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An introduction to the journal is presented that focuses on issues related to learning disabilities, including participation of people with learning disabilities in end-of-life care research, attitudes of support workers towards the affective and sexual lives of people with intellectual disabilities, and challenges concerning attention-deficit/hyperactivity disorder that is often misdiagnosed in people with learning disabilities.

This single-case study evaluated the effects of two levels of center-based behavioral intervention for a young child with diagnoses of autism, severe attention deficit hyperactivity disorder, bipolar disorder, and severe developmental delay. The child entered an applied behavior analysis school and residential program at age 4 years. At that time he was receiving fluoxetine and valproic acid for control of challenging behavior. Six other medication trials had been attempted previously. Assessments completed just before the child entered the behavioral program estimated his overall functioning at the 8–16 month level. Throughout the study, the child participated in comprehensive behavioral programming for about 30 hours per week. For the first (A) phase of the study, the teacher:student ratio was 1:1. This phase lasted 12 months. At that point resource limitations necessitated changing the teacher:student ratio to 1:2 (the B Phase), which continued for 9 months. Then 1:1 intervention was reinstated. Dependent variables included out-of-seat behavior, aberrant behavior, motor imitation, stereotypic responses, matching to sample, and appropriate communication (recognizable signs and pictures used as mands). By the end of the first A phase (1:1 intervention), substantial improvements were documented in five of six dependent variables, and fluoxetine was discontinued. These improvements were maintained for all dependent variables three months into the B phase, but after an additional six months of 1:2 intervention gains were maintained on only one dependent variable. Nine months after a return to 1:1 intervention, improvements over B-phase levels were evident for five dependent variables, four of which returned to levels comparable to those at the end of the first 1:1 phase. © 1998 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

In this paper I develop an urban social geography of neurodiversity that attends to the plurality of neurodiversity and of neurodiverse experiences of the city. Geographers have remained relatively silent on issues of neurodiversity in the city and, as such, the perspectives and experiences of neurodiverse individuals remain vastly unreported. The city is a crucial spatial context of everyday life for those who are neurodiverse as it can present challenges due to its complex, unpredictable and fluid nature. Drawing on recent calls for the development of a relational geography of disability, this paper explores the intricate geographies of neurodiversity in the city, revealing ways urban spaces become spaces of belonging or exclusion for those who are neurodiverse. Urban spaces are experienced in diverse and complex ways, linked to a multitude of neurological differences and their intersections. The paper reveals social, spatial and temporal practices and processes through which urban spaces acquire meaning for those who are neurodiverse. The research offers important insights for urban planning and policy, particularly in terms of thinking complexly about neurodiversity and associated questions of inclusion and exclusion in the city. The paper concludes with a discussion of some future research directions for an urban geography of neurodiversity. In this paper I develop an urban social geography of neurodiversity that attends to the plurality of neurodiversity and of neurodiverse experiences of the city. Drawing on recent calls for the development of a relational geography of disability, this paper explores the intricate geographies of neurodiversity in the city, revealing ways urban spaces become spaces of belonging or exclusion for those who are neurodiverse. The paper reveals social, spatial, and temporal practices and processes through which urban spaces acquire meaning for those who are neurodiverse. The research offers important insights for urban planning and policy, particularly in terms of thinking complexly about neurodiversity and questions of inclusion and exclusion in the city. [ABSTRACT FROM AUTHOR]

Based on evidence from the relevant research literature, we present a hypothesis that there may be a link between cholesterol, vitamin D, and steroid hormones which subsequently impacts on the development of at least some of the 'autisms' [Coleman & Gillberg]. Our hypothesis, driven by the peer reviewed literature, posits that there may be links between cholesterol metabolism, which we will refer to as 'steroid metabolism' and findings of steroid abnormalities of various kinds (cortisol, testosterone, estrogens, progesterone, vitamin D) in autism spectrum disorder (ASD). Further research investigating these potential links is warranted to further our understanding of the biological mechanisms underlying ASD. Autism Res 2017. © 2017 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research. Autism Res 2017, 10: 1022-1044. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

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]

The authors reflect on the factors as to theme for the June 2006 issue of the journal. They have chosen critically appraised papers related to children with autism for the reason that autism has been one of the most noted issues in the medical profession. They searched multiple databases with a broad search strategy for autism-specific material that would inform occupational therapy practice.

Background: Intensive interaction is an approach used to develop the communication and social inclusion of those who are pre‐verbal. It is used in a variety of settings by healthcare and educational staff. Method: A systematic search was conducted to identify and review the literature which explores staff experiences of intensive interaction being implemented within their places of work. Thematic synthesis was utilized to synthesize the findings. Results: Nine papers were included. Three higher‐order themes were generated: "Personal Doubt, Discordance & Discomfort," "A Turning Point" and "Needing Implementation at All Levels." Conclusions: There were consistent findings across a range of settings. Findings suggest that intensive interaction is rewarding for staff and beneficial to those that they work with. Implementation was sometimes perceived to be challenging and this review attempts to highlight solutions with guidance of the literature. Limitations largely relate to heterogeneity of the papers and methodological limitations are discussed. [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]

Background: Autistic children without intellectual disability will likely experience higher level language and communication difficulties. These may appear subtle, in that they are not immediately evident to those who do not know the child well and may not manifest in all environments. Because of this, the impact of such difficulties may be underestimated. This phenomenon has similarly attracted little research attention, meaning the extent to which subtle language and communication difficulties contribute to the needs of autistic individuals without intellectual disability may be underspecified in clinical services. Aims: To offer a detailed exploration of how relatively subtle language and communication difficulties impact on autistic children without intellectual disability and what strategies parents recognize can mediate those negative effects. Methods & Procedures: Twelve parents of autistic children from the target group (aged 8–14 years, attending mainstream school) were interviewed about how subtle language and communication difficulties impact their autistic child. Rich accounts were derived then analysed using thematic analysis. Eight of the children discussed had previously been interviewed independently in a parallel study. Comparisons are discussed in this paper. Outcomes & Results: Parents reported heterogeneous but pervasive higher level language and communication difficulties which universally impacted key areas of the children's function: peer relationships, developing independence and performance in education. Communication difficulties were also universally associated with negative emotional responses, social withdrawal and/or negative self‐perceptions. While parents identified a range of ad hoc strategies and naturally occurring opportunities that improved outcomes, there was little mention of the means to address primary language and communication difficulties. The current study showed a number of parallels with child accounts, demonstrating the benefits of collecting data from both sources in clinical and research investigations. However, parents were more concerned about longer term implications of language and communication difficulties and highlighted their impact on the child developing functional independence. Conclusions & Implications: Subtle language and communication difficulties, typically identified in this higher ability autistic group, can impact significantly on key areas of childhood function. Support strategies seem to be parent generated and inconsistently applied across individuals, without the benefit of coherent specialist services. Dedicated provision and resources targeting areas of functional need may be beneficial to the group. In addition, the commonly reported association between subtle language and communication difficulties and emotional well‐being indicates the need for greater exploration using empirical methods, and joined‐up clinical working between speech and language therapy and mental health services. What this paper adds: What is already known on the subject: There is now a wide understanding of how language and communication difficulties can impact the individual. However, where those difficulties are relatively subtle, for example, in children without intellectual disability and where difficulties are not immediately evident, less is known. Research has often speculated on how identified differences in higher level structural language and pragmatic difficulties might impact on the function of autistic children. However, to date dedicated exploration of this phenomenon is limited. The current author group explored first‐hand accounts of children. Corroborative evidence from parents of the same children would add further weight to understanding this phenomenon. What this paper adds to the existing knowledge: This study provides a detailed exploration of parents' perspective relating to the impact of language and communication difficulties on autistic children without intellectual disability. It provides corroborative detail that support child accounts of the same phenomenon, indicating the impact on peer relationships, school outcomes and emotional well‐being. Parents also report functional concerns around the child's ability to develop independence and this paper demonstrates how parents and children might deviate in their accounts, with parents reporting increased concerns around the longer term implications of early language and communication difficulties. What are the potential or actual clinical implications of this work?: Relatively subtle language and communication difficulties can have a significant impact on the lives of autistic children without intellectual disability. Greater service provision for this group is therefore indicated. Interventions could focus on areas of functional concern where language is implicated, for example, peer relationships, developing independence and school success. Additionally, the relationship between language and emotional well‐being points to further integration between speech and language therapy and mental health services. Differences found between parental and child reports highlight the need to collect data from both parties during clinical investigations. Parental strategies may offer benefits for the wider population. [ABSTRACT FROM AUTHOR]

Owing to the different models of disablement in different religions and cultures around the world, social and aesthetic representations of intellectually disabled people are diverse in various societies. Disability is perceived in a different way in India than in the West. There are very few studies on the complex role of Indian mainstream Hindi cinema in the representation of intellectual and developmental disabilities in India. This paper explores the potential of shifting representations of intellectual and developmental disability in the late twentieth and early twenty‐first century Bollywood films in the context of multiple aesthetic challenges they pose. The shift in screen image of intellectual impairment is strongly related to the shifting and ambiguous sociocultural model of personhood in India. In earlier Indian Hindi films, characters with intellectual disabilities were depicted in terms of good/bad moralistic labels, compromised body image, leading to aesthetic undesirability. In later Hindi films, they were instead represented as enduring human beings. In short, in earlier Hindi films, there was a discriminatory hegemonic bias in the depiction of intellectually disabled characters, in contrast to that in later Hindi films, where they were depicted in richly diverse perspectives. The changing artistic parlance becomes even more interesting in the context of major developments in Indian governmental policies and rights for the disabled in the last two decades. Thus, the paper highlights that contemporary Hindi films urge the audience to consider intellectual and developmental disability as a multilayered issue and rather than merely as a disease. Accessible summary: Our ideas about disability are linked with those of family, religion and tradition in a particular society.Cinema also reflects our perceptions and concepts of disability.This paper is about the how people with intellectual disabilities have been shown in Hindi cinema in the last 30 years, and how intellectual disability is understood in India.In Hindi cinema, intellectually disabled characters are represented in a way that is slightly different from those in Western literature and films.Research on representations of intellectual disability in cinema is important as it can stimulate healthy discussions on a more empathetic society with a better understanding of the various facts related to intellectual disability. [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]

Background: Early in development, caregivers' object labelling contributes to children's word learning. Language development is a bi‐directional process, and differences in joint engagement (JE) and language among children with developmental disabilities such as autism spectrum disorder (ASD) may provide caregivers varying contexts and opportunities to provide object labels. However, potential variation in caregivers' production of object labels and its relation to language development remain relatively unexplored among toddlers with ASD. Aims: This study characterized the structural and functional features of object labels produced by parents of children with typical (TL) or elevated likelihood (EL) of ASD during naturalistic toy play. We examined features of object labels within two JE contexts, supported and coordinated JE, which are differentiated by a child's use of eye contact, as well as their relations with concurrent and future child language skills. Methods & Procedures: The present study included 55 (TL = 12, EL = 43) children who completed a naturalistic parent–child interaction in the home at 18 months of age. Children's expressive and receptive language was assessed at 18, 24 and 36 months. At 36 months, EL children were assessed for ASD and classified as either EL‐No Diagnosis, EL‐Language Delay or EL‐ASD. Videos of interactions were divided into discrete engagement states, including supported and coordinated JE. All parent speech was transcribed and coded to capture structural (types, tokens, mean length of utterance (MLU), sentence position) and functional (follow‐in comments, directives, lead‐in labels) features of object labels as well as parent prompts for the child to produce a label. Outcomes & Results: Parents of toddlers across outcome groups labelled objects at similar rates within each engagement state. However, parents of EL‐ASD children provided the lowest rates of prompts for labels in supported JE and the highest rate of labels as the final word of an utterance (sentence‐final position) in coordinated JE. Additionally, parent prompts in supported JE were related to concurrent child expressive language. Labels in sentence‐final position were positively related to later language outcome when delivered in supported JE but were associated with poorer language outcomes when delivered in coordinated JE. Conclusions & Implications: Subtle differences in parent object labels across outcome groups demonstrate the role that child language and social engagement can play in influencing parent input and the cascading impact of this input on language development. WHAT THIS PAPER ADDS: What is already known on this subject: Variations in caregiver object labelling can impact child language development. However, child characteristics such as language ability also actively shape the input caregivers provide, demonstrating the bi‐directionality of language development. What this paper adds to existing knowledge: The present study demonstrates that characteristics of the engagement context in which a label is delivered may be important for understanding how object labelling relates to child language acquisition and whether this relation varies for children who face challenges in language learning. What are the potential or actual clinical implications of this work?: As child differences in social engagement emerge, parents may be more attuned to moments their children are engaging with eye contact. Caregiver‐mediated interventions might consider strategies that guide caregivers in recognizing engagement without eye contact as a similarly meaningful opportunity for learning and encourage the use of rich input within these moments. [ABSTRACT FROM AUTHOR]

The concept of neurodiversity has fuelled a social justice movement advocating for the rights of those whose lives diverge from a socially‐constructed default. However, deficit understandings of disability persist in educational settings and neurodivergent people continue to face disadvantage and discrimination in organisations constructed on normative understandings of the world. Although New Literacy Studies is concerned with ideas of power, dominance and worth, there is a notable lack of work that connects NLS with issues of neurodiversity. In this paper, I introduce the term 'neurodivergent literacies' to propose a field of study that links the ideological model of literacy with the neurodiversity paradigm. From this starting point, I outline a project that examined literacies around what are often referred to as the 'special interests' of autistic people. Presenting data from interviews with 13 neurodivergent adults, related to school experiences and the literacies they engage with around their self‐defined 'ruling passions', I make recommendations for literacies practitioners, arguing that schools need to do more to take account of difference and disability. By describing how 'neurodivergent literacies' can help teachers harness their own critical literacy skills to challenge deficit models of difference in the classroom, this paper illuminates how an understanding of neurodiversity is essential for anyone teaching and researching literacies with a commitment to social justice. [ABSTRACT FROM AUTHOR]

Anxiety is now recognized as one of the most common co‐occurring conditions in youth diagnosed with autism spectrum disorder (ASD). Despite the prevalence of this comorbid condition, accurate assessment and diagnosis of anxiety in ASD has proven difficult. This paper will address the considerable research literature on assessing anxiety in youth with ASD, including difficulties related to assessment and differential diagnosis. In addition, this paper will describe relevant tools and methods for assessing anxiety in this complex population. Highlights: Due to the communication and cognitive impairments that make it challenging to identify and diagnose anxiety in youth with autism spectrum disorder (ASD), when trying to tease apart whether a symptom is better explained by autism or anxiety, psychologists should ask questions about the behavioral markers of anxiety that may accompany the given symptom and attempt to directly observe these behaviors.Although some questionnaires that were designed to assess anxiety in neurotypical youth may be appropriate for screening anxiety in some youth with ASD, it may be more accurate to use questionnaires and interviews that were designed and validated specifically for youth with ASD, such as the Anxiety Scale for Children—ASD (ASC‐ASD), the Parent‐rated Anxiety Scale for ASD (PRAS‐ASD), or the Autism Spectrum Addendum to the Anxiety Disorders Interview Schedule (ADIS/ASA).Given that it may be challenging for children with ASD to verbally report their symptoms of anxiety and/or for parents or teachers to recognize the symptoms of anxiety in ASD, direct observation often provides more detailed and accurate information about the behaviors children exhibit when they are anxious, the situations that elicit anxiety, and the consequences that maintain anxiety in youth with ASD.In light of the challenges associated with assessing anxiety in youth with ASD, we recommend a multi‐informant and multi‐method approach for assessing anxiety in youth with ASD using a combination of direct observation, interviews, and questionnaires (self‐report, parent‐report, and teacher‐report questionnaires) to most reliably and accurately identify anxiety in this complex populationIt is important to differentiate between anxiety and other emotional states in youth with ASD, particularly in those with minimal verbal ability, so that parents, teachers, and clinicians do not misattribute anxiety to anger, frustration, sadness, boredom, or excitement, or vice‐versa. [ABSTRACT FROM AUTHOR]

Introduction: Echolalia, the repetition of others' speech, is a common observation in autistic people. Research has established that echolalia is functional and meaningful for many; however, some clinicians and researchers continue to characterise it as pathological and in need of reduction. The aim of this systematic review was to understand the range and impact of interventions for echolalia in autistic children. Method: A systematic search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A total of 15 studies met predetermined inclusion criteria. Screening, data extraction and quality rating using the Scientific Merit Rating Scale (SMRS) were performed in duplicate. Results: Ten interventions across 15 papers were found. Results indicated that interventions generally decreased levels of echolalia. However, there were considerable inconsistencies in the definitions and conceptualisations of echolalia, administration, generalisation techniques and the measures used. The quality of the studies was very low. Conclusion: Interventions for echolalia vary widely in terms of administration and measurement. There is limited consensus on the definition of echolalia among the reviewed studies, and no evidence that echolalia is recognised as functional or meaningful to the autistic children. Further, the lack of methodological rigour makes it difficult to draw clinical conclusions about the interventions. WHAT THIS PAPER ADDS: What is already known: Echolalia is the immediate or delayed repetition of others' speech and is a common observation in autistic children and in some older autistic people. While research and practice has established that echolalia is a functional and meaningful form of communication, particularly for those first developing spoken communication, some clinicians and researchers continue to characterise it as problematic and suggest that echolalia should be reduced or eliminated. What this study adds: We systematically searched the literature about echolalia interventions to try to find out about the types of interventions that aim to reduce or eliminate echolalia. We found 15 studies on this topic. The way they defined echolalia was varied, and there was a range of interventions researched. None of the research papers recognised echolalia as functional or meaningful and the quality of the research was very low. What are the potential or actual clinical implications of this work?: Clinicians, families and researchers should think carefully and critically about suggesting any programs or supports that aim to reduce echolalia as no recommendations can be drawn from the research we studied. Echolalia should be considered functional, and efforts made to understand the meaning and purpose of echolalic speech. [ABSTRACT FROM AUTHOR]

Background: Childhood Social Anxiety Disorder (SAD) is common and impairing. The recommended treatment is a disorder specific form of cognitive behavioural therapy (CBT) that includes social skills training and, whilst they appear to be more effective than more general treatments, it is not clear whether social skills training is the critical component involved in improved outcomes, particularly given that evidence for the relationship between social anxiety and social skills deficits in children is inconsistent. This may be partly due to an overlap in their observable features, and because the nature of the association may vary in different contexts (e.g. according to child age). An alternative approach is to examine the association between social anxiety and the social cognitive capacities that underpin social skills. This paper aims to examine the association between social anxiety and social cognition in children and adolescents, and examine conceptual and methodological moderators of this relationship. Methods: Papers published between 1980 and 2019 were screened systematically. Fifty studies were identified from which an effect size could be calculated for the relationship between social anxiety and social cognition, including 15,411 children and adolescents. Results: An overall significant, but moderate effect (r = −.15) was identified, where increased social anxiety was associated with lower social cognitive ability. Moderation analyses revealed specific associations within studies examining social anxiety among participants with and without ASD who were older than 7 years old, and studies assessing the relationship between social anxiety and specific aspects of Theory of Mind (ToM). No significant association was identified between social anxiety and emotion recognition. Conclusions: Significant associations between social anxiety and social cognitive abilities appear to be accounted for by elevated social anxiety among children with ASD, and those with difficulties in specific aspects of ToM but not broader social skills, such as emotion recognition. This reinforces the importance of accurately identifying and treating social anxiety within ASD populations. In addition, treatments for social anxiety among neurotypical populations may benefit from targeting particular aspects of ToM rather than emotion recognition and other broad social skills. [ABSTRACT FROM AUTHOR]

Background: Bridging the research–practice gap in autism communication services is an identified priority for improving services. Limited research has investigated the views of practitioners regarding this research–practice gap. Investigation of the barriers experienced and facilitators used in clinical practice may assist to identify scalable and sustainable strategies to increase use of evidence‐based practices (EBPs) in the delivery of communication services to children with autism. Aims: To elucidate how Australian speech pathologists engage with external evidence and how communication outcomes are measured to demonstrate the effectiveness of service provision to children with autism. Methods & Procedures: A total of 15 Australian speech pathologists, with experience ranging from less than 1 to more than 16 years, participated in three focus groups. Data from focus groups were analysed using reflexive thematic analysis within an interpretive phenomenological paradigm. Outcomes & Results: Seven themes were identified. Participants reported on the diversity of individuals with autism, their experiences of resource constraints, seeking collegial advice and accessing a diverse range of evidence sources, the role of clinical expertise in translating evidence to practice, the barriers experienced in outcome measurement and use of stakeholders to facilitate data collection to demonstrate outcomes. Conclusions & Implications: Individual practitioner skill and beliefs are facilitators to translating research to practice. Interventions to improve clinician use of EBP should address the skill and belief barriers, aiming to increase a clinician's EBP self‐efficacy and increasing their expectation that investing in EBP activities will result in improved services for children with autism. Modelling and reflective practice are two strategies that may have an application as interventions to improve EBP use in clinical practice. What this paper adds: What is already known on the subject: Constrained resources, especially lack of time, is a barrier to routine uptake of best available evidence in clinical services for children with autism. What this paper adds to existing knowledge: In this study, the perception that speech pathologists lacked time to engage in EBP activities was linked with the speech pathologist's research skill and their beliefs about the benefits of engaging in EBP. Speech Pathologists reported using a range of information sources, as "evidence" but also reported feeling uneasy when using evidence of disputable, or unknown quality. Accessibility and relevance to their individual client were highly prioritised in selecting evidence. Clinical expertise was an essential skill for research translation. What are the potential or actual clinical implications of this work?: Interventions which target professional beliefs and research translation capability are requisite for motivating speech pathologists to improve their use of EBP.Modelling of EBP use, individual reflective practice and collegial active listening to facilitate reflective practice, might be useful strategies which target beliefs and capability of individual speech pathologists; thereby changing their EBP use. [ABSTRACT FROM AUTHOR]

Objective: We are pleased to introduce this special issue about Autism and Feeding and Eating Disorders, representing reflections on this complex comorbidity. Method: Contributions focussed on several main themes: (1) the definition and assessment of autism and eating disorder (ED) comorbidity; (2) the brain imaging findings of similarities and differences between autism and EDs; (3) sensory systems and interoception; (4) comorbidity across the age spectrum and (5) improving treatment outcomes in ED and autism comorbidity. Results: The papers in this issue highlight the importance of research, screening and practical adaptations in the field of ED and autism comorbidity. Autism is a neurodevelopmental condition with several strengths and weaknesses. When patients present with this comorbidity, it is important that their ED is treated which requires careful adaptation and tailoring for people with autism. Discussion: This special issue is an attempt to facilitate further research and stimulate collaborations between all of the stakeholders, particularly clinicians who have expertise in autism and clinicians working in the field of ED. We have included diverse themes from international researchers conducting qualitative and quantitative studies, providing research evidence to inform treatment modifications for this complex comorbidity. [ABSTRACT FROM AUTHOR]

Background: Definitions of recovery from an eating disorder (ED) have generally been formulated around clinical conceptualisations, rather than based on the views of patients. This paper therefore asked those with lived experience of ED for their own definitions of recovery. Method: Data were collected as part of an online study looking at EDs, autism and relationships. About 173 participants identified as recovered from ED and gave free‐response definitions of recovery. Responses were subject to thematic analysis. Results: Seven major themes were identified: Weight restoration, lack of ED behaviours, thoughts and behaviours, cognitions, emotional responses, getting on with life, and ongoing challenges. Conclusions: Many definitions of recovery given by those who have lived experience of ED echoed those used by clinicians and researchers. There were also points of divergence around the ongoing challenges of recovery. Our findings highlight the need for continuing support post‐weight restoration to facilitate the successful long‐term recovery for those with ED. Key points: Definitions of recovery from ED have traditionally relied on clinical, rather than patient, priorities.Both autistic and non‐autistic people with a history of ED reported similar definitions of recovery, including weight restoration, lack of ED behaviours and cognitions, improved emotional responses around food and weight, the ability to get on with life, and the fact that they had ongoing challenges.The paper highlights that patients often think about recovery in ways which map on to clinical definitions, with some additional factors which could be utilised to support patients in this phase of illness. [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]

This paper considers recent evidence on autism education in Greece in order to shed light on current developments and attitudes. Given the increase in relevant research in the country, a scoping review to identify topics that have been explored so far and propose areas for future research and implications for practice is timely and necessary. Peer‐reviewed papers published between 2000 and 2019 were identified via electronic databases and their main themes were analysed. Themes related to autistic individual (i.e. the voice of autistic individuals and intervention studies), the family around them (i.e. the role of family and stigma), the role of teachers (i.e. teacher training and teacher stress levels) and the wider society (i.e. parent‐teacher collaboration, the medical/deficit model of disability and inclusion) emerged from the review. The above themes are discussed in the light of the cultural characteristics of Greece and the recent economic crisis the country underwent as well as similar findings from other European countries. [ABSTRACT FROM AUTHOR]

This paper presents the concerns of a client diagnosed with autism spectrum disorder about completing outcome measures. He was asked to complete CORE‐10 each time he attended a therapy session with the first author. This paper takes an epistemological position of co‐production, and written in response to the client's concerns, but this is limited by the client's wish and capacity to be involved in the writing up of this article. Implications of his experiences are drawn out for both clients with this diagnosis and more generally for all clients. Recommendations are made to recognise the limitations of measures and how to use outcome measures with more validity. [ABSTRACT FROM AUTHOR]

Introduction: Daily living skills (DLS) are essential for an increased quality of life and autonomous living. DLS are a focus of occupational therapy practice; however, there has been no identified review of DLS acquisition in autistic adolescents or adults. A scoping review was undertaken of which the objective was to evaluate and synthesise the extent, range, and nature of research activity, and to identify research gaps in the existing literature as they relate to DLS acquisition and autistic adolescents and adults. Methods: A structured search of the literature was conducted. Studies published in English between 2011 and 2021 that included a focus on the acquisition of DLS in autistic adolescents and young adults were included. The titles and abstracts of 103 records were screened, and the full text of 53 records was reviewed. These reference lists were hand searched. Following this process, 25 papers were found to meet the inclusion criteria. Results: Findings indicate inconsistencies throughout the literature, with a lack of consensus on best practice methods, mediums, and/or tools to support optimal outcomes in terms of DLS acquisition for the autistic population. Themes related to (1) Generalisation of Skills Across Contexts, (2) Skill Maintenance, (3) Technology as a Teaching Method, (4) Participant and Family Perspectives, and (5) The Balance of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) focus in research were extracted from the reviewed literature. There is a strong consensus in the findings of the identified papers that autistic adolescents and young adults experience poorer outcomes in terms of DLS acquisition than non‐autistic peers, and peers with other developmental or intellectual disabilities. Conclusion: Future research is needed to fill these identified gaps and provide a clearer understanding on interventions to support optimal outcomes for autistic individuals. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is a neurodevelopmental disability affecting 1 in 44 children nationally. Timely referral to intervention and support services for ASD has consistently demonstrated significant long‐term positive effects on symptoms and subsequent skills and family outcomes. This paper highlights a novel and innovative approach of short‐term consultations for best practices to ultimately increase access to timely ASD evaluations and support through a state‐wide school telehealth initiative. The goal of the initiative was to facilitate rapid access to ASD evaluation and support (within 2 weeks of referral in school‐age youth) among under‐resourced school systems in Central Texas. First, this paper provides background relative to current disparities that many children face when attempting to obtain ASD evaluations and support. Second, a statewide legislative response is described that created a mental health consortium targeting increased access to broad‐based mental health services and supports, particularly in underserved areas. Next, the Texas Child Health Access Through Telemedicine (TCHATT) program is outlined with a particular focus on day‐to‐day operationality and concentrated efforts to increase mental health literacy among school teams relative to ASD symptoms and co‐occurring behavioral health concerns. Year 1 utilization data metrics (September 2020–May 2021) and representative case examples are presented. Finally, early "lessons learned" and future directions are discussed. Highlights: In 2020, the Texas Child Health Access Through Telemedicine (TCHATT) program was implemented state‐wide as a partnership between local school districts, community mental health agencies, and developmental specialists at the 12 academic medical centers across Texas to increase access to services for youth with behavioral or developmental referral concerns.The model aims to provides timely access (within 1 week) to a telehealth visit with a developmental specialist for short‐term evaluation and support as well as pairing families with a system navigator to facilitate referral follow‐through to community resources.The TCHATT model offers school districts a potentially viable option for increasing access to timely autism evaluation and supports via telehealth. [ABSTRACT FROM AUTHOR]

Aim: Careful study and accurate description of behaviour are important to understand developmental challenges for individuals with Cornelia de Lange syndrome (CdLS). Here we present a systematic review of current understanding of behaviour in CdLS.Method: A systematic search was performed for articles published between January 1946 and December 2015 evaluating autism, self-injury, and/or cognition in CdLS. After study-selection, 43 papers were included. The Cochrane quality criteria were adjusted to assign quality scores to the included studies.Results: Participants were mostly categorized in the severe/profound developmental level. Methodology and quality were very heterogeneous, as well as reporting occurrence of autism. Self-injurious behaviour was reported in 15 papers. Physical conditions were reported in 21 studies, mostly related to hearing and vision. Only nine studies mentioned details about medication.Interpretation: Comparison of presented results was hindered by heterogeneous assessment methods. Improving our understanding of behavioural characteristics in CdLS requires more uniform methodology. We propose a criterion standard of instruments that can ideally be used in assessment of behaviour and development. This will improve understanding of behaviour in the context of developmental level and daily functioning. [ABSTRACT FROM AUTHOR]

Aim: To describe the development and initial psychometric evaluation of a new, freely available measure, the Autism Symptom Dimensions Questionnaire (ASDQ). Method: After development and revision of an initial 33‐item version, informants completed a revised 39‐item version of the ASDQ on 1467 children and adolescents (aged 2–17 years), including 104 with autism spectrum disorder (ASD). Results: The initial 33‐item version of the ASDQ had good reliability and construct validity. However, only four specific symptom factors were identified, potentially due to an insufficient number of items. Factor analyses of the expanded instrument identified a general ASD factor and nine specific symptom factors with good measurement invariance across demographic groups. Scales showed good‐to‐excellent overall and conditional reliability. Exploratory analyses of predictive validity for ASD versus neurotypical and other developmental disability diagnoses indicated good accuracy for population and at‐risk contexts. Interpretation: The ASDQ is a free and psychometrically sound informant report instrument with good reliability of measurement across a continuous range of scores and preliminary evidence of predictive validity. The measure may be a useful alternative to existing autism symptom measures but further studies with comparison of clinical diagnoses using criterion‐standard instruments are needed. What this paper adds: The Autism Symptom Dimensions Questionnaire (ASDQ) is a new, freely available measure of autism symptoms.The ASDQ showed reliable and accurate measurement of autism symptoms.The measure had good screening efficiency for autism spectrum disorder relative to other developmental conditions. [ABSTRACT FROM AUTHOR]

Background: Evidence demonstrating efficacy of dietary interventions for autism spectrum disorder (ASD) remains inconsistent. Recent research on the ketogenic diet (KD) for the treatment of ASD has suggested a benefit. Children with ASD often demonstrate ritualised food‐specific behaviours, taste and texture aversions, and an increased prevalence of food restrictions and allergies. There is a need to investigate how these features contribute to initiation and adherence of the KD. Two surveys were administered to assess the feasibility of utilising the KD for ASD. Methods: First, paper surveys were given to caregivers of children presenting to outpatient neurology clinics. Next, experienced clinicians were recruited and surveyed online using Qualtrics. Chi‐squared analysis was used to compare ASD and non‐ASD caregiver responses. Descriptive metrics were used to present clinician responses. Responses to each question were evaluated individually. Results: One hundred and fourteen surveys were collected from caregivers. There were no significant differences in (1) stated feasibility of adopting a new diet, (2) a carbohydrate restricted diet, (3) diet restrictions, (4) documented allergies or (5) personal/cultural restrictions between groups with and without ASD. Seventy clinician responses were collected. The majority (67.4%) indicated that feasibility for a child with ASD to adopt a KD for any reason depends on ASD severity. Some respondents 73% rated adherence to the KD as more difficult compared to age‐matched controls, whereas 26% considered it similar. Multiple familial and child characteristics were rated as increasing the difficulty of successful KD. Conclusions: The results of the present study suggest that it is feasible for children with ASD to adopt a KD, and success is highly individualised to child and family. Key points: Key points assessing the feasibility of using the ketogenic diet in autism spectrum disorderRates of reported feasibility of adopting either a new diet, or a carbohydrate restricted diet, were similar between caregivers of children with autism spectrum disorder (ASD) and without ASD. A majority of caregivers of children with ASD indicated they either would be willing to try, or that it would be feasible, to adopt a carbohydrate restricted diet.Most experienced clinicians indicated the feasibility of adopting a carbohydrate restricted diet depended on ASD severity. Multiple factors were rated by experienced clinicians as contributing to increased difficulty for a child with ASD to successfully adopt a Ketogenic.The results suggest that it is feasible for children with ASD to adopt a ketogenic diet, and success is highly individualised to child and family. [ABSTRACT FROM AUTHOR]

Researchers have observed that preference for edible items may displace preference for leisure items when items from the stimulus classes are assessed together within multiple stimulus without replacement (MSWO) preference assessments. The current study extends previous research by examining patterns of preference and displacement when assessing preference for high‐tech and low‐tech leisure items. We conducted three separate MSWO preference assessments; one assessing low‐tech items, another assessing high‐tech items, and a combined assessment (using the top four high‐ and low‐tech items from the previous assessments) to test for displacement. Preference for high‐tech items fully or partially displaced preference for low‐tech items in five of eight participants. We then conducted concurrent and single operant reinforcer assessments using the highly preferred high‐tech and low‐tech items. Reinforcer assessment results demonstrated similar levels of responding for the highest preferred high‐tech and low‐tech items, indicating that combining high‐ and low‐tech items within preference assessments may influence the validity of results. [ABSTRACT FROM AUTHOR]

Equivalence‐based instruction (EBI) is an efficient and efficacious methodology to establish equivalence classes that has been used to teach various academic skills to neurotypical adults. Although previous reviews confirmed the utility of EBI with participants with developmental disabilities, it is unclear whether certain procedural parameters are associated with positive equivalence outcomes. We extended previous reviews by categorizing studies that used EBI with individuals diagnosed with autism spectrum disorder and assessed whether any procedural parameters were associated with better equivalence responding. Due to the wide variability of procedural parameters in EBI research, the best procedural permutations to form equivalence classes with individuals diagnosed with autism spectrum disorder are still unknown. Thus, this paper serves as a call to action for applied researchers. Specifically, we encourage and invite researchers to systematically investigate the necessary variables or combination of variables that may lead to successful equivalence class formation. [ABSTRACT FROM AUTHOR]

This paper reports on the findings of a BERA‐funded small‐scale project that explores the impacts of COVID‐19 lockdowns on the educational experiences of autistic children and young people who attend mainstream schools and their parents/carers in England. We observe that, unsurprisingly, lockdown resulted in associated stresses for families. However, our main argument is that for the participants, the pandemic has not been experienced to the same extent as is popularly understood; that is, causing major disruption to children's schooling experiences and/or unusual levels of social isolation. Using the concept of stigma as a theoretical resource, we argue that this is because the families with whom we spoke were already experiencing, pre‐COVID‐19, disrupted schooling and degrees of social isolation. Indeed, for many of the young people, the break from school occasioned by lockdown allowed them a release from the more negative and stigmatising aspects of their routine experiences within school. We therefore argue that the disruption of the pandemic sheds light on how stigma shapes students' daily school experiences. [ABSTRACT FROM AUTHOR]

Most individuals show a small bias towards visual stimuli presented in their left visual field (LVF) that reflects right‐hemispheric specialization of visuospatial functions. Moreover, this bias is altered by some neurodevelopmental disorders, suggesting they may be linked to changes in hemispheric asymmetry. To examine whether autism potentially alters hemispheric asymmetry, we conducted a systematic search of scientific databases to review existing literature on the link between autism and alterations in visuospatial bias. This search identified 13 publications that had explored this issue using a wide range of experimental designs and stimuli. Evidence of reduced LVF bias associated with autism was most consistent for studies examining attentional bias or preference measured using tasks such as line bisection. Findings for studies examining attentional performance (e.g., reaction time) were more equivocal. Further investigation is called for, and we make several recommendations for how this avenue of research can be extended. Lay Summary: Most people show a very small bias or preference for objects or information presented in the left side of their visual field compared to the right side. However, several studies have reported that autism is associated with an absence of visual field biases. In this paper, we review the studies that have examined this issue and find tentative evidence for a reduction in left visual field bias, which suggests that the brain may be less asymmetrically organized in autistic individuals. [ABSTRACT FROM AUTHOR]

Background: Evidence shows that the relation with the referent (object manipulation, contact/no contact pointing) and the different hand features (index finger/open palm) when pointing indicate different levels of cognitive and linguistic attainment in typical development (TD). This evidences the close link between pointing, cognition and language in TD, but this relation is understudied in autism. Moreover, the longitudinal pathway these abilities follow remains unexplored and it is unclear what specific role (predictor or mediator) pointing and cognition have in both typical and atypical language development. Aims: The first aim was to investigate whether pointing hand features (index finger/open palm) and relation with the referent (manipulation, contact and no contact pointing) similarly predict language in children with and without autism. The second aim was to explore whether cognition mediates the longitudinal relationship between pointing and language development. Methods & Procedures: Sixteen children with autism, 13 children at high risk (HR) for autism and 18 TD children participated in an interactive gesture‐elicitation task and were tested on standardised cognitive and expressive language batteries in a longitudinal design. A two‐step analysis consisted of a stepwise linear regression and mediation analyses. First, the linear regression identified which hand features and types of relation with the referent predicted expressive language in all groups. Second, three mediation analyses (one per group) assessed the predictor/mediator role of the variables that met significance in the regression analysis. Outcomes & Results: Both cognition and index finger pointing were direct longitudinal predictors of further expressive language skills in the autism group. In TD and HR groups this relation was mediated by age. Conclusions & Implications: Findings highlight the role of age in communicative development, but suggest a key role of cognition and index finger use in the longitudinal relationship between pointing gestures and expressive language development in children with autism. This has important clinical implications and supports the view that index finger pointing production might be a useful tool in the intervention for communicative and language abilities in autism. What this paper adds: What is already known on the subject: There is evidence that no contact pointing is associated with complex socio‐cognitive abilities that underpin communication in TD. Similarly, studies in TD show that index finger pointing is closely linked with language acquisition. However, it is unclear whether these associations are present in autism. In addition, the mediating (or predictive) role of cognition in the pointing–language relation has not yet been explored neither in typical nor in atypical development. What this paper adds to existing knowledge: This paper shows that index finger pointing and cognition are direct longitudinal predictors of expressive language in the autism group. In the other groups this relation is mediated by age. This suggests that there is a window of opportunity for pointing to predict expressive language whereas the predictive value of cognition expands in development. Based on this, children with autism would share the same language predictors as TD children, but with delays. What are the potential or actual clinical implications of this work?: This study reveals that index finger, age and cognition reliably predict spoken language in autism, which may indicate that early prelinguistic intervention based on pointing production and the improvement of cognitive skills might have a positive impact on spoken language in this population. [ABSTRACT FROM AUTHOR]

This paper addresses the hypothesis that autism spectrum disorder features follow multiple long‐term developmental trajectories, including an absence of symptoms that were present in childhood, by the time of adolescence. In early work on this topic, this circumstance was called an 'optimal outcome'. To better reflect the reality of multiple excellent outcomes regardless of whether autism spectrum disorder features are present or absent, including autonomy, daily living skills, communication skills, and relationships and employment/activities outside the home, the terminology 'loss of autism diagnosis' (LAD) has been proposed as a substitute. The paper also contextualizes an LAD outcome within research, practice and advocacy. [ABSTRACT FROM AUTHOR]

Background: Documented inequalities in access to eye care for people with learning disabilities and/or autism are caused by poor uptake of primary eye care services, poor identification of eye problems, lack of signposting and reasonable adjustments of existing services, concerns about costs of care and the low priority historically given to these issues in eye care policy at a regional and national level. In 2019, the charity SeeAbility employed four eye care champions (ECCs) with lived experience of learning disability and/or autism to work in local communities in London and the Northwest of England. They provided peer‐to‐peer support on understanding the need for good eye health and engaged with policy makers, and learning disability, autism and eye care professionals at the local, regional and national levels to influence both the clinical practice of individual practitioners (within existing service/pathway models) and more widely to influence the commissioning of the Easy Eye Care pathway. This study explores the experiences of these ECCs. Methods: The study was conducted in April and May 2023. A case study approach was used to describe the experiences of the ECCs from March 2019 to March 2023. Data from structured interviews with the four ECCs and workload analysis were triangulated to provide a multifaceted understanding of this novel health promotion project. Findings: The ECCs found the role useful and reported that confidence in their practice and impact grew with time but they required ongoing support in the role. A good understanding of the promotional messages was reported. Developing a good network of contacts at an early stage, both people with learning disabilities and healthcare professionals, was key. Relationships with professionals were supportive and positive and a positive emotive response to their lived experience was reported in these interactions. Conclusions: From the perspective of the ECCs, the role is useful and beneficial. The work suggests some key recommendations for future development which include planning to build networks, support in presentation and communications skills and defining key messages and knowledge. Confidence of the ECCs builds with time in the role but also needs support the emotive impact of their lived experiences on audiences is highlighted. There is a need to evaluate how the programme is perceived by those who interact with it and how it changes behaviours which leads to better health outcomes. Accessible Summaries: People with learning disabilities are 10 times more likely than other people to have a problem with their eyes but less likely to get the eye care they need.This paper explains how people with a learning disability and/or autism are employed to tell other people with learning disabilities and/or autism, their supporters, health and care professionals and people who plan services about how important it is to get regular eye care. This job is an 'Eye Care Champion'.We share what the eye care champions did in their role, what worked well and what did not.We discuss how what we have learnt can help other people with learning disabilities and/or autism work as eye care champions and perhaps as champions for other areas of healthcare. [ABSTRACT FROM AUTHOR]

Neuro‐typically developing children demonstrate accurate, discriminated responding to a variety of questions in the presence of nonverbal stimuli. For children diagnosed with autism, however, such question discrimination skills can be significantly impaired. An error frequently observed in clinical practice is that of the child who, despite previous mastery of the relevant color tacts, says "Ball" when presented with a blue ball and the question "What color?" This paper explores the role of multiple verbal and nonverbal control in early intraverbal‐tacting as a basis for clinical intervention. The paper first presents a theoretical analysis based on multiply‐controlled verbal behavior (Skinner, 1957). Second, it provides clinical recommendations derived from recent research for establishing generalized intraverbal‐tacting in children diagnosed with autism. [ABSTRACT FROM AUTHOR]

Background: There is growing understanding of the potential benefits of a multi‐method approach to accurately capture language skills of children on the autism spectrum. Tools such as Language ENvironment Analysis (LENA) provide an efficient means of capturing and analysing early child vocalizations (CVs) and the language learning environment. While developed to capture whole‐day recordings of child language in naturalistic settings, there is potential utility in capturing, but little knowledge about, primary LENA metrics—including CVs and conversational turns (CTs)—and novel metrics, such as vocalization ratios (VRs), sampled in clinical practice settings where children are often seen. Moreover, recent research indicates that the novel VR may offer a broad indicator of children's developmental level, beyond just their language abilities, a hypothesis yet to be investigated in a large sample of children for whom the LENA was designed (i.e., pre‐schoolers). Aims: To explore the extent to which primary and novel LENA metrics collected during brief one‐to‐one clinical interaction was a useful indicator of developmental outcomes for children on the autism spectrum. Methods & Procedures: Participants were recruited as part of an on‐going research programme evaluating early intervention outcomes (n = 99; age 14–47 months). Language samples were collected at intake (T1) using the wearable LENA Digital Language Processors during a one‐to‐one, play‐based assessment with a clinician. Direct (Mullen Scales of Early Learning—MSEL) and parent‐report (Vineland Adaptive Behavior Scales—VABS) measures of verbal and non‐verbal skills were also collected at intake (T1) and again at exit (T2), approximately 12 months later. Outcomes & Results: Few correlations were observed between child measures and CVs, a primary LENA metric. The novel VR metric was associated with concurrent direct assessment (MSEL) (and to a lesser extent parent report; VABS) measures of verbal and non‐verbal skills, with moderate positive correlations found between VRs and all directly assessed subscale scores. However, VRs did not uniquely contribute to the prediction of child outcomes when baseline skills were also considered. Conclusions & Implications: The novel VR may provide an insight into autistic children's overall development in addition to their language ability, suggesting that even when collected in a short recording format, LENA might be a useful component of a multi‐method assessment approach. What this paper adds: What is already known on the subject: To accurately capture language skills of children on the autism spectrum, multi‐method approaches, including natural language sampling, are recommended. Tools such as LENA provide an efficient means of capturing and analysing naturalistic child language and the language learning environment. What this paper adds to existing knowledge: This study demonstrates the potential benefits, and limitations, of using LENA to augment assessment of young children on the autism spectrum. Specifically, LENA provides a complementary, and low burden, method for capturing child language samples. What are the potential or actual clinical implications of this work?: Novel metrics, such as the VR, collected during brief clinical interactions might be a useful component of a multi‐method assessment approach for children on the autism spectrum. [ABSTRACT FROM AUTHOR]