificación pero sí la habilidad para realizar inferencias acerca de los estados mentales de los otros. De esta manera, un entorno de riesgo social es un factor ambiental que parece disociar el proceso de desarrollo de la cognición social y de los procesos ejecutivos en adolescentes, desarrollo que debería darse de manera paralela.

The effect of methylphenidate-OROS^® on the narrative ability of children with attention-deficit hyperactivity disorder

BACKGROUND AND OBJECTIVE

Children with attention-deficit hyperactivity disorder (ADHD) experience difficulty with expressive language, including form (e.g. grammatical construction) and content (e.g. coherence). The current study aimed to investigate the effect of methylphenidate-Osmotic Release Oral System® (MPH-OROS®) on the narrative ability of children with ADHD and language impairment, through the analysis of microstructure and macrostructure narrative elements.

METHOD

In a single group off-on medication test design, narratives were obtained from 12 children with ADHD, aged 7-13 years, using wordless picture books. For microstructure, number of words, type-token ratio and mean length of utterance were derived from narrative samples using Systematic Analysis of Language Transcripts conventions. For macrostructure, the narratives were coded according to the Narrative Scoring Scheme, which includes seven narrative characteristics, as well as a composite score reflecting the child's overall narrative ability.

RESULTS

The administration of MPH-OROS® resulted in a significant difference in certain aspects of language macrostructure: cohesion and overall narrative ability. Little effect was noted in microstructure elements.

CONCLUSION

We observed a positive effect of stimulant medication on the macrostructure, but not on the microstructure, of narrative production. Although stimulant medication improves attention and concentration, it does not improve all aspects of language abilities in children with ADHD. Language difficulties associated with ADHD related to language content and use may be more responsive to stimulant medication than language form, which is likely to be affected by cascading effects of inattention, hyperactivity and impulsivity beginning very early in life and to progress over a more protracted period. Therefore, a combination of treatments is advocated to ensure that children with ADHD are successful in reaching their full potential.

Attention and written expression in school-age, high-functioning children with autism spectrum disorders

High-functioning children with autism spectrum disorders often find writing challenging. These writing difficulties may be specific to autism spectrum disorder or to a more general clinical effect of attention disturbance, as these children are often comorbid for attention-deficit/hyperactivity disorder (ADHD) symptomatology (and children with attention-deficit/hyperactivity disorder often also find writing challenging). To examine this issue, this study investigated the role of attention disturbance on writing in 155 school-age children across four diagnostic groups: high-functioning autism spectrum disorder (HFASD) with lower ADHD symptoms (HFASD-L), HFASD with higher ADHD symptoms (HFASD-H), ADHD symptoms but no autism spectrum disorder symptoms, and typical development. Both HFASD subgroups and the ADHD group displayed lower word production writing scores than the typical development group, but the clinical groups did not differ. The HFASD-H and ADHD groups had significantly lower theme development and text organization writing scores than the typical development group, but the HFASD-L and typical development groups were not significantly different. The findings support prior research reporting writing problems in children with autism spectrum disorder but also suggest that children with HFASD-H may be at greater risk for writing difficulties than children with HFASD-L. Better understanding the role of attention in writing development could advance methods for assessment and intervention for children with high-functioning autism spectrum disorder at risk for writing difficulties.

Narratives of children with high-functioning autism spectrum disorder: A meta-analysis

BACKGROUND

The aim of this meta-analysis was to analyze the narrative performance of children and adolescents with high-functioning Autism Spectrum Disorders (ASD) in terms of microstructure, macrostructure and internal state language.

METHOD

A systematic literature search yielded 24 studies that met the predetermined inclusion criteria. Effect sizes for each study were calculated for eight variables and analyzed using a random effects model. Intellectual ability, age and type of narrative were considered as potential moderators.

RESULTS

Results revealed that the children with ASD performed significantly worse than their peers on all the variables considered.

CONCLUSIONS

Findings are discussed taking into account the main explanatory psychological autism theories. Implications for intervention and orientations for future research are suggested.

Production of mental state terms in narratives of Mandarin-speaking children with autism spectrum disorder

This study investigates the ability of Mandarin-speaking children with autism spectrum disorder (ASD) to use mental state terms in narratives. The narrative data are from 16 children with ASD and 16 typically developing children, matched on language and cognitive abilities. The narratives were elicited using Frog, where are you? Participants' use of lexical expressions referring to emotion, cognition, desire and perception was examined. The 'deer episode' of the story was chosen to analyse children's ability to talk about misrepresentation. The results reveal that the two groups of children performed comparably in basic narrative measures, overall use of mental state terms and references to the misrepresentation. The outcomes underscore the importance of examining different types of mental state terms separately. These findings are discussed in relation to linguistic and cognitive factors in mental-state attribution.

The Autism Diagnostic Observation Schedule and narrative assessment: Evidence for specific narrative impairments in autism spectrum disorders

PURPOSE

The Autism Diagnostic Observation Schedule (ADOS) contains a narrative generation task in which clients tell a story from a wordless picture book; however, the resulting narrative is not usually examined for its linguistic properties. This study aimed to examine narrative generation in autism spectrum disorder (ASD) by comparing narratives elicited from children with ASD during the ADOS to those produced by language-matched typically-developing (TD) peers.

METHOD

Participants were children with ASD (n = 11) and TD controls (n = 17). Both groups were aged 9-15 years and were matched for expressive and receptive language skills and non-verbal intelligence. Narratives were analysed for local structure elements (length, fluency, errors, semantics and syntax), cohesion and global elements (story grammar and internal state language).

RESULT

Results indicated that the narratives of the children with ASD were syntactically less complex, contained more ambiguous pronouns and included fewer story grammar elements than their control counterparts; with further analysis showing differences between younger and older children.

CONCLUSION

The present findings provide evidence that children with ASD exhibit subtle story generation impairments and provide preliminary support for the inclusion of narratives elicited as part of the ADOS in the assessment of specific language skills in this population.

Commonly studied comorbid psychopathologies among persons with autism spectrum disorder

The study of comorbid psychopathology among persons with autism spectrum disorder (ASD) is picking up steam. The purpose of this paper was to review and describe important characteristics of existing studies. Among the current crop of papers, depression, anxiety, and attention-deficit/hyperactivity disorder (ADHD) have been frequently evaluated. Groups studied have most frequently been children. Persons with ASD and normal intelligence quotient (IQ) scores have been studied more often than individuals with ASD and intellectual disability. Additional characteristics are discussed, and the implications of these data for future developments in the field are reviewed.

Internal State Language in the Storybook Narratives of Children with and without Autism Spectrum Disorder: Investigating Relations to Theory of Mind Abilities

The current study examines narratives elicited using a wordless picture book, focusing on language used to describe the characters' thoughts and emotions (i.e., internal state language, ISL). The sample includes 21 children with Autism Spectrum Disorder (ASD) and 24 typically developing controls, matched on children's gender, IQ, as well as receptive and expressive vocabulary. This research had three major findings. First, despite equivalent performance on standardized language assessments, the volume of children's narratives (i.e., the number of utterances and words, the range of unique verbs and adjectives) was lower in children with ASD than in typically developing controls. Second, after controlling for narrative volume, the narratives of children with ASD were less likely to reference the characters' emotions than was the case for typically developing controls. Finally, our results revealed a specific association between children's use of emotion terms and their performance on a battery of experimental tasks evaluating children's Theory of Mind abilities. Implications for our understanding of narrative deficits in ASD as well as interventions that use narrative as a context for improving social comprehension are discussed.

Pragmatic language difficulties in children with hyperactivity and attention problems: an integrated review

BACKGROUND

Diagnostic criteria for attention deficit hyperactivity disorder (ADHD) suggest a range of difficulties in the pragmatic aspects of language, including excessive talking and interrupting others. Such difficulties have been periodically reported over several decades in studies on the language abilities of children with features of ADHD, yet a comprehensive review of the literature has been lacking.

AIMS

This review aims to integrate evidence from several lines of research from 1979 to the present on pragmatic language difficulties in children with ADHD or symptoms of ADHD.

METHODS & PROCEDURES

A comprehensive search of empirical literature on pragmatic language in children with ADHD or symptoms of ADHD was conducted using PsycINFO and PubMed databases and through following up relevant references cited in articles. Literature was reviewed with respect to the nature and extent of pragmatic language difficulties in ADHD.

OUTCOMES & RESULTS

Thirty studies met the review inclusion criteria, including recent questionnaire studies, observational studies of children's communication patterns, and studies of higher-level language comprehension and production. The studies indicate a consistent profile of pragmatic language impairments in children with features of ADHD, particularly in the areas of excessive talking, poor conversational turn-taking, and lack of coherence and organization in elicited speech.

CONCLUSIONS & IMPLICATIONS

Pragmatic language difficulties are common in children with features of ADHD. These difficulties are consistent with deficits in executive function that are thought to characterize ADHD, thus providing some support for the theory that executive function contributes to pragmatic language competency. As yet there is very little empirical evidence of specific relationships between particular aspects of pragmatic language and particular domains of executive function. Given the importance of pragmatic language competency for children's social and academic functioning, pragmatic language abilities should be considered during clinical assessment for ADHD and targeted for intervention.

The effect of DSM-5 criteria on externalizing, internalizing, behavioral and adaptive symptoms in children diagnosed with autism

OBJECTIVE

Diagnostic criteria for autism spectrum disorders (ASDs) are changing with the fifth edition of the Diagnostic and Statistical Manual (DSM-5), which simplifies the diagnostic categories into social/emotional deficits and repetitive and restricted behavior. ASDs have been closely linked to a variety of other disorders, in particular externalizing disorders such as ADHD, and internalizing disorders including anxiety disorders and obsessive compulsive disorder. The present study examines the externalizing, internalizing, behavioral and adaptive symptoms of children with ASD.

METHOD

Children diagnosed with the DSM-IV who do not meet diagnostic criteria for DSM-5 and were compared to a non-ASD sample and a sample of those who meet the new criteria. Differences were examined between the three experimental groups with respect to internalizing, externalizing, behavioral severity and adaptive behavior.

RESULTS

No significant differences were observed between the DSM-5 and DSM-IV groups with respect to composite and subscale scores on the externalizing, behavior severity index and adaptive behavior domains of the Behavior Assessment System for Children, Second Edition.

CONCLUSIONS

Significantly more impairment was evident for both ASD groups compared to the no-ASD group.

Narrative writing competence and internal state terms of young adults clinically diagnosed with childhood attention deficit hyperactivity disorder

OBJECTIVE

The first objective of this study was to compare the written expression competence of young adults with attention deficit hyperactivity disorder (ADHD) with that of young adults without ADHD on three types of measures: indicators of the story's microstructure with regard to productivity and morphosyntax; indicators of the macrostructure (story grammar); and expressions of the mental states of the story's characters (internal state language). The second objective consisted of determining the relationships among the different narrative writing measures and the ADHD behavior ratings of inattention and hyperactivity obtained using the family observer report.

METHOD

The sample was composed of 54 participants, aged from 18 to 24, divided equally into a group with a childhood clinical diagnosis of combined subtype ADHD and a control group without ADHD. Written composition was assessed using a narrative task based on a sequence of images.

RESULTS

As expected, the young adults with ADHD obtained significantly worse results than the control group on the majority of the parameters of the story's microstructure and macrostructure. Likewise, they included a significantly lower number of terms about the characters' mental states. A correlation was also observed between measures of narrative competence and core symptoms of ADHD, as well as between the use of words with an emotional content and estimations related to core symptoms of ADHD.

CONCLUSION

The findings of this study point out that expressive writing should be assessed in individuals with ADHD as part of screening and comprehensive evaluation. More research is needed to design and implement effective interventions in this area.