Narrative Abilities and Internal State Language in Children with Autism Spectrum Disorder and Typically Developing Children

Background:  Narratives allow us to interpret, integrate, and organize socio-cultural information and personal experiences in meaningful ways.   Therefore, difficulty in formulating narratives limits access to this rich form of interaction and can affect social-emotional and communicative competence (Losh & Capps, 2003).  Effective narrative telling depends on emotional and cognitive state interpretation.  As autism spectrum disorder (ASD) is marked by a deficit in social-emotional, cognitive, and linguistic abilities, analysis of narrative practices provides a unique opportunity to examine the nature of these deficits.  In prior research, children with ASD referred to internal states less often than typically developing (TD) children (Tager-Flusberg, 1995; Tager-Flusberg, 1992).

Objectives:  The current study compares TD children and children with ASD using a storybook narrative retelling paradigm accompanied by standardized developmental, linguistic and cognitive assessments to examine differences in usage of cognitive and emotional terms as well as any relationship to performance on developmental measures. 

Methods:  The sample included 20 children with ASD (M=86.25 months, SD=18.28 months) and 23 TD children (M=81.83 months, SD=19.62 months) from ethnically diverse backgrounds. The Social Responsiveness Scale (Constantino, 2002) was used to rule out ASD in TD children and the Autism Diagnostic Observation Schedules-General (ADOS-G; Lord et al., 2000) to confirm diagnoses in children with ASD. The samples were well matched on chronological age, gender ratio (ASD, 17/3; TD, 19/4, M/F), and receptive language age (ASD M=87.10 months; TD M=87.17 months). 

Participants were tested during a single laboratory visit at Hunter College, City University of New York.  During the laboratory visit, children were shown a wordless illustrated book, either Frog Goes to Dinner (Mayer, 1974) or Frog on His Own (Mayer, 1973).   Each story depicts situations in which characters express various emotional and mental states in response to actions of the protagonist.  The child narrated the story to a researcher.  Each session was audio and video recorded.  Audio recordings were then transcribed and divided into utterances.  Transcriptions were coded for narrative and linguistic variables by research assistants blind to group assignment.  Building on prior research, we assessed structural and evaluative aspects of the narratives including story length, utterance count, verb and adjective count, and internal state language (Capps, et al., 2000; Tager-Flusberg, 1995).  The two independent coders established strong inter-observer reliability for all measures (ICC = .78-.98).

Results:  After controlling for the number of utterances, children in the ASD group used significantly fewer emotional words than the TD group, t(41)=3.14, p<.01.  There were no group differences in usage of cognitive words, p=.97.  The ASD group also produced significantly shorter and less complex narratives, using fewer words t(41 )=3.52, p<.01, and fewer utterances t(41)=3.61, p<.01.  The TD group used significantly more distinct verbs and adjectives, t(41)=2.945, p<.01 and t(41)=3.08, p<.01.

Conclusions:  This research suggests that children with ASD produce significantly impoverished narratives when compared to TD children, specifically in the utilization of emotional language.  However, we did not find significant group differences in cognitive language, suggesting that children with ASD may not display global deficits in use of internal state language.