Background and aims

The purpose of the current exploratory study was to describe the inferential narrative comprehension skills of young school-age children on the autism spectrum who, as a group, are at high risk of significant and persistent reading comprehension difficulties. Our aim was to investigate whether the anticipated difficulties in inferential narrative comprehension in the group of children with autism could be explained by the children’s structural language ability as measured using a broad-spectrum standardized language test.

Methods

The participants were 35 children with a diagnosis of autism spectrum disorder (ASD), aged between 5;7 and 6;11, who attended their first year of formal schooling, and 32 typically developing (TD) children, matched to the ASD group for age and year of schooling. Children on the autism spectrum were divided into below normal limits (ASD_BNL, standard score ≤80; n = 21) or within normal limits (ASD_WNL, standard score >80; n = 14) on a standardized language test. All children participated in a narrative comprehension task, which involved listening to a novel story, while looking at pictures, and answering eight comprehension questions immediately afterwards. Comprehension questions were categorized into factual and inferential questions, with further categorization of the inferential questions into those tapping into the story characters’ internal responses (mental states) or not. Children’s responses were scored on a quality continuum (from 0: inadequate/off topic to 3: expected/correct).

Results

Our results showed significantly lower scores across factual and inferential narrative comprehension in the ASD_BNL group, compared to the ASD_WNL and TD groups, supporting the importance of structural language skills for narrative comprehension. Furthermore, the TD group significantly outperformed the children in the ASD_WNL group on inferential comprehension. Finally, the children in the ASD_WNL group showed specific difficulties in answering the internal response inferential questions compared to their TD peers.

Conclusions

Results from this exploratory study highlight the difficulties children on the autism spectrum may have in inferential narrative comprehension skills, regardless of sufficient structural language skills at word and sentence level. These findings support the importance of routinely assessing these narrative comprehension skills in children on the spectrum, who as a group are at high risk of persistent reading comprehension difficulties.

Implications

In this study, we demonstrate how narrative comprehension can be assessed in young school-age children on the autism spectrum. The scoring system used to categorize children’s responses may further assist in understanding children’s performance, across a quality continuum, which can guide detailed goal setting and assist in early targeted intervention planning.

中文翻译：

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孤独症谱系学龄儿童的推理叙事理解能力

背景和目标

当前探索性研究的目的是描述自闭症学龄儿童的推理叙事理解能力，作为一个群体，他们极有可能出现严重和持续的阅读理解困难。我们的目的是调查自闭症儿童群体在推理性叙述理解方面的预期困难是否可以通过使用广谱标准化语言测试测量的儿童结构语言能力来解释。

方法

参与者是 35 名被诊断患有自闭症谱系障碍 (ASD) 的儿童，年龄在 5;7 到 6;11 之间，他们参加了正规学校教育的第一年，以及 32 名典型发育 (TD) 儿童，与 ASD 组相匹配年龄和上学年级。自闭症谱系儿童分为正常范围以下（ASD_BNL，标准得分≤80；n  = 21）或正常范围内（ASD_WNL，标准得分>80；n = 14) 在标准化语言测试中。所有的孩子都参与了一项叙事理解任务，包括边听小说故事边看图片，然后立即回答八个理解问题。理解性问题分为事实性问题和推理性问题，推理性问题进一步分为是否利用故事人物的内部反应（心理​​状态）。儿童的回答按质量连续统一体评分（从 0：不充分/偏离主题到 3：预期/正确）。

结果

我们的结果显示，与 ASD_WNL 和 TD 组相比，ASD_BNL 组在事实和推理叙事理解方面的得分显着较低，这支持了结构语言技能对叙事理解的重要性。此外，TD 组在推理理解方面明显优于 ASD_WNL 组的儿童。最后，与 TD 同龄人相比，ASD_WNL 组的儿童在回答内部反应推理问题时表现出特殊的困难。

结论

这项探索性研究的结果强调了自闭症儿童在推理叙述理解技能方面可能存在的困难，无论在单词和句子层面是否具备足够的结构语言技能。这些发现支持定期评估频谱儿童的这些叙事理解技能的重要性，他们作为一个群体处于持续阅读理解困难的高风险中。

启示

在这项研究中，我们展示了如何评估自闭症学龄儿童的叙事理解能力。用于对儿童反应进行分类的评分系统可以进一步帮助了解儿童在质量连续体中的表现，这可以指导详细的目标设定并协助早期有针对性的干预计划。