Macrostructural Narrative Development in Chilean Children With Down Syndrome: An Interventional Cross-Case Study

Oral narrative abilities are essential for social participation, academic success, and the development of literacy. While children with Down syndrome (DS) often show relative strengths in narrative macrostructure, little is known about how these skills develop over time and how they respond to targeted intervention, particularly in Spanish-speaking contexts.

This cross-case study explored macrostructural narrative development in four Chilean children with DS aged 8-12 years over a 6-month period and evaluated the effects of a brief one-on-one narrative intervention. Participants' narrative competence was assessed, using the Frog Goes to Dinner story in retelling modality, at three points: 6 months earlier, 1 week before the intervention, and 1 week after. Macrostructural elements were scored using the Narrative Scoring Scheme (NSS), complemented by special coding for targeted elements.

Children showed modest improvement over the 6-month period without intervention but greater and more consistent gains following the 3-week intervention. Statistically significant increases were observed in overall macrostructure (NSS total score), character development, conflict-resolution, mental states, and use of emotional vocabulary and temporal markers. Microstructural measures remained stable, suggesting that macrostructural changes were not confounded by general linguistic development.

These findings underscore the value of brief structured narrative interventions for children with DS and highlight the importance of addressing specific macrostructural components, such as character detail and event sequencing. This is the first known study to explore narrative macrostructure development and intervention in Chilean children with DS, contributing culturally relevant insights to a growing field.