Growth in narrative retelling and inference abilities and relations with reading comprehension in children and adolescents with autism spectrum disorder.

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. 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. 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.

McIntyre NS ，Grimm RP ，Solari EJ ，Zajic MC ，Mundy PC ... -  《-》

Assessment of inference-making in children using comprehension questions and story retelling: Effect of text modality and a story presentation format.

Reading and listening comprehension are essential for accessing the school curriculum. Inference-making is integral to successful comprehension and involves integrating information between clauses (local coherence) and integrating information with background knowledge (global coherence). We require appropriate methods to assess comprehension and inference-making in order to identify areas of difficulty and provide appropriate support. Typically developing children's ability to generate local and global coherence inferences was assessed. The effect of text modality (reading and listening comprehension) and presentation format (stories presented in segmented and whole story format) was explored using two comprehension measures (question answering and story retell). The main aims were to determine whether there were advantages for reading or listening comprehension and for segmented or whole text presentation. Typically developing children in Year 3 (n = 33) and Year 5 (n = 40) either read or listened to short stories. Their ability to generate global and local coherence inferences was assessed in two ways: answers to inference-tapping questions and story retelling (scored for inclusion of necessary inferences). Stories were presented in either a whole format (all questions after the story) or a segmented format (questions asked at specific points during story presentation); the retelling was always after the complete story and questions had been presented. For both comprehension measures, there was developmental progression between age groups and a benefit for the reading modality. Scores were higher for global coherence than local coherence inferences, but the effect was significant only for the question-answering responses, not retells. For retells there was a benefit in presenting the text as a whole compared with the segmented format, but this effect was not present for the comprehension questions. There was a significant interaction between inference type and modality for both comprehension measures (question answering and story retell): for the local coherence inferences scores were significantly greater in the reading compared with the listening modality, but performance on the global coherence inferences did not differ significantly between modalities. Clinicians, teachers and other professionals should consider the modality and presentation format for comprehension tasks to utilize areas of strength and support areas of difficulty. Oral presentation may result in poorer comprehension relative to written presentation in general, and may particularly affect local integrative processing. These findings have important implications for the development of appropriate assessments as well as for supporting children with comprehension difficulties. What this paper adds What is already known on the subject Reading and listening comprehension are critical for accessing the school curriculum and educational success. Inference-making is integral to successful comprehension and involves integrating information between clauses (local coherence) as well as integrating information with background knowledge (global coherence). Children have an awareness of the need to generate coherence inferences, but not all children will generate sufficient coherence inferences for adequate comprehension during text presentation. Existing assessment tools measure comprehension by asking questions after story presentation. This provides an overall indication of comprehension or inference-making ability and can identify children with comprehension or language and communication difficulties. What this paper adds to existing knowledge The study compared coherence inference-making in two presentation conditions: whole format (all questions after the story) or segmented format (questions asked at specific points during story presentation). Children (aged 7-10 years) were assessed in the reading or listening modality. Two comprehension measures were used (inference-tapping questions and story retell). There was developmental progression and a benefit for the reading modality for both comprehension measures. Scores were higher for global coherence than local coherence inferences for the comprehension questions. There was a benefit in presenting the text as a whole compared with the segmented format for story retells. What are the potential or actual clinical implications of this work? The results are important for clinicians and other professionals assessing and supporting comprehension skills. The results suggest that the modality and presentation format of comprehension tasks should be considered to utilize areas of strength and support areas of difficulty. The optimum form of input and structure may depend on a child's individual profile and the skill being assessed or supported. Targeted questions may identify a child's potential to generate an inference. This may assist identification of children who may require more targeted or specialist intervention. The reading modality may provide a means of support for development of verbal comprehension.

Freed J ，Cain K 《-》

Reading comprehension differences between children with Autism Spectrum Disorder and low cognitive abilities and children with Autism Spectrum Disorder and intact cognitive skills: the roles of decoding, fluency and morphosyntax.

Reading comprehension is one of the most important skills learned in school and it has an important contribution to the academic success of children with Autism Spectrum Disorder (ASD). Though previous studies have investigated reading comprehension difficulties in ASD and highlighted factors that contribute to these difficulties, this evidence has mainly stemmed from children with ASD and intact cognitive skills. Also, much emphasis has been placed on the relation between reading comprehension and word recognition skills, while the role of other skills, including fluency and morphosyntax, remains underexplored. This study addresses these gaps by investigating reading comprehension in two groups of school-aged children with ASD, one with intact and one with low cognitive abilities, also exploring the roles of word decoding, fluency and morphosyntax in each group's reading comprehension performance. The study recruited 16 children with ASD and low cognitive abilities, and 22 age-matched children with ASD and intact cognitive skills. The children were assessed on four reading subdomains, namely, decoding, fluency, morphosyntax, and reading comprehension. The children with ASD and low cognitive abilities scored significantly lower than their peers with intact cognitive abilities in all reading subdomains, except for decoding, verb production and compound word formation. Regression analyses showed that reading comprehension in the group with ASD and intact cognitive abilities was independently driven by their decoding and fluency skills, and to a lesser extent, by morphosyntax. On the other hand, the children with ASD and low cognitive abilities mainly drew on their decoding, and to a lesser extent, their morphosyntactic skills to perform in reading comprehension. The results suggest that reading comprehension was more strongly affected in the children with ASD and low cognitive abilities as compared to those with intact cognitive skills. About half of the children with ASD and intact cognitive skills also exhibited mild-to-moderate reading comprehension difficulties, further implying that ASD may influence reading comprehension regardless of cognitive functioning. Finally, strengths in decoding seemed to predominantly drive cognitively-impaired children's reading performance, while the group with ASD and intact cognitive skills mainly recruited fluency and metalinguistic lexical skills to cope with reading comprehension demands, further suggesting that metalinguistic awareness may be a viable way to enhance reading comprehension in ASD.

Peristeri E ，Frantzidis CA ，Andreou M 《Frontiers in Psychology》

Inferential narrative comprehension ability of young school-age children on the autism spectrum.

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. 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). 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. 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. 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.

Westerveld MF ，Filiatrault-Veilleux P ，Paynter J 《-》

Comparing growth in linguistic comprehension and reading comprehension in school-aged children with autism versus typically developing children.

Many children with autism spectrum disorders (ASD) struggle with reading comprehension. Linguistic comprehension is an important predictor of reading comprehension, especially as children progress through elementary school and later grades. Yet, there is a dearth of research examining longitudinal relations between linguistic comprehensions in school-age children with ASD compared to typically-developing peers (TD). This study compared the developmental trajectories of linguistic and reading comprehension in samples of children with ASD and age-matched TD peers. Both groups were administered measures of linguistic and reading comprehension multiple times over a 30-month period. Latent growth curve modeling demonstrated children with ASD performed at significantly lower levels on both measures at the first timepoint and these deficits persisted across time. Children with ASD exhibited growth in both skills comparable to their TD peers, but this was not sufficient to enable them to eventually achieve at a level similar to the TD group. Due to the wide age range of the sample, age was controlled and displayed significant effects. Findings suggest linguistic comprehension skills are related to reading comprehension in children with ASD, similar to TD peers. Further, intervention in linguistic comprehension skills for children with ASD should begin early and there may be a finite window in which these skills are malleable, in terms of improving reading comprehension skills. Autism Res 2018, 11: 624-635. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. There is relatively little research concerning reading comprehension development in children with ASD and how they compare to TD peers. This study found children with ASD began at lower achievement levels of linguistic comprehension and reading comprehension than TD peers, but the skills developed at a similar rate. Intervening early and raising initial levels of linguistic and reading comprehension may enable children with ASD to perform similarly to TD peers over time.

Grimm RP ，Solari EJ ，McIntyre NS ，Zajic M ，Mundy PC ... -  《-》