STORY RETELLING AND ATTENTION DEFICIT HVPERACTIVITY DISORDER
Shonna Claudelle Francis John
A thesis submitted in conforrnity with the requirernents for the degree of Master's of Arts
Department of Human Development and Applied Psychology Ontario Institute for Studies in Education of the
University of Toronto
O Copyright by Shonna Claudelle Francis John, 2001
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Story Retelling and Attention Deficit Hyperactivity Disorder
Shoma Claudelle Francis John
Master's of Arts, 2001
Human Development and Applied Psychology
Ontario Institute for Studies in Education of the University of Toronto
Abstract
Objective: Investigate story-reteiling in children with Attention-DeficitMyperactivi~
Disorder (ADHD) using the Strong Narrative Assessrnent Procedure (SNAP). Method:
(1) Investigated effect of stimulant medication on story-retelling in ADHD children. (2)
Examined normal development of story-retelling in children. (3) Investigated story-
retelling in chilren, wvith and without ADHD. Results: (1) Stimulant medication had
specific effects on story gramma. in the retold stories of ADHD children. (2)
Developmental differences in story structure were found; sex difference found in
inferential comprehension; SNAP stimulus stories are not equivalent. (3) ADHD
children included less story grammar components in their stories, which were shorter and
contained less units of information; the ADHD children also made more arnbiguous
reference story-retelling errors compared to normal controls. Comprehension
performance did not differ between the ADHD and control groups. Conclusion: ADHD
children are impaired in story-retelling. The SNAP is a limited- but useful assessment
tool to elicit and analyze children's retold stories.
ACKNOWLEDGEMENTS
Thank you to God for providing me with His grace and strength to complete a
successful Masters of Arts program.
Thank you to my supervisor, Dr. Rosemary Tannock, for her inspiration and
confidence in my abilities. Her encouraging words, unique guidance and stirnulating
ideas wili continue to inspire me throughout the years. 1 also thank Dr. Judith Wiener for
reviewing the present thesis and for her helphl suggestions.
1 greatly appreciate the time, insights, and generosity of Elizabeth Morley and the
teachers, parents and students of the Institute for Child Study.
Thank you to Mariko Lui and Anne-Claude Bedard for their assistance with data
collection and transcription.
1 would like to acknowledge the support provided by the Samuel Lunenfeld
Research Surnmer Student Program and the Ontario Graduate Scholarship program.
Finally, 1 dedicate this thesis to my parents Wilma and Godric Francis and my
newly wedded husband, Anthony John. 1 t h d each of you for your loving support.
i i i
TABLE OF CONTENTS Page
Abstract
Acknowledgmen ts
List of Tables
List of Figures
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Refe rences
Introduction 0 Measurernent of Narrative Abi lities 0 Organization and Rationale of Thesis
Stimulant Effects on Story Retelling in Children with ADHD
Abstract Introduction
0 Method Results Discussion
Developmental Changes in Story Retelling Abstract Introduction Method Results Discussion
Story Retelling in Children with ADHD and Normal Controis
Abstract Introduction Method Results Discussion
Discussion
iii
viii
Parts of this thesis have been accepted for publication (Chapter 2) and submitted for
publication (Chapter 3).
Chapter 2 Franicis, S. C., Fine, J., & Tannock, R. (in press). Methylphenidate
selectively improves story retelling in children with Attention-
Deficit&iyperactivity Disorder. Journal of Child and Adolescent
Psychopharmacolom, i l (3 ) . 200 1.
This article has been selected to be featured as the most noteworthy article in this issue.
Chapter 3 Francis, S. C., Lui, M., & Tmnock. R. (2001). Children's story retelling
and comprehension using a new narrative resource. Manuscript submitted
to the Journal of Educational Research.
Permission to reproduce excerpts of this thesis was obtained from the necessary sources.
List of Tables
Chapter 2
Table:
1 . Demographic characteristics of sample stratified for language impairment. 19
2. Stimulant effects on story reteliing by children with ADHD. 26
Chapter 3
Table:
1 . Demographic characteristics of the sample stratified by age group.
2. Developmental effects on story retelling.
3. Story group effect on story retelling.
4. Hierarchicai regression analyses predicting Interna1 Responses.
Chapter 4
Table:
1 . Demographic characteristics of the cornparison sample.
2. Group effects on story retelling.
Page
List of Figures
Chapter 2
Figure:
1. Story grarnmar characteristics and their relation to BarHey's (1 997) model of executive functioning.
2. Types of errors and cheir relation to Barkley's (1 997) model of executive fnctioning .
Chapter 3
Figure:
1. Story grarnmar categories.
2 . Error coding categories.
Chapter 4
Figure:
1. Story grammar characteristics and their relation to Barkley's (1 997) mode1 of executive functioning.
2. Types of errors and their relation to Barkley's (1997) model of executive functioning.
Page
vii
Introduction
Attention Deficit Hyperactivity Disorder (ADHD) is a common behavioural
disorder arnong elementary aged children, with prevalence rates ranging from
approximately 3%-6% (reviewed by Tannock and Schachar, 1 996). Persistent and
developmentally inappropriate levels of inattention, impulsiveness and hyperactivity
mark this disorder (Arnerican Psychiatrie Association, 1994). It is hypothesized that
executive functioning deficits in children with ADHD result in problems with planning.
organization, monitoring and self-regulation, which increase the risk for
comrnunication/language disorders (Barkley, 1997; Pennington & Ozonoff, 1 996). such
as deficits in expressive, receptive and pragmatic language (Tannock & Schachar, 1996).
A specific language ski11 that tends to be problematic for children with ADHD is the
ability to produce and comprehend stories.
Narrative production and comprehension skills are factors in achieving academic
success and positive social exchanges. The use of narratives in acadernic and social
situations allow children to summarize, gossip, impress, clarify, inform, tell jokes.
criticize, persuade, threaten and befnend (Crais & Lorch, 1994). Through narratives,
children c m attach rneaning to various experiences and impose order on disconnected
events by sequencing them in time and rendering them fiom a particular point of view
(Capps, et al. 2000). Story narratives also transmit a society's value system, reflecting
problem-solving strategies used in social interactions. Therefore ADHD children's
difficulties with narratives might account for their academic and social problems
(Hinshaw, 1992; Whalen, et d. 1979).
Evaluating specific language skills using narrative tasks provides vital
information about a student's ability to produce and comprehend discourse units beyond
the sentence level, which is essential for acadernic success. Narrative assessments also
yield important information about children's ability to recali and iogically order ideas,
relate story schema to on-going events, use appropriate linguistic devices to create a
cohesive text, and take into account the needs of the listener, in the case of oral story
telling (Griffith, e t al., 1985).
Story retelling is a specific narrative ski11 which draws upon pragmatic language
skills, such as the ability to use extended amounts of language, to recall details and to
sumrnarize information into an intelligible whole for a listener who has never heard a
particular story before (Strong, 1998). Such skills allow a student to benefit fiom
extended discussions, reports, explanations, retellings, and stories in the classroom. As
well, story retelling enhances a student's ability to summari
