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Purpose: Language and autism research each typically excludes racially and ethnically minoritized (REM) autistic individuals. In addition, in the case of autistic individuals with language impairment, investigators often approach caregivers to discuss research participation, rather than autistic individuals themselves. This gap limits the ecological validity of language research in autism. To address this gap, this clinical focus article describes strategies for engaging REM autistic young adults with language impairment using lessons learned from 5 years of longitudinal research with this population. This approach involved an ongoing community partnership, as well as participatory partnerships with REM autistic individuals and community stakeholders, consistent with a “slow science” approach. Conclusions: The approach yielded excellent retention of participants over 5 years and led to co-development of research projects aimed at priorities described by REM autistic individuals and their families, including understanding self-determination, social determinants of health, and language variability in autistic REM individuals with language impairment. Findings support the utility of community-based methods with autistic REM young adults with language impairment, with key takeaways for diversifying research while replicating, extending, and building theory.

Purpose: Open science that is truly accessible and transparent to all will enhance reproducibility. However, there are ethical and practical concerns in implementing open science practices, especially when working with populations who are systematically excluded from and marginalized in communication sciences and disorders (CSD) research, such as Black, Indigenous, and People of Color (BIPOC) from clinical populations. The purpose of this article was to discuss these concerns and present actionable steps to support open science in CSD research with BIPOC. Conclusions: In the movement toward open and reproducible science, the discipline of CSD must prioritize accessibility and transparency, in addition to the implementation of individual scientific practices. Such a focus requires building trust with BIPOC not only as research participants but also as valued leaders of the scientific community.

Little is known about the internal mental experiences of individuals with ASD. While some research suggests a limited capacity for imagination, other studies show heightened interest in fantasy and unique forms of creative thinking in ASD. This study explored daydreaming experiences in adults with ASD, with a focus on immersive daydreaming and its relation to divergent thinking abilities. Individuals with and without a diagnosis of ASD were surveyed on their daydreaming habits and completed a divergent thinking task. Experiences of immersive daydreaming were identified in 42% of adults with ASD and were related to broad ASD traits in those without a diagnosis of ASD. However, ASD diagnosis was unrelated to originality of divergent thinking, which was negatively associated with immersive daydreaming. Moreover, daydreaming experiences in ASD were diverse. A more nuanced understanding of the mental experiences in ASD may assist in the development of interventions and support for this population.

Previous research has demonstrated that speakers adapt individual characteristics of speech production to the social context, for example via phonetic convergence. Studies have measured the impact of social dynamics on convergence in typical speakers, but the impact of individual differences is less well-explored. The present study measures phonetic convergence before and after a cooperative interaction with an undergraduate student by comparing teens with a history of autism spectrum disorder (ASD) and with typical development. Results revealed a small temporal convergence effect for typically developing dyads; in contrast, dyads including autistic teens showed no convergence. Furthermore, the degree of convergence was negatively related to severity of ASD symptomatology and atypical sensory profiles. While social and sensory processing abilities may play a role in phonetic convergence, high covariance between these measures makes it difficult to differentiate their contributions in isolation.

This study evaluates an online ADOS-2 Module 4 administration. Adolescents and adults with (n = 24; 7 females) and without (n = 13; 5 females) a history of autism spectrum disorder (ASD) completed the ADOS-2 Module 4 via videoconference. Parents or caregivers completed the Parent/Caregiver Form of the Vineland Adaptive Behavior Scales and the Achenbach Adult Behavior Checklist. The ADOS-2 was reviewed and scored by five trained clinicians and supervised by a senior clinician with established research reliability. The autistic group's scores differed on ADOS total (Calibrated Severity Score, WPS instrument) and domain scores, KSADS domain scores, and Achenbach T-scores. Inter-rater reliability was "moderate" (κ = 0.732), and percentage item-wise agreement was r = 0.69. The online ADOS-2 showed significant convergence with parent-reported assessments of ASD-relevant symptoms and characteristics, suggesting it was a valid assessment. While any online assessments must be used with caution, results suggest that the approach described here could have sufficient validity and reliability to fill the urgent need to assess and evaluate ASD symptomatology, as one component of a thorough clinical evaluation of ASD-related behaviors. LAY SUMMARY: In this exploratory study, we asked whether it was possible to give the ADOS-2 to adolescents and adults in a completely online way. Results showed that expert clinicians agreed on 69% of ADOS-2 items; also, participants with autism had higher scores on all parts of the ADOS-2. The online ADOS-2 scores had strong and significant relationships with parents' reports of friendship and social skills. While we need more research that tests this method, this way of doing the ADOS-2 online may be useful for clinicians and researchers who have an urgent need to evaluate autism during the pandemic.

Purpose: Language and autism research each typically exclude racially and ethnically minoritized (REM) autistic individuals. In addition, in the case of autistic individuals with language impairment, investigators often approach caregivers to discuss research participation, rather than autistic individuals themselves. This gap limits the ecological validity of language research in autism. To address this gap, this clinical focus article describes strategies for engaging REM autistic young adults with language impairment using lessons learned from five years of longitudinal research with this population. This approach involved an ongoing community partnership, as well as participatory partnerships with REM autistic individuals and community stakeholders, developed through “slow science.”Conclusion: The approach yielded excellent retention of participants over five years and led to co-development of research projects aimed at priorities described by REM autistic individuals and their families, including understanding self-determination, social determinants of health, and language variability in autistic REM with language impairment. Findings support the utility of community-based methods with autistic REM young adults with language impairment, with key take-aways for diversifying research while replicating, extending, and building theory.

Approximately 30% of autistic children are considered minimally verbal. The field lacks an efficient and reliable measure of communicative capacity among minimally verbal autistic children. Improved methods are needed to determine which children are at greatest risk for minimally verbal outcomes to better target interventions. Here, we present the Low Verbal Investigatory Survey (LVIS), a brief parent-report measure designed to assess communicative capacity among minimally verbal autistic children. The 36-item easy-to-complete LVIS was developed to capture the atypical language trajectories associated specifically with autism. We report pilot results from a sample of 147 children (1–8 years) whose caregivers completed the LVIS as part of other studies. Principal components analysis was used to assess dimensionality of the LVIS; composite scores were compared with existing measures of communicative capacity, all of which take significantly more time and training to administer and score. Scores on the LVIS were strongly correlated with existing gold-standard measures of communication. Presence of atypical vocalizations was determined to be particularly relevant for symptoms of autism as well as language and cognitive abilities. These findings provide initial validation of a tool designed to capture multiple dimensions of communicative capacity in children with minimal or low verbal skills. Lay abstract Approximately one in three autistic children is unable to communicate with language; this state is often described as minimally verbal. Despite the tremendous clinical implications, we cannot predict whether a minimally verbal child is simply delayed (but will eventually develop spoken language) or will continue to struggle with verbal language, and might therefore benefit from learning an alternative form of communication. This is important for clinicians to know, to be able to choose the most helpful interventions, such as alternative forms of communication. In addition, the field lacks a standard definition of “minimally verbal.” Even when we do agree on what the term means (e.g. fewer than 20 words), describing a child based on their lack of words does not tell us whether that child is communicating in other ways or how they are using those 20 words. To address these concerns, we developed the Low Verbal Investigatory Survey (LVIS), a one-page parent-report measure designed to help us characterize how minimally verbal autistic children are communicating. Parents of 147 children (aged 1–8 years) completed the LVIS. Here, we ask (1) whether the survey measures what it was designed to measure, that is, communicative ability in children without much spoken language, and (2) how the LVIS relates to cognitive and language ability, and symptoms of autism. Results suggest that this survey, which takes only 5 min to complete, is a good estimate of the child’s communication skills. Furthermore, LVIS survey scores are correlated with other measures of language and cognitive abilities as well as autism symptomatology. The LVIS has the potential to save time and money in both clinical and research efforts to assess communication skills in minimally verbal autistic children.

Copying other people’s mannerisms (i.e., mimicry) occurs spontaneously during social interactions, and is thought to contribute to sharing emotions, affiliation with partners and interaction quality. While previous research shows decreased mimicry of emotional facial expressions in autism spectrum disorders (ASD), we know relatively little about how non-emotional, non-facial behavioural mimicry manifests and, more importantly, what it means for autistic individuals’ social interactions. In a controlled, semi-naturalistic interaction setting, this study examined how often autistic and neurotypical (NT) children mimicked a virtual partner’s non-facial mannerisms as they engaged in an interactive story-telling activity. Subsequently, children reported how affiliated they felt towards their interaction partner using an established implicit measure of closeness and a set of questions. Results revealed reduced mimicry (p = .001, φ = .38) and less affiliation (p = .01, φ = .33) in ASD relative to NT children. Mimicry was associated with affiliation for NT (r(23) = .64, p = .0009), but not ASD, children (r(31) = .07, p = .72). These results suggest an autism-associated reduction in mimicry and that mimicry during social interactions may not substantially contribute to affiliation in autism.

Purpose: Typical speakers tend to adopt words used by their conversational partners. This “lexical alignment” enhances communication by reducing ambiguity and promoting a shared understanding of the topic under discussion. Lexical alignment has been little studied to date in autism spectrum disorder (ASD); furthermore, it has been studied primarily via structured laboratory tasks that may overestimate performance. This study examined lexical alignment in ASD during discourse and explored associations with communicative success and executive function. Method: Thirty-one autistic and nonautistic adolescents were paired with a study-naïve research assistant (RA) to complete a social communication task that involved taking turns verbally instructing (guiding) the partner to navigate on a map. Lexical alignment was operationalized as the proportion of shared vocabulary produced by guides on successive maps. Task accuracy was operationalized as the pixels contained within the intended and drawn routes. Results: Results indicated that autistic adolescents had greater difficulty describing navigational routes to RAs, yielding paths that were less accurate. Alignment was reduced in autistic participants, and it was associated with path accuracy for nonautistic, but not autistic, adolescents. The association between lexical alignment and executive function missed significance ( p = .05); if significant, the association would indicate that greater executive function difficulty was associated with reduced lexical alignment. Conclusions: These findings provide preliminary evidence of reduced lexical alignment in ASD in an unstructured discourse context. Moreover, positive associations between lexical alignment and task performance in the neurotypical group raise the possibility that interventions to promote the use of shared vocabulary might support better communication. Supplemental Material: https://doi.org/10.23641/asha.21313719

Autism research tends to exclude racially and ethnically minoritized autistic individuals, limiting the quality of the evidence base for characterizing and diagnosing language impairment in racially and ethnically minoritized autistic individuals. This systematic review examines reporting practices for participant socio-demographics in studies pertaining to language impairment in autistic school-age individuals using age-referenced assessments. This review was preregistered (PROSPERO: CRD42021260394) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Database searches took place in August of 2021 in Linguistics and Language Behavior Abstracts, PsycINFO, PubMed, and the Directory of Open Access Journals, for publications during 1980–2021. Search terms included three essential concepts: autism, language, and age. Two coders independently screened and evaluated articles. Of qualifying studies ( n = 59), 17 (29%) reported any information on participant race and ethnicity; in these studies, participants were at least 77% white. Thirty-two studies (54%) reported gender or sex; just 10 studies (17%) reported socio-economic status using multiple indicators. These findings indicate insufficient adherence to reporting guidelines and systematic exclusion of racially and ethnically minoritized. Future work must address replicable reporting and inclusion in autism research. Lay abstract Although exclusion of racially and ethnically minoritized autistic individuals from research is a long-standing issue, we have yet to determine how exclusion impacts areas of autism research important for identifying language impairment. Diagnosis depends on the quality of the evidence (i.e. research) and is often the pathway to gaining access to services. As a first step, we examined how research studies related to language impairment in school-age autistic individuals report participant socio-demographics. We analyzed reports using age-referenced assessments in English ( n = 60), which are commonly used by both practitioners and researchers to diagnose or identify language impairment. Findings showed only 28% of studies reported any information on race and ethnicity; in these studies, most (at least 77%) of the participants were white. In addition, only 56% of studies reported gender or sex and specified what they were reporting (gender, sex, or gender identity). Just 17% reported socio-economic status using multiple indicators. Altogether, findings indicate broad issues with underreporting and exclusion of racially and ethnically minoritized individuals, which might overlay with other aspects of identity including socio-economic status. It is impossible to determine the extent and precise nature of exclusion without intersectional reporting. To ensure that language in autism research is representative of the autistic population, future research must implement reporting guidelines and broaden inclusion of who participates in research studies.

This is the preprint for a manuscript submitted for publication.

This study investigates the role of recursive language and working memory (WM) in second-order false belief skills in Danish-speaking children with autism spectrum disorder (ASD; n = 62; 8 females) and typical development (n = 41; 15 females), ages 6-16. Second-order false belief skills correlated with receptive grammar, vocabulary, and age; sentential complement production predicted second-order false beliefs, controlling for age, receptive grammar and WM. Regressions showed that second-order false belief was associated with age across groups, but with sentential complements in the ASD group only. Second-order false belief skills improved in children who received training in either recursive phrases (d = 0.21) or WM (d = 0.74), compared to an active control group. Results suggest that false belief skills are entwined with both linguistic and executive functions.

The current study investigated whether the difficulty in finding group differ- ences in prosody between speakers with autism spectrum disorder (ASD) and neurotypical (NT) speakers might be explained by identifying different acous- tic profiles of speakers which, while still perceived as atypical, might be characterized by different acoustic qualities. We modelled the speech from a selection of speakers (N = 26), with and without ASD, as a network of nodes defined by acoustic features. We used a community-detection algorithm to identify clusters of speakers who were acoustically similar and compared these clusters with atypicality ratings by naïve and expert human raters. Results identified three clusters: one primarily composed of speakers with ASD, one of mostly NT speakers, and one comprised of an even mixture of ASD and NT speakers. The human raters were highly reliable at distinguishing speakers with and without ASD, regardless of which cluster the speaker was in. These results suggest that community-detection methods using a net- work approach may complement commonly-employed human ratings to improve our understanding of the intonation profiles in ASD.

This study tests the role of verbal mediation during theory of mind processing in autism spectrum disorder (ASD). Adolescents with ASD or typical development completed a false belief task while simultaneously performing a verbal or nonverbal load task. There was no group difference in false belief accuracy; however, under verbal load, the ASD group was relatively less efficient, with slower reaction times, in false belief compared to true belief trials. Faster false belief task performance under verbal but not nonverbal load was associated with pragmatic language ability for the ASD group only. Results were consistent with the theory that there are two (implicit, nonverbal and explicit, verbal) processes that support cognitive reasoning about other people’s minds (Apperly & Butterfill, 2009), and that people with ASD rely more on the explicit system. Verbal mediation may be critical for false belief understanding in individuals with ASD, but not typical development.

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.

Purpose: Open science that is truly accessible and transparent to all will enhance reproducibility. However, there are ethical and practical concerns in implementing open science practices, especially when working with populations who are systematically excluded from and marginalized in communication sciences and disorders (CSD) research, such as Black, Indigenous, and People of Color (BIPOC) from clinical populations. The purpose of this article is to discuss these concerns and present actionable steps to support open science in CSD research with BIPOC. Conclusion: In the movement towards open and reproducible science, the field of CSD must prioritize accessibility and transparency, in addition to the implementation of individual scientific practices. Such a focus requires building trust with BIPOC as not only research participants, but also as valued leaders of the scientific community.

Motor skill differences have been consistently reported in individuals with ASD. Associations between motor skill and social communication skills have been reported in both typical development (TD) and autism spectrum disorder (ASD). The current study extends these findings to characterize performance on a fine motor imitation task, probing skills as a predictor of social and communicative functioning, and co-speech gesture use. These research questions were addressed by a secondary analysis of data collected during a previous study characterizing a cohort of individuals who were diagnosed with ASD in early childhood but lost the autism diagnosis (LAD) by the time of adolescence. Fine motor imitation skills were compared between 14 individuals with LAD, 15 individuals with autism spectrum disorder (ASD), and 12 typically developing (TD) individuals. LAD and TD groups had more advanced fine motor imitation skills than the ASD group, and abilities were significantly associated with ASD symptoms and amount of gesture use (though there was a counterintuitive interaction between group and fine motor skill in the LAD and TD groups only, in which lower motor skills predicted more ASD symptoms; this relationship was of a small effect size and is likely driven by the compressed range of fine motor skills in these two groups). Findings suggest that fine motor skills normalize along with social communication skills and restricted and repetitive behaviors and interests in individuals who lose the ASD diagnosis, and that individuals with better fine motor abilities produce more co-speech gesture.

Sensorimotor-based theories of cognition predict that even subtle developmental motor differences, such as those characterizing autism spectrum disorder (ASD), impact how we represent the meaning of manipulable objects (e.g., faucet). Here, we test 85 neurotypical participants, who varied widely on the Adult Autism Spectrum Quotient (AQ), a measure intended to capture variability in ASD characteristics in the general adult population (participant scores were all below the clinical threshold for autism). Participants completed a visual world eyetracking task designed to assess the activation of conceptual representations of manipulable objects. Participants heard words referring to manually manipulable objects (e.g., faucet) while we recorded their eye movements to arrays of four objects: the named object, a related object typically manipulated similarly (e.g., jar), and two unrelated objects. Consistent with prior work, we observed more looks to the related object than to the unrelated ones (i.e., a manipulation-relatedness effect). This effect likely reflects the overlapping conceptual representations of objects sharing manipulation characteristics (e.g., faucet and jar), due to embodied sensorimotor properties being part of their representations. Critically, we observed—among typically developed young adults—that as AQ scores increased, manipulation-relatedness effects decreased. In contrast, in a visual control condition, in which a target object was paired with related objects of a similar shape (e.g., snake and rope), relatedness effects increased with AQ scores. The results show that AQ scores can predict variation in how object-concept representations are activated for typically developed individuals. More speculatively, they are consistent with the hypothesis that in individuals with ASD, differences in object-concept representations emerge at least in part via differences in sensorimotor experience.

In addition to deficits in pragmatics, children with autism spectrum disorders (ASD) have weaknesses in complex syntax and working memory (WM). These two deficits may be closely related. Previous work investigated the effects of WM training in developmental language disorders and showed significant improvement in both WM and syntax. The current study tests the impact of 12 h of WM training across 8 weeks in 30 children with ASD, aged 5 to 11. Results showed direct improvements on untrained WM tasks, as well as transfer effects to syntax and processing speed. Stronger WM led to better syntactic abilities. While they must be replicated, these exciting results provide impetus for further studies of WM interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s10803-021-05295-z.

Mimicry facilitates social bonding throughout the lifespan. Mimicry impairments in autism spectrum conditions (ASC) are widely reported, including differentiation of the brain networks associated with its social bonding and learning functions. This study examined associations between volumes of brain regions associated with social bonding versus procedural skill learning, and mimicry of gestures during a naturalistic interaction in ASC and neurotypical (NT) children. Consistent with predictions, results revealed reduced mimicry in ASC relative to the NT children. Mimicry frequency was negatively associated with autism symptom severity. Mimicry was predicted predominantly by the volume of procedural skill learning regions in ASC, and by bonding regions in NT. Further, bonding regions contributed significantly less to mimicry in ASC than in NT, while the contribution of learning regions was not different across groups. These findings suggest that associating mimicry with skill learning, rather than social bonding, may partially explain observed communication difficulties in ASC.

Sensorimotor-based theories of cognition predict that even subtle developmental motor differences, such as those found in individuals on the autism spectrum, affect how we represent the meaning of manipulable objects (e.g., faucet). Here, we test 85 participants, who completed the Adult Autism Spectrum Quotient (to measure autism-spectrum characteristics), on a visual world experiment designed to assess conceptual representations of manipulable objects. Participants heard words referring to manually manipulable objects (e.g., faucet) while we recorded their eye movements to arrays of four objects: the named object, a related object typically manipulated similarly (e.g., jar), and two unrelated objects. Consistent with prior work, we observed more looks to the related object than to the unrelated ones (i.e., a manipulation-relatedness effect). This effect has been taken to reflect overlapping conceptual representations of objects sharing manipulation characteristics (e.g., faucet and jar) due to embodied sensorimotor properties being part of their representations. Critically, we observed that as participant-level autism-spectrum characteristics increased, manipulation-relatedness effects became smaller, whereas in control trials that included a shape (instead of manipulation) related object, relatedness effects increased. The results support the hypothesis that differences in object-concept representations on the autism spectrum emerge at least in part via differences in sensorimotor experience.

Background Yoga is gaining popularity as a multisystem intervention due to its impact on both the physical and mental well-being of children with typical development. However, there is limited empirical evidence to support the use of this approach in school-aged children with Autism Spectrum Disorder (ASD). The current pilot study evaluated the impact of a creative yoga intervention on the joint attention and social communication skills, as well as affective states of children with ASD. Methods 24 school-aged children with ASD received eight weeks of yoga (e.g., breathing, poses, relaxation) or tabletop play/academic intervention (e.g., reading, arts-crafts, building activities). Children were tested before and after the intervention using a standardized measure of responsive joint attention. Additionally, changes in socially directed verbal communication and affective states of children were assessed three times during the intervention period, i.e. during early, mid, and late intervention sessions. Results Children with ASD showed improvements in responsive joint attention in both groups in the posttest vs. the pretest. Furthermore, children in the yoga group showed improvements in socially directed verbal communication skills across the intervention sessions, i.e. greater spontaneous and responsive communication from early/mid to late intervention sessions compared to the academic group. There were no changes in affective states with the intervention, however, the yoga group showed greater interested and less negative affect compared to the academic group. Conclusions Creative yoga intervention is a promising tool as it led to improvements in intervention-related social communication skills and generalized joint attention skills of children with ASD.