Narrative Ability In AUTISM and the BROAD AUTISM PHENOTYPE

Background: Family and twin studies indicate that the defining features of autism can manifest in more subtle form among unaffected relatives. These features have been described as constituting a ‘broad autism phenotype’ (BAP).  Subtle differences in language use constitute a principal feature of the BAP.  In particular, prior studies have documented patterns of pragmatic language use and impoverished narrative production among parents of individuals with autism (Landa et al., 1991, 1992).  This study aimed to better define the narrative abilities of parents, through analysis of narratives elicited by socially complex stimuli (Paul, Schieffer, & Brown, 2004,) in high functioning individuals with ASD and their parents. 

Objectives: This study examined narrative production among high functioning individuals with ASD, their parents, and respective control groups in order to better define the nature and potential overlap of narrative profiles in ASD and the BAP. 

Methods:  Participants included 30 high functioning adults with ASD, 9 age- and IQ-matched controls, 44 parents of individuals with ASD, and 12 control parents.  Following procedures detailed in Paul et al. (2004), an illustrated slide drawn from the Thematic Apperception Test (TAT) was used to elicit narratives.  Participants were instructed to “tell a story with a beginning, middle, and end,” and to “describe what the characters were thinking, feeling, and doing.” These interactions were video-recorded and transcribed verbatim.  Narratives were coded by two coders blind to group status for the following features: 1) story structure (including a beginning, middle, and end); 2) description of characters’ thoughts or feelings; 3) whether the participant produced a story or simply described disparate elements of the picture; 4) temporal coherence; and 5) expressed anxiety about the narrative task. All disagreements were resolved through discussion.

Results:  While there were no group differences in the number of narratives produced, marked differences were detected in the quality of narratives across groups.  Specifically, nearly half of the ASD group and a quarter of the ASD parent group failed to describe character feelings or thoughts, whereas this was not the case among controls (p values <.05).  Furthermore, individuals with ASD and their parents more often neglected to conclude their stories with formal resolutions (p values<.05).  Additionally, we noted that 17% of the ASD group and 11% of the ASD parent group expressed task-related anxiety. These anxieties were not voiced by either control group.

Conclusions: Both the ASD and ASD parent groups exhibited similar differences from controls in narrative production, although such differences were more pronounced in the ASD group.  These results provide further evidence that narrative ability is impacted in ASD, and that differences in narrative skill are also evident among unaffected parents.  Given the centrality of narrative to communicative interactions, results showing impairment in narrative construction and in expression of thoughts and feelings may hold clinical implications. That both individuals with ASD and parents showed an awareness of these difficulties is also of clinical importance. Finally, these findings may also help to define genetically meaningful language features.