Using the Question-Answer Relationship Strategy to Improve Listening Comprehension in Young Children with Autism Spectrum Disorder.

Four preschoolers with autism listened to picture books while an adult asked four kinds of questions. The adult sorted each question into one of four boxes: Right There, Think and Search, Author and Me, or On My Own. Color icons and think-aloud scripts helped the kids see where the answer lived.

The team used a multiple-baseline design. They started the lessons at different times for each child to be sure the teaching, not chance, caused any gains.

Every child learned to point to or say the correct box for each question type. Comprehension scores stayed high weeks later without extra practice.

The kids also began answering harder inference questions they had never seen before.

Whalon et al. (2019) taught story grammar with pictures and saw the same jump in listening scores. The new study swaps story grammar for QAR boxes, showing the visual frame, not the frame brand, drives success.

Lo et al. (2021) and Hou et al. (2025) used parent-led dialogic reading. Their kids made similar gains, proving the adult can be a parent, teacher, or therapist as long as the questions stay scripted and visual.

El Zein et al. (2014) reviewed older reading studies and said, "We need more work." This 2023 paper answers that call with a tight single-case package ready for classrooms today.

You already read picture books for reinforcement. Add four colored cards and the QAR script and you turn that time into evidence-based comprehension training. No extra materials, no extra staff. Try it during circle time or parent coaching next week.