What are the effects of Autism on Discourse Micro- and Macro-structure? A systematic review

Narrative tasks provide a comprehensive picture of language deficits in individuals with autism spectrum disorder (ASD), yet a comprehensive picture of these deficits is lacking. This paper investigates recent studies on narrative productions synthesizing previous research on narrative deficits in individuals with ASD. Thus, a systematic review was conducted in Covidence following PRISMA guidelines. The review showed language deficits on both narrative microstructure and macrostructure. Across studies, individuals with ASD typically were found to produce narratives that are shorter, lexically less diverse, and syntactically simpler than those of neurotypical individuals; morphosyntactic accuracy is often relatively preserved compared to macrostructural abilities, particularly in individuals without comorbid language impairments, though it remains vulnerable under high discourse pressure. At the macrostructural level, individuals with ASD include fewer complete story grammar elements, show weaker causal/temporal linking, use sparser mental-state vocabulary, and display greater referential ambiguity. Narrative difficulties in individuals with ASD arise from discourse planning and socio-cognitive difficulties, with local linguistic form though being relatively more preserved.