Systematic Individualized Narrative

Language Intervention on the Personal

Narratives of Children with Autism

Background

Children with autism are likely to have

difficulties with the complex linguistic and
psychological landscape of a narrative
This is the first study to investigate the effect
of systematic, individualized intervention on
narratives for children with autism
Narrative comprehension and production is
fundamental
U.S. Common Core State Standards
Area of difficulty for children with
language impairment
Encompass much of our daily discourse
Plays a role in social competence

There is evidence that narrative

intervention works!
Narrative intervention is effective for treating the language
of children with other types of communicative disorders

Research Questions:
1. Did intervention have an effect on the story grammar of
independent narrative generations obtained
immediately after each intervention session?
2. Would intervention have an effect on the linguistic
complexity of independent narrative generations
immediately after intervention?
3. Did the improvements maintain after intervention has
been withdrawn?

Participants

Three boys diagnosed with autism spectrum disorder

English monolingual Caucasian children
Middle socioeconomic status
Met qualifying criteria for special education services in the public school
None of the participants had previously received narrative intervention at
school
A play-based conversation sample was collected to obtain information
about the participants language ability
Two narrative retell samples were collected using the Test of Narrative
Retell (TNR)
All three boys showed weakness in expressive language and social
interaction

Method - Experimental Design

Combination of two single-subject designs

Multiple baseline design across participants
Multiple baseline design across behaviors
The combination provides greater experimental
control, with the staggered baselines across
participants and behaviors
Changes in the outcome attribute to the
intervention
Intervention targets were introduced in a
staggered pattern after the primary behavior
(story grammar) indicated a stable baseline

Method - Narrative Skills Assessed

and Taught

Scoring: scored each story generation using the Test of Personal Generation:
School Age (TPG). Each element of story grammar and linguistic complexity
can receive 0-3 points.
Selecting targets: Individually chosen based on the participants baseline
scores.
Intervention phase: 12 intervention sessions were conducted. Clinicians
sequentially targeted elements according to the individuals need. Previous
targets were maintained when new targets were added. Elements not yet
introduced were monitored in an extended baseline phase.
Model Intervention: 12 stories were chosen and told at the end of the session.
The child was then asked to generate a personal story that was related to the
model story.
Visual supports were used to accompany story grammar elements.

Method - Narrative Skills Assessed

and Taught cont.

Every session 8 steps are performed:

Step 1: Story model with visual supports (child listens)

Step 2: Story retell with full support (pictures and icons used)
Step 3: Story retell with partial support (icons only)
Step 4: Independent story retell (no visual support)
Step 5: Thematically related personal narrative (clinician sketches)
Step 6: Retell of generation with full support (pictographs and icons)
Step 7: Retell of generation with partial support (icons only)
Step 8: Independent personal narrative retell (no visual or verbal support) This
step is also the outcome measure.

Question 1: Multiple Baseline

Results for Story Grammar
Did intervention have an effect on
the story grammar of independent
narrative generations obtained
immediately after each intervention
session?
The graphical and statistical
outcomes showed an overall
effect of the intervention.
Travis showed the most
reliable treatment effects.
The elements of plan and
combined emotions showed
the most reliable treatment
effects.

Question 2: Multiple Baseline

Results for Linguistic Complexity
Would intervention have an
effect on the linguistic
complexity of
independent narrative
generations immediately
after intervention?
Show changes
occurring during
intervention for seven
of the nine variables.
Indicating a possible
treatment effect.

Question 3: Generalization of
Intervention
Did the improvements maintain after intervention has been withdrawn?
For story grammar: Luke- action, Travis- emotion and plan, and Daniel- location showed
evidence of maintenance.
For linguistic complexity- three of the nine elements showed graphical performance at
maintenance greater than baseline performance.
Therefore, the intervention showed mixed maintenance effects.

Discussion

All three participants demonstrated weakness in linguistic complexity in

conversation with consistent difficulty connecting narrative elements causally
and temporally.
The systematic narrative intervention appeared to be an effective means to
address participants individual needs and their unique learning styles
In story grammar, the participants showed varied results:
Luke- required help with elements that contributed to action and problem
Travis- required help with elements related to internal states (plan &
emotions)
Daniel- required help with providing more detailed information to the
listeners (location) and producing a plan

Our Questions for YOU

What are the benefits of this individualized, structured narrative

intervention?
Did you find any limitations within their research method?
Mixed results for maintaining effects: what does this mean for clinical
implications? (ex. carryover)
What are some ideas for visuals that could be used in conjunction with the
story grammar visuals?