Linguistic Markers of Autism Spectrum Disorder in Narrative Production: Evidence From the Monkey Cartoon Storytelling Task of the Autism Diagnostic Observation Schedule

Background and aims The Autism Diagnostic Observation Schedule (ADOS-2) is considered a “gold standard” diagnostic instrument in the assessment of autism spectrum disorder (ASD). The Monkey Cartoon task is an optional pictured storytelling task in ADOS-2, which has been designed to assess gestural a...

Full description

Saved in:
Bibliographic Details
Main Authors: Eleni Peristeri, Katerina Drakoulaki, Antonia Boznou, Michaela Nerantzini, Spyridoula Varlokosta
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Autism and Developmental Language Impairments
Online Access:https://doi.org/10.1177/23969415251331045
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850138728751693824
author Eleni Peristeri
Katerina Drakoulaki
Antonia Boznou
Michaela Nerantzini
Spyridoula Varlokosta
author_facet Eleni Peristeri
Katerina Drakoulaki
Antonia Boznou
Michaela Nerantzini
Spyridoula Varlokosta
author_sort Eleni Peristeri
collection DOAJ
description Background and aims The Autism Diagnostic Observation Schedule (ADOS-2) is considered a “gold standard” diagnostic instrument in the assessment of autism spectrum disorder (ASD). The Monkey Cartoon task is an optional pictured storytelling task in ADOS-2, which has been designed to assess gestural and verbal communication in autistic children while telling a story. It is well established that storytelling is challenging for autistic children, particularly for the content and coherent organization of the story, also known as narrative macrostructure. Existing evidence on the efficacy of the Monkey Cartoon task to pinpoint differences between autistic and neurotypical individuals in narrative macrostructure is scant. In this study, we used a version of the Monkey Cartoon task with modified scoring to analyze the narrative macrostructural skills of two groups of children with and without ASD. We also investigated the relations between narrative macrostructure and language ability in each group. Methods A group of 16 Greek-speaking autistic children and 16 age- and IQ-matched neurotypical children were administered the Monkey Cartoon storytelling task. Children's vocabulary and syntactic skills were also measured. Narratives were analyzed in terms of macrostructural features, including story completeness and story grammar, as well as units denoting the setting, internal responses and added details. Results The autistic children had lower scores in communicating the story content rather than story grammar. Moreover, the autistic group tended to include less information on the story's setting and more off-topic utterances than their neurotypical peers. Regarding the relations between narrative macrostructure and language ability, the two groups dissociated since the autistic children tended to rely on vocabulary at the expense of including irrelevant information in their narratives, while neurotypical children relied on both lexical and syntactic skills, especially when instantiating references to the story characters’ mental states and the setting of the story, respectively. Conclusions The Monkey Cartoon storytelling task seems to be efficient at revealing pragmatic weaknesses mainly at the thematic content level in autistic children. Also, the frequent use of semantically- and pragmatically-irrelevant information in storytelling differentiated autistic from neurotypical children, and may thus be treated as a distinguishing feature of ASD in narrative production. Implications The findings demonstrate the viability of the Monkey Cartoon task in highlighting language markers of ASD in narrative macrostructure, with clinical implications for enhancing clinical practice in countries like Greece that face a shortage of narrative assessment tools for autistic children.
format Article
id doaj-art-3e475a4c5dc94dfebad8c9bba690114e
institution OA Journals
issn 2396-9415
language English
publishDate 2025-05-01
publisher SAGE Publishing
record_format Article
series Autism and Developmental Language Impairments
spelling doaj-art-3e475a4c5dc94dfebad8c9bba690114e2025-08-20T02:30:31ZengSAGE PublishingAutism and Developmental Language Impairments2396-94152025-05-011010.1177/23969415251331045Linguistic Markers of Autism Spectrum Disorder in Narrative Production: Evidence From the Monkey Cartoon Storytelling Task of the Autism Diagnostic Observation ScheduleEleni PeristeriKaterina DrakoulakiAntonia BoznouMichaela NerantziniSpyridoula VarlokostaBackground and aims The Autism Diagnostic Observation Schedule (ADOS-2) is considered a “gold standard” diagnostic instrument in the assessment of autism spectrum disorder (ASD). The Monkey Cartoon task is an optional pictured storytelling task in ADOS-2, which has been designed to assess gestural and verbal communication in autistic children while telling a story. It is well established that storytelling is challenging for autistic children, particularly for the content and coherent organization of the story, also known as narrative macrostructure. Existing evidence on the efficacy of the Monkey Cartoon task to pinpoint differences between autistic and neurotypical individuals in narrative macrostructure is scant. In this study, we used a version of the Monkey Cartoon task with modified scoring to analyze the narrative macrostructural skills of two groups of children with and without ASD. We also investigated the relations between narrative macrostructure and language ability in each group. Methods A group of 16 Greek-speaking autistic children and 16 age- and IQ-matched neurotypical children were administered the Monkey Cartoon storytelling task. Children's vocabulary and syntactic skills were also measured. Narratives were analyzed in terms of macrostructural features, including story completeness and story grammar, as well as units denoting the setting, internal responses and added details. Results The autistic children had lower scores in communicating the story content rather than story grammar. Moreover, the autistic group tended to include less information on the story's setting and more off-topic utterances than their neurotypical peers. Regarding the relations between narrative macrostructure and language ability, the two groups dissociated since the autistic children tended to rely on vocabulary at the expense of including irrelevant information in their narratives, while neurotypical children relied on both lexical and syntactic skills, especially when instantiating references to the story characters’ mental states and the setting of the story, respectively. Conclusions The Monkey Cartoon storytelling task seems to be efficient at revealing pragmatic weaknesses mainly at the thematic content level in autistic children. Also, the frequent use of semantically- and pragmatically-irrelevant information in storytelling differentiated autistic from neurotypical children, and may thus be treated as a distinguishing feature of ASD in narrative production. Implications The findings demonstrate the viability of the Monkey Cartoon task in highlighting language markers of ASD in narrative macrostructure, with clinical implications for enhancing clinical practice in countries like Greece that face a shortage of narrative assessment tools for autistic children.https://doi.org/10.1177/23969415251331045
spellingShingle Eleni Peristeri
Katerina Drakoulaki
Antonia Boznou
Michaela Nerantzini
Spyridoula Varlokosta
Linguistic Markers of Autism Spectrum Disorder in Narrative Production: Evidence From the Monkey Cartoon Storytelling Task of the Autism Diagnostic Observation Schedule
Autism and Developmental Language Impairments
title Linguistic Markers of Autism Spectrum Disorder in Narrative Production: Evidence From the Monkey Cartoon Storytelling Task of the Autism Diagnostic Observation Schedule
title_full Linguistic Markers of Autism Spectrum Disorder in Narrative Production: Evidence From the Monkey Cartoon Storytelling Task of the Autism Diagnostic Observation Schedule
title_fullStr Linguistic Markers of Autism Spectrum Disorder in Narrative Production: Evidence From the Monkey Cartoon Storytelling Task of the Autism Diagnostic Observation Schedule
title_full_unstemmed Linguistic Markers of Autism Spectrum Disorder in Narrative Production: Evidence From the Monkey Cartoon Storytelling Task of the Autism Diagnostic Observation Schedule
title_short Linguistic Markers of Autism Spectrum Disorder in Narrative Production: Evidence From the Monkey Cartoon Storytelling Task of the Autism Diagnostic Observation Schedule
title_sort linguistic markers of autism spectrum disorder in narrative production evidence from the monkey cartoon storytelling task of the autism diagnostic observation schedule
url https://doi.org/10.1177/23969415251331045
work_keys_str_mv AT eleniperisteri linguisticmarkersofautismspectrumdisorderinnarrativeproductionevidencefromthemonkeycartoonstorytellingtaskoftheautismdiagnosticobservationschedule
AT katerinadrakoulaki linguisticmarkersofautismspectrumdisorderinnarrativeproductionevidencefromthemonkeycartoonstorytellingtaskoftheautismdiagnosticobservationschedule
AT antoniaboznou linguisticmarkersofautismspectrumdisorderinnarrativeproductionevidencefromthemonkeycartoonstorytellingtaskoftheautismdiagnosticobservationschedule
AT michaelanerantzini linguisticmarkersofautismspectrumdisorderinnarrativeproductionevidencefromthemonkeycartoonstorytellingtaskoftheautismdiagnosticobservationschedule
AT spyridoulavarlokosta linguisticmarkersofautismspectrumdisorderinnarrativeproductionevidencefromthemonkeycartoonstorytellingtaskoftheautismdiagnosticobservationschedule