Narrative Comprehension and Engagement with E-Books vs Paper-Books in Autism Spectrum Condition

Bethany Wainwright*, Melissa Allen, Kate Cain

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

8 Citations (Scopus)
139 Downloads (Pure)


Background and aims: Children with autism spectrum condition (ASC) often have specific difficulties with narrative comprehension, a skill which has a strong association with both concurrent and longitudinal reading comprehension. A better understanding of narrative comprehension skills in ASC has the potential to provide insight into potential later reading comprehension difficulties and inform early targeted intervention. In the current study, the main objective was to investigate how differences in the medium of story presentation (paper-book vs e-book) and differences in story narration (adult narration vs in-app narration) would influence narrative comprehension in general, and between groups (ASC and a receptive language-matched control group). We were also interested in how task-engagement (visual attention and communication) differed between group and conditions and whether task-engagement was related to narrative comprehension.

Method: 42 children with ASC and 42 typically developing (TD) children were read a story either via a paper-book or an e-book with interactive and multimedia features. The e-book was either narrated by the experimenter (adult narrated iPad condition) or narrated by an in-app voiceover (e-book narrated iPad condition). Children’s behaviour during storybook reading was video recorded and coded for engagement (visual attention and communication). They then completed two measures of narrative comprehension: multiple-choice questions (measuring recall of literal information) and a picture ordering task (measuring global story structure).

Results: Contrary to predictions, we did not find any significant group or condition differences on either measure of narrative comprehension, and both groups demonstrated a similar level of narrative comprehension across the three conditions. We found differences in engagement between conditions for both groups, with greater visual attention in the e-book conditions compared to the paper-book condition. However, visual attention only significantly correlated with narrative comprehension for the TD group.

Conclusion: Overall, this study suggests that children with ASC are just as able as language-matched peers to comprehend a narrative from storybooks. Presenting a story on an iPad e-book compared to a paper-book does not influence narrative comprehension, nor does adult narration of the story compared to in-app narration. However, on-task engagement is linked to narrative comprehension in TD children.

Implications: Taken together, our findings suggest that e-books may be more successful than paper-based mediums at encouraging visual attention towards the story, but no better at supporting narrative comprehension and eliciting communication.
Original languageEnglish
JournalAutism and Developmental Language Impairments
Publication statusPublished - 14 Apr 2020

Structured keywords

  • SoE Centre for Psychological Approaches for Studying Education
  • SoE Language Literacies and Education Network


  • narrative comprehension
  • autism
  • engagement
  • e-books


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