Background and aims

Extant research indicates that children and adolescents with autism spectrum disorder (ASD) without an intellectual disability (ID) often experience difficulty comprehending written texts that is unexpected in comparison with their cognitive abilities. This study investigated the development of two key skills, narrative and inference abilities, that support higher level text comprehension and their relation to lexical-semantic knowledge, ASD symptomatology, and age. Three questions were addressed: 1.) What was the nature of narrative and inference skill development over time? 2.) What was the relation between narrative or inference development and lexical-semantic knowledge, ASD symptomatology, and age? 3.) Did initial narrative and inferencing skills, and the development of these skills, predict reading comprehension outcomes? Methods: Data from 81 children and adolescents with ASD without ID (FIQ ≥ 75) between the ages of 8-16-years-old at timepoint 1 were collected at 15-month intervals across three timepoints. ASD symptomatology was assessed with the ADOS-2. Standardized narrative retelling, inference, reading comprehension, lexical-semantic knowledge and cognitive assessments were administered. Latent growth curve models were conducted to examine narrative and inference skill development, and conditional growth models were fit to examine the relation between growth trajectories and covariates (lexical-semantic knowledge, ASD symptomatology, age) as well as with the reading comprehension distal outcome.

Results

Narrative retelling skills followed a linear trajectory of growth and were a relative strength in this sample, while inference skills were well below average and declined over time relative to age-normed standard scores. Lexical-semantic knowledge explained significant heterogeneity in initial narrative and inference skills, whereas ASD symptomatology was only related to initial narrative retelling abilities and age was only related to initial inference abilities. Timepoint 3 reading comprehension skill (in the below average range) was significantly explained by initial narrative retelling and inference abilities.

Conclusions

The results of this study indicate that narrative retelling and inference skills are important for successful reading comprehension for individuals with ASD without ID and that lexical-semantic knowledge underpins these skills. Furthermore, the observation that ASD symptom severity was associated with narrative retelling skills is consistent with the hypothesis that problems in narrative reading skills are associated with the autism phenotype. Finally, inference skill was a particular challenge for individuals in this sample, although age was positively associated with better performance on the assessment.

Implications: These findings suggest that narrative and inference skills, in addition to lexical-semantic knowledge, are important to target beginning in elementary grades to improve reading comprehension outcomes for children and adolescents with ASD without ID.

中文翻译：

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自闭症谱系障碍儿童和青少年叙事复述和推理能力的增长以及与阅读理解的关系

背景和目标

现有研究表明，没有智力障碍 (ID) 的自闭症谱系障碍 (ASD) 儿童和青少年在理解书面文本时经常遇到困难，这与他们的认知能力相比是出乎意料的。本研究调查了支持更高水平文本理解的两项关键技能——叙述和推理能力的发展及其与词汇语义知识、ASD 症状学和年龄的关系。解决了三个问题：1.) 随着时间的推移，叙述和推理技能发展的本质是什么？2.) 叙述或推理发展与词汇语义知识、ASD 症状学和年龄之间的关系是什么？3.) 最初的叙述和推理技能，以及这些技能的发展，是否预测了阅读理解的结果？方法：在三个时间点每隔 15 个月收集时间点 1 的 81 名年龄在 8-16 岁之间的没有 ID 的 ASD 儿童和青少年（FIQ ≥ 75）的数据。使用 ADOS-2 评估 ASD 症状。进行了标准化的叙述复述、推理、阅读理解、词汇语义知识和认知评估。潜在增长曲线模型用于检查叙述和推理技能的发展，条件增长模型适用于检查增长轨迹和协变量（词汇语义知识、ASD 症状、年龄）之间的关系以及阅读理解远端结果。使用 ADOS-2 评估 ASD 症状。进行了标准化的叙述复述、推理、阅读理解、词汇语义知识和认知评估。潜在增长曲线模型用于检查叙述和推理技能的发展，条件增长模型适用于检查增长轨迹和协变量（词汇语义知识、ASD 症状、年龄）之间的关系以及阅读理解远端结果。使用 ADOS-2 评估 ASD 症状。进行了标准化的叙述复述、推理、阅读理解、词汇语义知识和认知评估。潜在增长曲线模型用于检查叙述和推理技能的发展，条件增长模型适用于检查增长轨迹和协变量（词汇语义知识、ASD 症状、年龄）之间的关系以及阅读理解远端结果。

结果

叙事复述技能遵循线性增长轨迹，在这个样本中是相对强项，而推理技能远低于平均水平，并且相对于年龄标准化的标准分数会随着时间的推移而下降。词汇语义知识解释了初始叙事和推理技能的显着异质性，而 ASD 症状学仅与初始叙事复述能力相关，年龄仅与初始推理能力相关。时间点 3 的阅读理解能力（低于平均水平）主要由最初的叙述复述和推理能力来解释。

结论

这项研究的结果表明，叙事复述和推理技能对于没有 ID 的 ASD 患者成功阅读理解很重要，而词汇语义知识是这些技能的基础。此外，自闭症谱系障碍症状严重程度与叙事复述技能相关的观察结果与叙事阅读技能问题与自闭症表型相关的假设一致。最后，推理技能对于这个样本中的个人来说是一个特殊的挑战，尽管年龄与更好的评估表现呈正相关。

启示：这些研究结果表明，除了词汇语义知识之外，叙述和推理技能对于从小学开始的目标来说很重要，以提高没有 ID 的 ASD 儿童和青少年的阅读理解结果。