Exploring Narrative Ability in Greek-Speaking Children with High-Functioning ASD: Associations with Memory and...

Background/Objectives: Narration is a sensitive tool for the assessment of language in children with high-functioning autism spectrum disorder (HF-ASD) since mild language deficits beyond the sentential level are not always noticeable through the administration of standardized language tests targeting the lexical or sentential level. This study investigated the narrative ability of monolingual Greek-speaking HF-ASD children in comparison to that of their typically developing (TD) peers and explored the associations between narrative variables, ADHD symptomatology, and memory skills in the participants on the autistic spectrum. Methods: The participants were 39 children aged 7 to 12 years, 19 with HF-ASD and 20 age-matched, vocabulary-matched, and cognitively matched TD peers. Results: The two groups were similar in most microstructural and macrostructural variables but differed significantly in syntactic complexity (p = 0.024; d = 0.754) and subordination (p < 0.001; d = -1.576) indices, implying that the HF-ASD group presented syntactic delay in comparison to their TD peers. The HF-ASD participants showed significantly higher heterogeneity in the amount of information generated for the story's main character (p = 0.004; d = -0.093) in comparison to their TD peers. Significant associations were observed between verbal and visual memory, complex syntactic structures, and Theory of Mind-related internal state terms. ADHD symptomatology was negatively correlated with the generation of simple and coordinated clauses. Finally, complex syntax and delayed vSTM were correlated with retelling total scores, indicating that language ability and verbal memory compensate for narrative competence in HF-ASD children. Conclusions: The findings highlight the impact that language skills, memory ability, and ADHD symptomatology have on narrative competence in children with HF-ASD, as well as the importance of narrative use for assessing the language skills in populations with mild language impairment.