A Systematic Review of the Effects of Autism on Narrative Performance

Narrative tasks externalize language and social cognition providing a powerful window in individuals with autism spectrum disorder (ASD). This systematic review synthesizes previous research on the effects of ASD on narrative microstructure (i.e., lexical diversity, syntactic complexity, morphosyntactic accuracy, productivity) and macrostructure (i.e., story grammar/episodic structure, causal and temporal cohesion, mental-state language, referential clarity in individuals with ASD. To address this aim, a systematic review was conducted following PRISMA 2020 guidelines. Records were screened in Covidence by two independent reviewers and data was extracted using standardized procedures, and appraised risk of bias. Across studies and languages, children with ASD typically were found to produce narratives that are shorter, lexically less diverse, and syntactically simpler than those of typically developing (TD) peers; morphosyntactic accuracy is comparatively mixed and often relatively preserved. At the macrostructural level, children with ASD include fewer complete story grammar elements, show weaker causal/temporal linking, use sparser mental-state vocabulary, and display greater referential ambiguity. Variability in outcomes is explained partly by moderators such as age and cognitive level, language experience (mono-/bilingual status), elicitation demands, and analytic indices. Narrative difficulties in ASD arise primarily from discourse planning and socio-cognitive impairment, with local linguistic form though being relatively more preserved. The field would benefit from longitudinal and intervention studies using harmonized narrative measures to assess causal links between social cognition, and multimodal computational studies with executive control measures, and narrative growth.