Assessing ?coherence? in the spoken narrative accounts of autistic people: A systematic scoping review

Background: The ability to produce a well-structured, coherent narrative account is essential for successful everyday communication. Research suggests that autistic people may find this chal-lenging, and that narrative assessment can reveal pragmatic difficulties in this population that are missed on sentence-level tasks. Previous studies have used different methodologies to assess spoken narrative skills in autism. This review systematically examined these approaches and considered their utility for assessing narrative coherence. Method: Keyword database searches were conducted, with records screened by two independent reviewers. Eligible studies (n = 59) included specified frameworks for evaluating structure/ coherence in spoken narrative accounts by autistic participants of any age. Studies were cat-egorised according to the type of narrative scoring scheme used, and strengths and limitations were considered. Results: Over 80% of included articles reported observational cross-sectional studies, with par-ticipants generally matched on age and cognitive ability with non-autistic comparison groups. The most common approaches involved coding key elements of narrative structure ('story grammar') or scoring the inclusion of pre-determined 'main events'. Alternative frameworks included 'holistic' rating scales and subjective quality judgements by listeners. Some studies focused specifically on 'coherence', measuring diverse aspects such as causal connectedness and incongruence. Scoring criteria varied for each type of framework. Conclusions: Findings indicated that solely assessing story structure ignores important features contributing to the coherence of spoken narrative accounts. Recommendations are that future research consider the following elements: (1) context, (2) chronology, (3) causality, (4) congru-ence, (5) characters (cognition/emotion), and (6) cohesion; and scoring methods should include rating scales to obtain sufficiently detailed information about narrative quality.