Tech Tuesday: Interpreting Research on Narratives and Autism

In this Autism Awareness and Acceptance Month, we turn our attention more specifically on our students and clients with unique social learning and language characteristics. A recent (2017) study by Westerveld and Roberts, The Oral Narrative Comprehension and Production Abilities of Verbal Preschoolers on the Autism Spectrum, has a number of implications that I would like to interpret in the context of tools available for narrative intervention.

The study involved assessment of preschoolers’ narratives (notably an uninvestigated area for preschool students with autism, according to the article) via presentation of a fictional narrative and administration of comprehension questions and a retelling task. A large grouping within the sample did not produce a retelling that could be analyzed, but the 19 that did were assessed for length, semantic diversity, grammatical complexity and accuracy, intelligibility, inclusion of critical events, and narrative stage.

The article notes that most of the research on spontaneous language of preschoolers with autism has focused on free play, rather than the ability to pull language together into narratives.

• The study used a protocol called the Profile of Oral Narrative Ability which involved presenting a picture book via screen along with an audio recording, followed by factual and inferential comprehension questions, a second exposure, and a retelling task.
• Regarding the students who were unable to produce a retelling, the authors suggest that this was not accountable by differences in age, cognition, and communication profiles but rather “other factors may have played a role, such as general interest and motivation.”
• Very few of the subjects were able to answer inferential questions such as “Why did Ana get bored?” and “Why did Ana get scared?”
• The narrative samples were analyzed for inclusion of 10 “critical events” in the story as well as for macrostructure using Westby’s (2009) decision tree, an important factor of which is the presence of “goal-directed behavior” in the narrative. In the study, 78% of the children produced descriptive or action sequences which lack the element of goal-directed behavior.

Back to the motivation factor, the authors conclude that future focus should include adapting assessment and therapy procedures to meet the needs and interests of children with autism.

Though this article does not mention technology as a potential tool to address the issues unearthed by the study, I always look for these potential interpretations. Take for example, two potential benefits of technology tools:

1. They allow us to create materials that can emphasize the language structures, skills and contexts of narrative and other levels of language and
2. They are engaging, motivating and potentially interactive for any child, perhaps supplying the interest boost that makes language elicitation easier for us as clinicians.

So, given this first factor, I wanted to emphasize some recent success I have had in creating and modifying books and materials through the free/inexpensive app Book Creator (available in Chrome or via an iPad app). Book Creator has a very simple interface allowing you to integrate photos, drawings, text, audio and video, and, importantly for some elements of the study described above, word and thought balloons. These elements can be used to visually and perhaps interactively scaffold inferential language.

In the above image, you can see an easily created “narrative” material (the menus are the same in the Chrome and iPad versions of Book Creator). For some preschool interventions recently, we created interactive books in this manner, using Custom Boards (you may also consider LessonPix), to create visuals of items that could be placed in thought bubbles. All materials were printed, laminated and velcroed to create interactive books, which we found were a scaffold for students using language to describe the highly inferential area of thoughts and feelings. As in the above with Book Creator, you can also place images on the page to be tapped and dragged into thought balloons on screen as you read with a child.

Another suggestion is to create goal-directed narrative situations for language elicitation through apps such as the Toca Life series from Toca Boca. This would involve considering the highly interactive screen scenes with Story Grammar Marker^® in tow, for Character-Setting-Kickoff-Reaction (or Feeling-Plan-Action) sequences and language, and scaffolding microstructure cohesive ties such as because and so.

Take, for example, these two scenes from Toca Life: Stable ($2.99 for multiple platforms), which suggest a number of Kick-Offs and Reactions that can be acted out in a motivating way:

• The horse’s hair is messy so it needs to be brushed.
• The horse doesn’t like getting her hair brushed so we need to sing her a song.
• We can’t reach the horse’s head so we need to get a stool.
• The horse tries to jump the fence but fails, so needs to try again.
• The rider falls off the horse so he needs to take a rest (and so on, these “goal-directed narratives” are only limited by our own imaginations!).