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Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications WHAT THIS PAPER ADDS What is already known on the subject What this study adds What are the clinical implications of this work? The conceptualisation of autism as a disorder where Theory of Mind (ToM) and pragmatics are fundamentally impaired has prompted a wealth of research on autistic deficits, most of which is characterised by two main assumptions: first, that autistic people would display said deficits, if present, with any conversation partner and in any situation; second, that neurotypical people do not present these deficits, regardless of the conversation partner. However, this is not necessarily reflected in autistic accounts of the way they experience social cognition and pragmatics.The present paper aims to investigate the autistic experience of communication with both autistic and neurotypical people, with a particular focus on their perception of the ability of autistic and neurotypical people to understand their communicative intentions.Participants, 23 adult Italian autistic people without intellectual disability or language disorders, were recruited online. Two virtual focus groups of 2 hours each were conducted, transcribed and analysed through thematic analysis with a descriptive phenomenological approach by two independent researchers.Six themes were developed from the analysis, the most relevant being Autistic–Autistic communication and Autistic ToM. The results, in line with the Double Empathy theory, suggest there seem to be important differences between neurotypical and autistic people's ToM. These appear to make it easier for autistic people to communicate with one another, as well as to create difficulties for neurotypical people to understand autistic people, not just the other way around.These results seem to confirm that challenges in cross‐neurotype communication are better interpreted as mutual miscomprehension and reciprocal differences in ToM rather than deficits on the autistic part. This calls for a reframing of ToM and/or the need for autistic ToM as a construct, of which neurotypical people seem to be lacking. Moreover, these insights should be taken into account for speech and language therapy and clinical practice in general, advocating for a neurodiversity‐informed view of co‐constructed communication as well as for a broader societal change in which therapists can play a crucial role, through participatory approaches or raising awareness in their daily practice. Autism is conceived as characterised by social cognition and communication difficulties, often linked to Theory of Mind (ToM) deficits. However, recent research suggested variations in ToM abilities within the autistic population and proposed alternative theories like the Double Empathy theory. Nevertheless, only a few studies examined how autistic individuals perceive communication across neurotypes. Autistic individuals seem to find it easier to communicate with other autistic people, and they identify specific characteristics of neurotypical communication that hinder successful communication. Moreover, neurotypical people are perceived as having difficulties in autistic ToM, which seems to emerge as a relevant and needed construct in light of the Double Empathy problem. These findings can inform speech and language therapy and clinical practice about the potential gains of raising awareness on the Double Empathy problem and the higher communication ease inside the autistic community, alongside individualised support. Participatory approaches and closer collaboration with the autistic community also seem to be crucial for therapists to help improve communication experiences for autistic individuals. [ABSTRACT FROM AUTHOR]

Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications WHAT THIS PAPER ADDS What is already known on the subject What this paper adds to the existing knowledge What are the potential or actual clinical implications of this work? Parental input plays a central role in typical language acquisition and development. In autism spectrum disorder (ASD), characterized by social communicative and language difficulties, parental input presents an important avenue for investigation as a target for intervention. A rich body of literature has identified which aspects of grammatical complexity and lexical diversity are most associated with child language ability in both typical development and autism. Yet, the majority of these studies are conducted with English‐speaking children, thus potentially overlooking nuances in parental input derived from cross‐linguistic variation.To examine the differences in verbal parental input to Bulgarian‐ and English‐speaking children with ASD. To examine whether aspects of verbal parental input found to be concurrent predictors of English‐speaking children's expressive language ability are also predictors of the expressive language of Bulgarian‐speaking children with ASD.We compared parental input to Bulgarian‐speaking (N = 37; 2;7–9;10 years) and English‐speaking (N = 37; 1;8–4;9 years) children with ASD matched on expressive language. Parent–child interactions were collected during free play with developmentally appropriate toys. These interactions were transcribed, and key measures of parental input were extracted.English‐speaking parents produced more word tokens and word types than Bulgarian‐speaking parents. However, Bulgarian parents produced more verbs in relation to nouns and used more statements and exclamations but asked fewer questions than English‐speaking parents. In addition, child age and parents’ use of questions were significant concurrent predictors of child expressive vocabulary.This is one of the first studies to conduct a cross‐linguistic comparison of parental input in ASD. The differences found emphasize the need to further study parental input to Bulgarian children and adapt naturalistic parent‐mediated interventions to the local language and its specific characteristics. A rich body of literature has identified the specific aspects of grammatical complexity, lexical diversity, and question‐asking that are concurrently and longitudinally associated with the language ability of children with typical development and of children with ASD. Yet, the majority of these studies are conducted with English‐speaking children. The present study finds that there are specific differences in verbal parental input to Bulgarian‐ and English‐speaking children with autism in terms of lexical composition and question‐asking. Bulgarian parents used more verbs than nouns, and the opposite pattern was found for English‐speaking parents. In addition, Bulgarian parents asked fewer questions but used more statements and exclamations. Nevertheless, parental question use was significantly correlated with children's language ability across both groups, suggesting that question‐asking should be further examined as a potential target for parent‐mediated language interventions for Bulgarian children with autism. Most language and social communication interventions for autism are designed and piloted with English‐speaking children. These interventions are often simply translated and used in different countries, with different populations and in different contexts. However, considering that one of the defining characteristics of autism is language difficulty, more studies should examine (1) how these language difficulties manifest in languages other than English, and (2) what characterizes verbal parental input in these other contexts. Such research investigations should inform future language and social communication interventions. The present study emphasizes the cross‐linguistic differences between Bulgarian‐ and English‐speaking parents’ verbal input to their children with autism. [ABSTRACT FROM AUTHOR]

Background: Neurodiversity is increasingly discussed in relation to autism research and practice. However, there is a lack of scholarship concerning the neurodevelopmental condition of Developmental Language Disorder (DLD) and the neurodiversity movement. While this movement may hold opportunities for the DLD community, the application of the concept of neurodiversity to DLD research and practice needs consideration, as DLD and autism have very different levels of public and professional awareness and understanding. Aims: In this article, we discuss what the concept of neurodiversity and the associated neurodiversity movement could mean for DLD research and practice. We aim to critique some assumptions that may arise from the application of neurodiversity principles (or assumed principles) to the field of DLD. Methods: This is a discussion paper, drawing on the personal experiences and reflections of the author team. Main Contributions: We make the case for why DLD should be included in discussions about neurodivergence and outline considerations for doing so, and why some issues and applications may be particular to DLD. We outline points of similarity and contrast with autism in relation to our understanding of neurodiversity. We consider the issues around diagnosis and terminology and urge practitioners to continue to diagnose DLD using currently agreed terminology, so as not to undermine recent awareness efforts. We note that a neurodiversity‐informed perspective challenges us to offer interventions that operate at the level of our environments, not just at the level of an individual. Indeed, neurodiversity offers a platform to argue for better rights and more inclusive spaces in mental health settings, education and work for children and adults with DLD. Conclusions: DLD should be considered from a neurodiversity‐informed perspective, and it is our hope that this will lead to neurodiversity‐affirming practice that will afford young people with DLD better understanding from members of the public and the professionals who work with them. Further work is needed to better support children, young people and adults with DLD to have a voice in the neurodiversity movement. WHAT THIS PAPER ADDS: What is already known on the subject: Neurodiversity approaches are increasingly being taken up in research and practice in relation to autism, meaning that our understanding of autism and how autistic people are supported is increasingly drawing on the principles of neurodiversity. However, autism is not the only neurodivergent population. Developmental Language Disorder (DLD) is another neurodevelopmental condition; however, relative to autism, DLD has lower awareness amongst professionals and the public. There has been no scholarship that has examined DLD through the lens of neurodiversity, or considered the application of neurodiversity‐affirming approaches to DLD. What this paper adds to existing knowledge: In this paper, we examine what the neurodiversity movement means for DLD research and practice. In particular, we consider what neurodiversity in the field of autism might teach us about the application of neurodiversity in the field of DLD, and highlight where we believe there are important differences between the two populations. We reflect on what neurodiversity means for intervention, diagnosis, terminology and championing the need for accessibility, especially with regard to mental health support, education and employment. What are the potential or actual clinical implications of this work?: Neurodiversity highlights the need to consider interventions at the level of an individual's environment (e.g., how can we make this space more inclusive?) as well as interventions operating at the level of the individual themselves (e.g., interventions focusing on an individual's language skills). We challenge the notion that neurodiversity‐affirming approaches mean not diagnosing DLD or changing DLD's terminology: we argue that this is not in the spirit of the original neurodiversity movement, but also that for a condition with such low public awareness, these actions could do more harm than good for families affected by DLD. We call for more in‐depth scholarship and discussion around the application of neurodiversity approaches to DLD and argue that the neurodiversity movement offers an important opportunity to raise better awareness and understanding of DLD in multiple sectors, including (but not limited to) mental health, education and employment. [ABSTRACT FROM AUTHOR]

Background: Video‐based interventions (VBIs) are an approach that can be used to promote social behavioural skills for autistic children and young people. Despite an abundance of literature in this area, previous evidence syntheses are limited by their exclusive search strategies and eligibility criteria. Therefore, there is a lack of comprehensive evidence syntheses to provide insight on whether these interventions work, for whom, and in what circumstances. Evidence and Gap Maps (EGMs) are used to collate vast literature on a broad topic area such as this, highlighting areas for synthesis, and identifying gaps for future research. Objectives: To identify, map and synthesise existing primary research on VBIs promoting social behavioural skills for autistic children and young people, creating a live, searchable and publicly available EGM. Search Methods: Searches were conducted in electronic databases (n = 8), web search engines, and other repositories including published papers and grey literature. The search strategy was developed around two concepts including (1) terms related to autism, and (2) terms related to VBIs. Searches were conducted in May 2021. Selection Criteria: All primary studies evaluating the effectiveness of VBIs in promoting social behaviours for autistic children and young people aged 3–18 were included in the EGM. Data Collection and Analysis: Search results were imported into Eppi‐Reviewer where duplicates of identical studies were removed. Titles and abstracts were then screened by two independent reviewers. Potentially eligible full texts were located and also screened by two reviewers. Data were then extracted on study design, participant characteristics, type of intervention, type of outcome, and country of study, by one of three reviewers. EPPI‐Mapper was used to create the interactive EGM. Main Results: The current EGM contains 438 studies reporting on 394 single subject research designs, 25 randomised controlled trials, 15 non‐randomised group designs, and 8 pretest–posttest designs. Included studies evaluated VBIs in all male (n = 238), mixed gender (n = 172) or all female (n = 17) samples. VBIs employed included video modelling (n = 273), video self‐modelling (n = 82), point‐of‐view modelling (n = 61), video prompting (n = 57), video feedback (n = 12) and computer‐based video instruction (n = 4). The most frequently used models were adults (n = 191) and peers (n = 135). In relation to social outcomes, almost half evaluated social engagement (n = 199) with limited studies looking at safety (n = 9) and community (n = 7) skills. Authors' Conclusions: This EGM provides a valuable resource for policy‐makers, practitioners, researchers, funders and members of the public to access evidence on VBIs promoting social behavioural skills in autistic children and young people. The map has identified areas of sufficient research where evidence can undergo synthesis. In addition, important gaps in the evidence were highlighted and suggest further research is warranted in all female samples and less frequently evaluated types of VBIs and social outcomes. Evidence included in this EGM will be further explored via systematic review and meta‐analysis on control group designs. [ABSTRACT FROM AUTHOR]

Autism is a neurodevelopmental disorder, the prevalence of which has increased dramatically in the United States over the past two decades. It is characterized by stereotyped behaviors and impairments in social interaction and communication. In this paper, we present evidence that autism can be viewed as a PIN1 deficiency syndrome. Peptidyl‐prolyl cis/trans isomerase, NIMA‐Interacting 1 (PIN1) is a peptidyl‐prolyl cis/trans isomerase, and it has widespread influences in biological organisms. Broadly speaking, PIN1 deficiency is linked to many neurodegenerative diseases, whereas PIN1 over‐expression is linked to cancer. Death‐associated protein kinase 1 (DAPK1) strongly inhibits PIN1, and the hormone melatonin inhibits DAPK1. Melatonin deficiency is strongly linked to autism. It has recently been shown that glyphosate exposure to rats inhibits melatonin synthesis as a result of increased glutamate release from glial cells and increased expression of metabotropic glutamate receptors. Glyphosate's inhibition of melatonin leads to a reduction in PIN1 availability in neurons. In this paper, we show that PIN1 deficiency can explain many of the unique morphological features of autism, including increased dendritic spine density, missing or thin corpus callosum, and reduced bone density. We show how PIN1 deficiency disrupts the functioning of powerful high‐level signaling molecules, such as nuclear factor erythroid 2‐related factor 2 (NRF2) and p53. Dysregulation of both of these proteins has been linked to autism. Severe depletion of glutathione in the brain resulting from chronic exposure to oxidative stressors and extracellular glutamate leads to oxidation of the cysteine residue in PIN1, inactivating the protein and further contributing to PIN1 deficiency. Impaired autophagy leads to increased sensitivity of neurons to ferroptosis. It is imperative that further research be conducted to experimentally validate whether the mechanisms described here take place in response to chronic glyphosate exposure and whether this ultimately leads to autism. [ABSTRACT FROM AUTHOR]

This paper represents a sociological approach to autism spectrum disorder that critiques the terms neurodiverse and it obverse, neurotypical, because they promote a cognitive approach that mystifies what is actual and real about human activity in everyday life. It is in dynamic interactional practices rather than putative cognitive states that human diversity is manifest or observable. The empirical part of the paper, following Bleuler, defines and examines “autistic talk” as a turning away from the ordinary social world or commonsense “reality,” and engaging self‐oriented practices and orientations. However, the range of participants who produce such talk is not confined to those on the putative autism spectrum. Rather, that range encompasses the entire human span. If so, then a question is raised about what autism is as a “condition,” which term individualizes social difficulties rather than appreciating that they are always about diverse social actions‐in‐interaction. [ABSTRACT FROM AUTHOR]

Background Aims Methods and procedures Outcomes and results Conclusions and implications What this paper adds What is already known on the subject What this paper adds to existing knowledge What are the potential or actual clinical implications of this work? In typically developing (TD) children, gesture emerges around 9 months of age, allowing children to communicate prior to speech. Due to the important role gesture plays in the early communication of autistic and TD children, various tasks have been used to assess gesture ability. However, few data exist on whether and how tasks differentially elicit gesture, particularly for samples of racially and ethnically diverse autistic children.In this study, we explored if task (a naturalistic parent–child interaction [NPCI]; structured assessment of child communication) differentially elicited rate or type of gesture production for young autistic children.This secondary analysis included baseline data from 80 racially and ethnically diverse autistic children aged 18–59 months who participated in one of two larger studies. Video recordings of NPCIs and an assessment of child communication with standardised administration procedures were collected at baseline. Child gesture rate (number of gestures produced per 10 min) and type were extracted from these recordings and analysed.The structured assessment elicited more gestures than the NPCI. In terms of gesture type, points, gives, and reaches accounted for 76% of child gestures. Points (which are developmentally more advanced than reaches and gives) were produced at the highest rates within book exploration. Distal points (which are more developmentally advanced than proximal or contact points) were produced at the highest rates when children were tempted to request.Our findings indicate elicitation tasks differentially elicit type and rate of gesture for young autistic children. To assess the gesture production of young autistic children, a structured task designed to elicit child requests will probe the developmental sophistication of the child's gesture repertoire, eliciting both the most gestures and the most developmentally advanced gestures. Because of the importance of gesture in early communication for autistic and typically developing children, various tasks have been used to assess it. However, little is known about whether tasks differentially elicit type or rate of gesture for young autistic children from diverse racial and ethnic backgrounds. Elicitation tasks differentially elicit type and rate of gesture for young autistic children in the early stages of gesture. We recommend a structured task designed to elicit child requests to assess the developmental sophistication of a child's gesture repertoire. [ABSTRACT FROM AUTHOR]

Recent studies have shown that white–gray contrast (WGC) of either cortical or subcortical gray matter provides for accurate predictions of age in typically developing (TD) children, and that, at least for the cortex, it changes differently with age in subjects with autism spectrum disorder (ASD) compared to their TD peers. Our previous study showed different patterns of contrast change between ASD and TD in sensorimotor and association cortices. While that study was confined to the cortex, we hypothesized that subcortical structures, particularly the thalamus, were involved in the observed cortical dichotomy between lower and higher processing. The current paper investigates that hypothesis using the WGC measures from the thalamus in addition to those from the cortex. We compared age‐related WGC changes in the thalamus to those in the cortex. To capture the simultaneity of this change across the two structures, we devised a metric capturing the co‐development of the thalamus and cortex (CoDevTC), proportional to the magnitude of cortical and thalamic age‐related WGC change. We calculated this metric for each of the subjects in a large homogeneous sample taken from the Autism Brain Imaging Data Exchange (ABIDE) (N = 434). We used structural MRI data from the largest high‐quality cross‐sectional sample (NYU) as well as two other large high‐quality sites, GU and OHSU, all three using Siemens 3T scanners. We observed that the co‐development features in ASD and TD exhibit contrasting patterns; specifically, some higher‐order thalamic nuclei, such as the lateral dorsal nucleus, exhibited reduction in codevelopment with most of the cortex in ASD compared to TD. Moreover, this difference in the CoDevTC pattern correlates with a number of behavioral measures across multiple cognitive and physiological domains. The results support previous notions of altered connectivity in autism, but add more specific evidence about the heterogeneity in thalamocortical development that elucidates the mechanisms underlying the clinical features of ASD. [ABSTRACT FROM AUTHOR]

Background: Narrative discourse, or storytelling, is used in daily conversation and requires higher‐level language and social communication skills that are not always captured by standardised assessments of language. Many autistic individuals and individuals with fetal alcohol spectrum disorders (FASD) have difficulties with both social communication and language skills, and narrative discourse analysis offers an ecologically relevant approach to assessing those challenges. Aims: This study investigated narrative discourse in individuals with autism and FASD, as well as an age‐ and sex‐matched comparison group. Methods and Procedures: Narratives from 45 adolescents and adults, 11 with autism, 11 with FASD and 23 age‐ and sex‐matched comparison participants were elicited using a wordless storybook. They were then transcribed orthographically, formatted to the Systematic Analyses of Language Transcript (SALT) convention and scored based on the SALT Narrative Scoring Scheme (NSS), a standardised language analysis protocol. In addition to the NSS total score, which assesses the overall structure and cohesion of the narratives produced, local and global measures of language ability were also employed. The local language measures included the number of mental state and temporal relation terms produced, while the global language measures included mean length of utterance, total different words, total words, total utterances, rate of speech, the number of mazes (e.g., repetitions, 'um', 'uh' or self‐corrections) per total word and the NSS total score. Outcomes and Results: Using the SALT Language Sample Analysis tool, our results revealed that on global language measures, group differences were found on rate of speech, number of mazes per total words and the description of conflict/resolution in the narratives produced. The autism group produced significantly more mazes per total word and scored higher on the NSS conflict/resolution category score compared to the FASD and comparison groups. Both the autism and FASD groups spoke at a lower rate than the comparison group. On local language measures of narrative production, all groups were comparable, on average. Conclusions and Implications: While many aspects of narrative discourse in the autism and FASD groups were similar to each other and to the comparison group, we observed group differences on global measures of narrative production and significant individual variability within groups, suggesting that narrative abilities considered at an individual level may provide important clinical information for intervention planning. Future research should also consider additional variables that influence narrative discourse, such as motivation, distractibility or decision‐making of individual participants. What this paper adds: What is already known on the subject: Narrative discourse, or storytelling, is used in daily conversational interactions and reveals higher‐level language skills that may not be well captured by standardised assessments of language. Many autistic individuals and individuals with fetal alcohol spectrum disorders (FASD) show difficulty with pragmatic and expressive language skills. What this paper adds to existing knowledge: We found that many aspects of the narratives produced by the adolescents/young adults in the autism and FASD groups were comparable to each other and to the neurotypical group. However, the groups differed on three global measures of narrative production: rate of speech, number of mazes per total words and the description of conflict/resolution in the narratives produced. Also, significant variability was observed within groups, suggesting that narrative abilities should be considered at an individual level as opposed to their clinical groups. What are the potential or actual clinical implications of this work?: This study showed that narrative discourse is an appropriate task that can be added to routine clinical assessments of language abilities in autistic adolescents/young adults as well as those with FASD or typical development and has the potential to reveal higher‐level, real‐world language skills. An important clinical implication of this study is that narrative language abilities should be considered at an individual level and individual‐tailored interventions based on ability level due to the variability observed across individuals. [ABSTRACT FROM AUTHOR]

Motor features of autism have long been acknowledged by clinicians, researchers, and community stakeholders. Current DSM‐5 and ICD‐11 guidelines allow clinicians to assign a co‐occurring diagnosis of developmental [motor] coordination disorder (DCD) for autistic individuals with significant motor problems. DCD is characterized by poor motor proficiency with an onset of symptoms in early development. Studies have shown considerable overlap in the behavioral motor features observed in autism and DCD. However, others indicate that motor problems in autism and DCD may stem from different underlying sensorimotor mechanisms. Regardless of whether autism has a unique motor phenotype or an overlap with DCD, changes need to be made in the clinical pipeline to address motor problems in autism at the stages of recognition, assessment, diagnosis, and intervention. Consensus is needed to address unmet needs in research on the etiology of motor problems in autism and their overlap with DCD, to optimize clinical practice guidelines. The development of screening and assessment tools for motor problems that are valid and reliable for use with autistic individuals is essential, and an evidence‐based clinical pipeline for motor problems in autism is urgently needed. What this paper adds: Motor problems in autism are highly prevalent, yet underdiagnosed and poorly managed.An evidence‐based clinical pipeline for motor problems in autism is urgently needed. What this paper adds: Motor problems in autism are highly prevalent, yet underdiagnosed and poorly managed.An evidence‐based clinical pipeline for motor problems in autism is urgently needed. [ABSTRACT FROM AUTHOR]

Summary: Sleep problems are common in neurological conditions for which ketogenic dietary therapies (KDTs) are recognised as an effective intervention (drug‐resistant epilepsy, autism spectrum disorder, and migraine). Given the composite framework of action of ketogenic dietary therapies, the prevalence of sleep disturbance, and the importance of sleep regulation, the present scoping review aimed at identifying and mapping available evidence of the effects of ketogenic dietary therapies on sleep. A comprehensive web‐based literature search was performed retrieving publications published to June 2023 using PubMed and Scopus, yielding to 277 records. Twenty papers were finally selected and included in the review. Data were abstracted by independent coders. High variability was identified in study design and sleep outcome evaluation among the selected studies. Several changes in sleep quality and sleep structure under ketogenic dietary therapies were found, namely an improvement of overall sleep quality, improvement in the difficulty falling asleep and nighttime awakenings, improvement in daytime sleepiness and an increase of REM sleep. The relevance and possible physiological explanations of these changes, clinical recommendations, and future directions in the field are discussed. [ABSTRACT FROM AUTHOR]

It could be argued that autistic females, attending high school, have a distinct set of needs when compared to their male counterparts. The purpose of this review is to synthesise reported findings on what could be considered as effective for supporting the needs of autistic females in high school settings. The review adhered to PRISMA guidelines. Searches identified 12 papers that included direct perspectives of autistic females, their families and the professionals supporting them. Data were analysed using thematic synthesis. The findings indicate seven main themes for support related to: mental health; identification of specific needs and post‐diagnostic support; friendship interventions and skills development; tiered support; relationships between home and school; transitions between levels of education; self, peer and staff advocacy, and sense of belonging. Social and emotional experiences of autistic females in high school are key areas to target in ensuring successful education. Findings are discussed in relation to integrated, inclusive practices that high schools may adopt to support this cohort of students. Implications for professional practice, policy and research are discussed, which will be of interest to educators and helping professionals alike. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Neurodevelopmental conditions frequently co‐occur. The aim of this paper was to determine whether there is a cumulative association between (1) the number of neurodevelopmental conditions, specifically hyperkinetic disorder (hereafter referred to as attention deficit hyperactivity disorder), autism spectrum disorder (hereafter referred to as autism) and intellectual disability, and (2) behavioural and socio‐emotional problems and the level of clinician‐rated functioning for young males and females.In this cross‐sectional study, diagnostic information, caregiver‐rated behavioural and socio‐emotional data (as conceptualised by the Strengths and Difficulties Questionnaire) and clinician‐rated functioning scores (as conceptualised by the Children's Global Assessment Scale) were extracted from electronic patient records for 2768 young people aged 3–17 years (mean = 11.55, SD = 3.46). All data were extracted at baseline, that is, at the time the young person was diagnosed with attention deficit hyperactivity disorder, autism and/or an intellectual disability. Ordinal regression analyses tested associations between the number of neurodevelopmental conditions met (i.e. 1, 2 or 3) and behavioural and socio‐emotional outcomes and functioning.After controlling for age and biological sex, the number of neurodevelopmental conditions was associated with higher levels of inattention/hyperactivity and peer problems, lower levels of prosocial behaviour and poorer clinician‐rated functioning. Although these findings were consistent for males, a cumulative association was not identified for females, except for clinician‐rated functioning.For young people, the presence of multiple neurodevelopmental conditions may have a cumulative impact across domains, but this may differ between males and females. [ABSTRACT FROM AUTHOR]

In recent years, several publications and media outlets have highlighted how the skills and interests of autistic individuals may benefit organizations. However, there is scant empirical research on the topic. The present study's authors conducted a systematic review to find which potential employability skills, strengths, and interests of autistic individuals available research has highlighted. Data extraction methods identified 51 papers related to skills in this population. The skill sets autistic individuals may possess and the research behind these findings were organized, evaluated, and summarized. Based on these findings, investigators discuss implications for employment counseling and future research. [ABSTRACT FROM AUTHOR]

This paper critically synthesizes leading edge scholarship on neurodiversity, arguing that sociology could expand its account for the relationship between self and society through attention to the (a)social practices of those constructed as neurologically disabled. Autistic scholar‐activism birthed the neurodiversity paradigm, which claims respect for neurological diversity and its social manifestations. Sexual and gender variation are among those. I review research on the confluence of neurological, sexual, and gender variance, pointing to opportunities for documenting the roles of social institutions in constructing and regulating divergent bodyminds, as well as new intersectional identities and social movements. Next, I synthesize nascent literature developing neuroqueer theory. "Neuroqueer" articulates the queer nature of neurodivergence and examines the entwinement of the two. Centering the epistemic authority of bodyminds problematized as lacking self‐control/intent, perspective‐taking, and reliance on the social symbolic, neuroqueer scholars forward (a)social ways of knowing, communicating, communing, and being human. Focusing on neuronormativity, interdependent with better‐recognized normativities (e.g., gender, ethnicity, etc.), neuroqueer theory offers fresh perspective on how dominant concepts and relations render some bodyminds problematic—legitimate objects of exclusion, marginalization, and "rehabilitation." In doing so, it troubles sociological ideas about agency, sociality, communication, and what it means to be/have a (social) self. [ABSTRACT FROM AUTHOR]

The use of creative qualitative research methods in psychology and other disciplines has increased over recent decades to address power imbalances within research and to centre the voices of participants. These considerations are particularly salient when conducting research with historically marginalized groups, including neurodivergent people. However, research foregrounding the first‐person perspectives of neurodivergent children is still limited. In this paper, we discuss the application of creative qualitative research methods when conducting research with neurodivergent children with a range of communication and wider skill profiles. The benefits and challenges of each method are considered, drawing on examples from the first phase of an ongoing longitudinal study. Additional considerations for working ethically and respectfully with neurodivergent children are discussed. Readers are encouraged to consider how best to adapt their research protocols when working with neurodivergent children, in order to minimize research hierarchies, build positive relationships, and produce rich and meaningful data. [ABSTRACT FROM AUTHOR]

Background: Paid employment represents a challenge for people with an intellectual disability and/or autism. This paper analyses the quality of jobs offered by the Engage to Change project and their relationship to the 'typicalness' of the employment offered. Method: Data on the quality of 384 paid jobs were collected, including hours worked and wages earned, and reported social integration at work. The typicalness of the employment experience was assessed for 141 young people, using the Index of Typicalness of Placement Questionnaire. Results: The Engage to Change project offered a wide range of jobs. There is no difference in the typicalness of the employment experience in relation to the interactions in the workplace, but there are some differences in the recruitment process for men and women. Conclusion: Job coaches should make sure that, despite the procedures being 'atypical' for the workplace, the outcome is 'a typical employment experience' for each employee. [ABSTRACT FROM AUTHOR]

In this paper, we investigated the psychometric properties of the Child Communication Checklist‐Revised (CCC‐R) for the first time with an English‐speaking sample. We used a confirmatory application of exploratory structural equation modeling (ESEM) to re‐evaluate the CCC‐R's psychometric properties. We found strong support for its use as an assessment for pragmatic and structural language. Our second main aim was to explore associations between pragmatic and structural language and restricted and repetitive behaviors (RRBs), two hallmark characteristics of autism. We used the CCC‐R and Repetitive Behavior Questionnaire (RBQ‐2) to investigate these associations in a diverse non‐clinical sample of children, taking a transdiagnostic approach. We intentionally excluded autism and other neurodevelopmental diagnoses to test, (1) the CCC‐R in a broad sample and (2) the association between pragmatic language and RRB in children not already selected for that association. The sample comprised two groups of children, one was community sampled (n = 123) and the other (n = 143) included children with non‐specific behavioral, emotional and/or cognitive difficulties referred to an assessment unit by schools. We found clear associations between pragmatic language difficulties and RRBs in both groups. Regression analysis showed that pragmatic language was the only significant contributor to RRBs even after Grammatical‐Semantic score, age, sex, and socioeconomic status were controlled. The pattern was the same for both recruitment groups. However, the effects were stronger for the school‐referred group which also had more pragmatic difficulties, grammatical‐semantic difficulties and RRBs. A robust link between pragmatic language and RRBs, established in autism, has continuity across the broader non‐clinical population. Lay Summary: We studied language difficulties in a diverse child population. First, we tested the brief Revised Children's Communication Checklist‐2 (CCC‐R) and confirmed that it is a valid assessment tool in an English‐speaking sample. Second, we found that CCC‐R pragmatic language difficulties were associated with restricted and repetitive behaviors. As no child had a clinical diagnosis, we were able to identify this result in children not already selected to have this association. These findings have implications for understanding how repetitive behavior and language come to be related in autistic children. [ABSTRACT FROM AUTHOR]

Perspectives on autism and psychiatric conditions are affected by a mix of scientific and social influences. Evolutionary psychiatry (EP) and the neurodiversity movement are emerging paradigms that reflect these distinct influences, with the former grounded in scientific theory and the latter driven by political and social principles. Despite their separate foundations, there is a significant overlap between EP and neurodiversity that has not been explored. Specifically, both paradigms reframe disorders as natural cognitive differences rather than disease; expand the concept of "normal" beyond that implied in modern psychiatry; focus on relative strengths; recognize that modern environments disadvantage certain individuals to cause functional impairment; emphasize cognitive variation being socially accommodated and integrated rather than treated or cured; and can help reduce stigmatization. However, in other ways, they are distinct and sometimes in conflict. EP emphasizes scientific explanation, defines "dysfunction" in objective terms, and differentiates heterogenous cases based on underlying causes (e.g. autism due to de novo genetic mutations). The neurodiversity movement emphasizes social action, removes barriers to inclusion, promotes inclusive language, and allows unrestricted identification as neurodivergent. By comparing and contrasting these two approaches, we find that EP can, to some extent, support the goals of neurodiversity. In particular, EP perspectives could be convincing to groups more responsive to scientific evidence and help achieve a middle ground between neurodiversity advocates and critics of the movement. Lay Summary: This paper introduces neurodiversity and evolutionary psychiatry and explores the ways in which they overlap and contrast. Both approaches emphasize strengths, question what we think of as "pathological," reflect on the role of modern environments in disabling people, and could help destigmatize autism and other conditions. However, there are also notable differences: neurodiversity principles apply to any type of diagnosable mental condition, but evolutionary explanations are only suitable for certain conditions and individuals. Nevertheless, evolutionary psychiatry may be useful for convincing scientifically‐minded people of the validity of the neurodiversity concept and movement. [ABSTRACT FROM AUTHOR]

The mainstream notions of gender and sexuality among neurodivergent individuals lack wisdom and input from those who have the lived experience of the same. Queer phenomenology (2008) proposed by Sarah Ahmed, offers an interpretative framework to understand neurodivergent life by moving beyond the definitions of sexuality as a set of constructed identity formations aligned to normative gender and reproductive practices. Queer phenomenology along with a feminist phenomenological lens can be employed to analyze the narratives of queer neurodivergent women to see how they access and experience their sexualities. In this way, the present paper argues that queer neurodivergent women "neuroqueer" (a term developed by Yergeau) sexuality by actively subverting and disrupting compulsory heterosexual norms. [ABSTRACT FROM AUTHOR]

There is minimal research on the quality of community partnerships in studies of interventions for autistic children. However, building high quality community engagement in autism intervention research may improve implementation outcomes. This systematic review examined studies that report community partnership in autism intervention research. A total of 135 articles were identified and 11 of these articles were included in the final review. Community partnership data were extracted using indicators from the conceptual framework for assessing research‐practice partnerships (RPP; Henrick et al., Henrick et al., Assessing research‐practice partnerships: Five dimensions of effectiveness, William T. Grant Foundation, 2017) and implementation outcomes data were extracted using the taxonomy of distinct implementation outcomes (Proctor et al., Administration and Policy in Mental Health and Mental Health Services Research, 38:65–76, 2011). Quality of studies were appraised using JBIs critical appraisal tools (Munn et al., JBI Evidence Synthesis, 18:2127–2133, 2020). RPP indicators and implementation outcomes were variably reported across studies. RPP indicators and implementation outcomes more likely to be reported were related to building trust, cultivating partnership relationships, conducting rigorous research to inform action, acceptability, and feasibility. RPP indicators and implementation outcomes less likely to be reported were related to building capacity to engage in partnership work, sustainability, cost, and penetration. Together, these results may suggest the need for increased sustainability and capacity building efforts in partnerships and increased guidelines for reporting outcomes. Lay Summary: This paper reviewed autism intervention studies that report partnerships between researchers and community members. The quality of the partnerships and outcomes of implementing the interventions were found to be variably reported. There may be a need for clearer guidelines on reporting outcomes of partnerships between researchers and community members and partnerships may benefit from increased focus on building capacity and sustainability. [ABSTRACT FROM AUTHOR]

Initial studies of the emotional safety plan (ESP), a new, brief telehealth and mobile intervention to support autistic adults to cope with periods of distress, have reported feasibility and acceptability (Bal et al., 2023, Autism, 1–13). Herein we report the preliminary clinical outcomes of thirty‐six autistic adults who developed a personalized ESP, with a specific interest in comparing "outcomes" demonstrated by different instruments and assessment frequencies in order to inform outcome measurement in future clinical trials. Comparison of pre‐intervention baseline to post‐monitoring outcome (pre–post) anxiety symptoms (Generalized Anxiety Disorder‐7 [GAD‐7]) and depressive symptoms (Patient Health Questionnaire‐9 [PHQ‐9]) revealed medium effect sizes for reduction in symptoms, though, low effect sizes were observed for pre–post Adult Self‐report Anxiety and Depressive Problems scales and the Emotion Dysregulation Inventory Reactivity and Dysphoria scales. Weekly assessments showed an initial decrease in GAD‐7 anxiety symptoms but no effect on weekly PHQ‐9 depressive ratings. Ecological momentary assessment (EMA) data suggested that, when participants reported feeling sad or agitated and used the ESP, reduced negative feelings and increased positive states were reported in subsequent EMA. Perhaps not surprisingly, preliminary outcomes of these feasibility trials differed depending on measure chosen. Implications for the design of clinical trials are discussed. Lay Summary: The newly developed Emotional Safety Plan (ESP) is a brief telehealth and mobile intervention to help autistic adults handle distress and has been shown to be acceptable (Bal et al., 2023, Autism, 1–13). In this paper, we describe how levels of clinical symptoms, like "sad" and "anxious" are different based on how they are measured. We compared levels of anxiety and depressive symptoms at the start and end of the study and found a reduction in symptoms using one set of measures, but not the other. Assessing anxiety and depression symptoms every week showed anxiety decreased at first, but that depression symptoms did not decrease by week. We also used an assessment that looked at daily changes in symptoms and found that when participants felt sad or agitated and used the ESP, negative feelings got lower. These analyses show that clinical symptoms are different based on what type of measure is used. [ABSTRACT FROM AUTHOR]

In this study, we sought to objectively and quantitatively characterize the prosodic features of autism spectrum disorder (ASD) via the characteristics of prosody in a newly developed structured speech experiment. Male adults with high‐functioning ASD and age/intelligence‐matched men with typical development (TD) were asked to read 29 brief scripts aloud in response to preceding auditory stimuli. To investigate whether (1) highly structured acting‐out tasks can uncover the prosodic of difference between those with ASD and TD, and (2) the prosodic stableness and flexibleness can be used for objective automatic assessment of ASD, we compared prosodic features such as fundamental frequency, intensity, and mora duration. The results indicate that individuals with ASD exhibit stable pitch registers or volume levels in some affective vocal‐expression scenarios, such as those involving anger or sadness, compared with TD and those with TD. However, unstable prosody was observed in some timing control or emphasis tasks in the participants with ASD. Automatic classification of the ASD and TD groups using a support vector machine (SVM) with speech features exhibited an accuracy of 90.4%. A machine learning‐based assessment of the degree of ASD core symptoms using support vector regression (SVR) also had good performance. These results may inform the development of a new easy‐to‐use assessment tool for ASD core symptoms using recorded audio signals. Lay Summary: This paper describes an experiment with a new acting‐out reading task in various social situations to investigate the speech prosody, such as pitch, voice volume, and speech rate, pausing affected by the traits of autism spectrum disorders (ASD). The results indicate that the stability and variability of prosody in reacting to different speakers' auditory stimuli in the same sentence can be utilized for automatic diagnosis or assessment of ASD. [ABSTRACT FROM AUTHOR]

Background: Prelinguistic communication complexity refers to the use of different communication forms such as eye gaze, gestures and vocalisations and the degree to which these forms are coordinated and how directed to a communication partner. To date, little is known about the relationship between prelinguistic communication complexity and expressive language in minimally verbal autistic children. Aims: To test the hypothesis that prelinguistic communication complexity predicts expressive language 12 months later in autistic children and explore whether there are any differences in specific prelinguistic intentional communicative behaviours that are related to later expressive language levels. Methods & Procedures: This longitudinal study examined 37 minimally verbal autistic children (29–71 months old). The Communication Complexity Scale (CCS) was used to measure participants' prelinguistic communication behaviours, which were extracted from a semi‐structured play interaction at Time 1. The Chinese Communicative Development Inventory (CCDI) was used to examine participants' expressive language at Time 1 and Time 2 (12 months later). According to Time 2 vocabulary size, participants were divided into two groups: Low CCDI, between 0 and 62 words, and High CCDI, more than 100 words. Linear regression was used to examine the relationship between early prelinguistic communication complexity and later expressive language. Binary logistic regression was used to determine which of the early communication behaviours were uniquely significantly related to later expressive language levels. Outcomes & Results: There was a significant positive relationship between prelinguistic communication complexity and expressive language 12 months later, even after controlling for age and concurrent language. Findings revealed a group difference in the frequency of gesture and vocalisation combinations between the Low and High CCDI groups at Time 1. Gesture‐vocalisation combinations also predicted better expressive language levels at Time 2. Conclusions & Implications: Our findings suggest that it may be beneficial to incorporate different complex communication behaviours into prelinguistic intervention targets for minimally verbal autistic children. The CCS hierarchies can be used as a reference for the intervention goals of minimally verbal autistic children. These findings highlight the importance of targeting gesture and vocalisation combinations when autistic children transition from single prelinguistic communication behaviours to multimodal behaviours. What this paper adds: What is already known on this subject: Children use eye gaze, gestures and vocalisations to communicate with others before they learn spoken language. There is strong evidence suggest that the frequency of prelinguistic communication predicts later linguistic achievements in autistic children. However, less is known about whether prelinguistic communication complexity also predicts later language and which specific behaviours are most predictive of language outcomes. What this study adds: Minimally verbal autistic children who exhibit more complex prelinguistic communication behaviours have better expressive language 12 months later. Gestures combined with vocalisations predict better expressive language in minimally verbal autistic children. What are the clinical implications of this work?: When identifying intervention targets for minimally verbal autistic children, the clinicians may reference the prelinguistic communication behaviours from the CCS. The gesture and vocalisation combinations are the key behaviours when targets transit from single form to two‐form behaviours. [ABSTRACT FROM AUTHOR]

Background: At least 25% of autistic children worldwide have the potential to grow up in a bilingual environment. However, many autistic children are being denied opportunities to access additional languages and the cultural, familial and community connections that come with this. There is little evidence identifying the barriers to language learning and access, and no research addressing the perspectives of speech and language therapists (SLTs), who are crucial in supporting parents to make informed choices about bilingualism with their child. Aims: The aim of this research was to understand the experiences of SLTs working with autistic bilingual children, to understand the main considerations when working with families, and the opportunities and barriers for training, including the sources of information that current practice is based on. Methods and Procedures: Twelve SLTs from across the United Kingdom were recruited for this study. All participants were experienced in working with autistic bilingual children and their families (M = 7 years, range 4–23 years). Semi‐structured interviews were conducted and focused on the experiences of SLTs regarding familial bilingual experiences, the effect of sociocultural factors of practice, and the extent to which practice is based on current research. Outcomes and Results: Data were analysed using reflexive thematic analysis. Three central themes were identified from the interviews: (1) participants discussed parental uncertainties as to whether they were doing the right thing for their child, (2) while participants were in support of bilingualism, they were not always confident that they were providing the right advice and found it difficult to in keep up to date with relevant, evidence‐based research, and (3) participants highlighted a need to shift towards a more inclusive and culturally diverse practice. Conclusions and Implications: This is the first qualitative study to understand the perspectives of SLTs working with autistic bilingual children. We identify several key difficulties in supporting access to language learning, and these findings have immediate and longer‐term implications for supporting SLTs, and in turn, the children and families they support. WHAT THIS PAPER ADDS: What is already known on the subject: Research suggests that autistic children currently have fewer opportunities to maintain bilingualism compared to neurotypical peers. Despite the lack of evidence, many families remain concerned that bilingualism will have a negative impact on their child's development. To date, little is known about the perspectives of speech and language therapists (SLTs) who play a significant role in supporting the development of autistic bilingual children. This is the first study to provide an in‐depth qualitative analysis of the experiences of SLTs working with autistic bilingual children and their families in the United Kingdom. What this study adds: The results highlight a number of reoccurring barriers in providing optimal support: first, frequently cited concerns about bilingualism from parents that link to a lack of understanding about autism and the role of SLTs more generally. Second, SLTs do not have confidence in the assessments and tools available and described a lack of emphasis on cultural factors in practice. Many SLTs were concerned about the limited options for resources and interventions available in other languages, which could be challenging for parents who were less proficient or confident communicating in English. Third, SLTs reported having limited opportunities to keep up to date with relevant research to support their decision‐making processes. What are the clinical implications of this work?: These results have several important implications for practice—they highlight the need for more inclusive practices where possible, a need for more diversity within the profession and further opportunities to be provided with evidence‐based advice around good practice. The results also suggest a benefit of providing accessible, evidence‐based resources for parents about autism and bilingualism, to ensure that research key findings are reaching families. [ABSTRACT FROM AUTHOR]

Fragile X syndrome (FXS) is the leading cause of inherited autism and intellectual disabilities. Aberrant protein synthesis due to the loss of fragile X messenger ribonucleoprotein (FMRP) is the major defect in FXS, leading to a plethora of cellular and behavioral abnormalities. However, no treatments are available to date. In this study, we found that activation of metabotropic glutamate receptor 7 (mGluR7) using a positive allosteric modulator named AMN082 represses protein synthesis through ERK1/2 and eIF4E signaling in an FMRP-independent manner. We further demonstrated that treatment of AMN082 leads to a reduction in neuronal excitability, which in turn ameliorates audiogenic seizure susceptibility in Fmr1 KO mice, the FXS mouse model. When evaluating the animals’ behavior, we showed that treatment of AMN082 reduces repetitive behavior and improves learning and memory in Fmr1 KO mice. This study uncovers novel functions of mGluR7 and AMN082 and suggests the activation of mGluR7 as a potential therapeutic approach for treating FXS. [ABSTRACT FROM AUTHOR]

Around 3% of people are Autistic. Autistic people communicate differently from non‐Autistic people and experience the sensory world differently. There is limited evidence that Autistic people can face additional barriers to breastfeeding. We are an Autistic‐led research team that developed an online survey following consultation with the Autistic community. Autistic people from the UK who had been pregnant were eligible to take part in the survey, which focused on the entire maternity journey. A total of 193 people participated, of whom 152 had experiences of infant feeding (137 breastfeeding, 82 formula feeding). Participants were highly motivated to breastfeed, and almost half of those who breastfed found it positive always or most of the time. However, breastfeeding—and in particular the milk let‐down reflex—could result in pain and sensory difficulties, including 'feeling odd'. Expressing breastmilk always or most of the time was reported by 10% of breastfeeding participants. The intensity and unpredictability of both breast and formula feeding were challenging to manage. Parents reported that it was easy to understand how to prepare infant formula, but that it could also be a negative and anxiety‐inducing experience. Support for breast and formula feeding was often considered inadequate. When parents did access breastfeeding support, this significantly improved a range of breastfeeding experiences. However, participants recommended more tailored support and continuity of carer. To meet the needs of Autistic birthing parents, those providing infant feeding support should receive training on Autism through a neurodiversity‐affirming lens, which should be delivered by Autistic people. Key messages: Many Autistic people are highly motivated to breastfeed, regardless of challenges.Autistic people may experience sensory discomfort when breastfeeding, including from the intensity of touch between themselves and their baby. Distraction and reducing sensory burdens can help.Expressing always or most of the time was relatively common (10%), and a route to maintaining exclusive breastfeeding when directly breastfeeding was too uncomfortable.Receiving breastfeeding support was significantly associated with improvements in a range of breastfeeding experiences.Breastfeeding support for Autistic people should be offered on a one‐to‐one basis with continuity of carer. [ABSTRACT FROM AUTHOR]