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Abstract The production of speech and gesture is exquisitely temporally coordinated. In autistic individuals, speech-gesture synchrony during spontaneous discourse is disrupted. To evaluate whether this asynchrony reflects motor coordination versus language production processes, the current study examineddeliberatelyperformed hand movements during speech in youth with autism spectrum disorder (ASD) compared to neurotypical youth. Neurotypical adult performance provided a mature baseline. Participants read aloud rhythmic nursery rhymes, while producing a beat-like hand movement. An automated pixel-change video measure identified kinematic peaks; using smoothed acoustic envelope analyses, we identified peaks in speech. Results indicated few diagnostic group differences in explicit speech-movement coordination, although adolescent performance differed from adults. Adults demonstrated higher tempo and greater rhythmicity in their coordination; this group difference suggests that the method is sufficiently subtle to reveal individual differences and that this form of complex coordination undergoes ongoing maturation beyond adolescence. The sample is small, and thus results are necessarily preliminary. In the context of prior speech-gesture coordination studies, these findings of intact synchrony are consistent with the hypothesis that it is the demands of discourse planning, rather than motor coordination, that have led to prior findings of asynchrony during spontaneous speech; this possibility awaits future research. 

Language in autism is heterogeneous, with a significant proportion of individuals having structural language difficulties and inclusion of language impairment as a specifier under Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for autism. This systematic review asked: What are the reporting patterns of variables pertaining to structural language in autism prior to and after publication of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.)? What norm-referenced assessments does research use to characterize the language abilities of autistic individuals with respect to language impairment? This preregistered review (PROSPERO: CRD42021260394) followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches took place in September 2022 and included Linguistics and Language Behavior Abstracts, PsycINFO, PubMed, and the Directory of Open Access Journals. Search terms included three essential concepts: autism, language, and age. Two coders independently screened and evaluated articles. Searches yielded 57 qualifying studies, with mostly consistent reporting practices prior to and after the Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Studies varied in how they defined language groups and in what norm-referenced measures they used. Interpreting research on structural language in autism requires attention to diagnostic and grouping criteria. Although inconsistency in reporting in original studies limited this review, better understanding the available information on structural language in autistic individuals aged 3–21 years may support identification of language needs. Lay abstractUnder the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), language impairment can co-occur with autism. It is not yet clear how research defines, reports, and characterizes structural language abilities of autistic individuals eligible for school-based special education services (aged 3–21 years) in the United States. In the United States, students typically must be formally diagnosed to be eligible for services and supports. However, the quality of diagnosis is only as good as the research evidence on which diagnosis depends. To evaluate evidence quality, we examined how studies of school-aged autistic individuals report assessments of language ability. This systematic review included 57 studies using English language age-referenced assessments used to measure structural language. Findings showed many differences across studies in how language abilities were measured and reported. Also, none of the studies fully reported the variables relevant to characterizing language impairment. Outcomes were similar across versions of the Diagnostic and Statistical Manual of Mental Disorders. Findings indicate that researchers and clinicians should pay attention to reporting diagnostic and grouping criteria. Carefully interpreting research evidence is critical for ensuring that diagnostic criteria and supports are representative of and accessible to autistic individuals and relevant parties. 

Alongside the behavioral features of autism, this neurodevelopmental disorder is characterized by important differences in the neural circuitry underlying language processing. Regarding brain structure, most neurotypical individuals have larger left-hemisphere volumes of brain regions that are important for language, compared to the same regions in the right hemisphere (the right half of the brain). This asymmetry is due to neural specialization of left hemisphere regions for the purpose of language functions. In contrast, the brains of autistic individuals seem to be more symmetrical, suggesting that language difficulties are associated with reduced left hemisphere specialization for language in the brain. The activity of brain regions involved in language also differs in autism. Examining brain activity reveals nuanced and important differences in the processes underlying language production and comprehension in neurotypical and autistic individuals, even when their language behavior appears similar. 

Although theory of mind (ToM) is seen as a primary contributor to pragmatic language use in autistic individuals, less work has considered the influence of structural language. This study examines grammaticality judgements, ToM (Reading the Eyes in the Mind, Social Attribution Test), and pragmatic language (a de novo measure based on Pragmatic Language Scales), and their associations, in three groups with heterogenous abilities: Current autism (n = 36); those with a history of autism spectrum disorder, who no longer display symptoms ( “loss of autism diagnosis”, LAD; n = 32), and non-autistic (n = 36) adolescents and adults with fluent verbal skills. Results showed pragmatic difficulties in autism, relative to both other groups, difficulties in affective ToM relative to both other groups, and difficulties in structural language relative to neurotypical controls; LAD individuals showed no impairments. While pairwise associations of structural language and matrix reasoning with pragmatic language were observed, ToM was the only unique predictor of pragmatic language when all measures were included in the models. Results suggest complex interactions among pragmatic and structural language, and ToM, and that pragmatic language improves meaningfully with broad changes in broad aspects of autism when individuals lose the autism diagnosis. 

Racial and ethnic disparities in service utilization in autism are widely documented. Autism-related parental stigma may play a role if parents from racial/ethnic minoritized backgrounds experience dual stigma from autism and from membership in a marginalized group. This study examines racial/ethnic differences in autism-related stigma and compares the impact of stigma on service utilization in a large, diverse sample of US-based parents of autistic children (final sample = 764; White 41.6%, Black 16.6%, Latino/a/x/Hispanic 20.9%, Asian 7.5%, Multiracial 9.6%, Native American 1.8%, Pacific Islander 0.5%, Middle Eastern 0.2%, and Other 0.2%). Parents completed online surveys assessing affiliate and community stigma, service utilization, and perceived unmet treatment needs. Small but significant racial/ethnic group differences emerged in some aspects of stigma and service utilization. Specifically, Asian and Latino/a/x parents were less likely to fully engage in recommended services; Asian parents endorsed less service availability; Latino/a/x and multiracial parents reported more unmet needs; and Asian and White parents reported significantly more affiliate stigma. There was little indication that stigma contributed to racial/ethnic differences in service utilization, except for Asian families. Results indicate that socioeconomic factors interact with race/ethnicity to impact service use and stigma. 

Background: "Frank autism," recognizable through the first minutes of an interaction, describes a behavioral presentation of a subset of autistic individuals that is closely tied to social communication challenges, and may be linked to so-called "prototypical autism." To date, there is no research on frank autism presentations of autistic adolescents and young adults, nor individuals diagnosed with autism spectrum disorder (ASD) in childhood who do not meet diagnostic criteria during or after adolescence (loss of autism diagnosis, LAD). In addition, there are currently no data on the factors that drive frank autism impressions in these adolescent groups. Methods: This study quantifies initial impressions of autistic characteristics in 24 autistic, 24 LAD and 26 neurotypical (NT) individuals ages 12 to 39 years. Graduate student and expert clinicians completed five-minute impressions, rated confidence in their own impressions, and scored the atypicality of behaviors associated with impressions; impressions were compared with current gold-standard diagnostic outcomes. Results: Overall, clinicians' impressions within the first five minutes generally matched current gold-standard diagnostic status (clinical best estimate), were highly correlated with ADOS-2 CSS, and were driven primarily by prosodic and facial cues. However, this brief observation did not detect autism in all cases. While clinicians noted some subclinical atypicalities in the LAD group, impressions of the LAD and NT groups were similar. Limitations: The brief observations in this study were conducted during clinical research, including some semi-structured assessments. While results suggest overall concordance between initial impressions and diagnoses following more thorough evaluation, findings may not generalize to less structured, informal contexts. In addition, our sample was demographically homogeneous and comprised only speaking autistic participants. They were also unmatched for sex, with more females in the non-autistic group. Future studies should recruit samples that are diverse in demographic variables and ability level to replicate these findings and explore their implications. Conclusions: Results provide insights into the behavioral characteristics that contribute to the diagnosis of adolescents and young adults and may help inform diagnostic decision making in the wake of an increase in the demand for autism evaluations later than childhood. They also substantiate claims of an absence of apparent autistic characteristics in individuals who have lost the diagnosis. 

Some autistic children acquire foreign languages from exposure to screens. Such Unexpected Bilingualism (UB) is therefore not driven by social interaction; rather, language acquisition appears to rely on less socially mediated learning and other cognitive processes. We hypothesize that UB children may rely on other cues, such as acoustic cues, of the linguistic input. Previous research indicates enhanced pitch processing in some autistic children, often associated with language delays and difficulties in forming stable phonological categories due to sensitivity to subtle linguistic variations. We propose that repetitive screen-based input simplifies linguistic complexity, allowing focus on individual cues. This study hypothesizes that autistic UB children exhibit superior pitch discrimination compared to both autistic and non-autistic peers. From a sample of 46 autistic French-speaking children aged 9 to 16, 12 were considered as UB. These children, along with 45 non-autistic children, participated in a two-alternative forced-choice pitch discrimination task. They listened to pairs of pure tones, 50% of which differed by 3% (easy), 2% (medium), or 1% (hard). A stringent comparison of performance revealed that only the autistic UB group performed above chance for tone pairs that differed, across all conditions. This group demonstrated superior pitch discrimination relative to autistic and non-autistic peers. This study establishes the phenomenon of UB in autism and provides evidence for enhanced pitch discrimination in this group. Acute perception of auditory information, combined with repeated language content, may facilitate UB children's focus on phonetic features, and help acquire a language with no communicative support or motivation. 

Purpose Autistic individuals exhibit elevated rates of depression; however, assessment is complicated by clinical presenta- tions and limited validation in this population. Recent work has demonstrated the utility of the Beck Depression Inventory (BDI-II) in screening for depression in ASD. The current study extends this work by examining the convergence and diver- gence of self- and informant-reported depression in autistic (n = 258) and non-autistic (n = 255) young adults. Methods Participants completed the BDI-II as a self-report measure of depression; informants completed the Achenbach Adult Behavior Checklist. Analyses probed for between-group differences in rates of depression symptoms, convergence between self- and informant-reported depression, and discrepancy between self- and informant-reported depression. Results Results indicated significantly higher rates of depressive symptoms in the autistic group. Convergence was signifi- cant in both groups, with significantly greater agreement in the autistic group. There was differential divergence, with the autistic group reporting significantly lower scores relative to informants, and the non-autistic group reporting significantly higher scores relative to informants. Conclusions Consistent with prior reports, results suggest that depression rates are elevated in autism. Additionally, while the BDI-II may be adequate for screening depressive symptoms in speaking autistic young adults, eliciting information from a close adult informant provides valuable diagnostic information, due to clinically critical concerns about underreporting in this population. Although controlled in analyses, between-group differences in gender, age, race, and informant identity, and a predominantly White and non-Latinx sample, limit the generalizability of these results. 

Recent findings suggest that stigma and camouflaging contribute to mental health difficulties for autistic individuals, however, this evidence is largely based on UK samples. While studies have shown cross-cultural differences in levels of autism-related stigma, it is unclear whether camouflaging and mental health difficulties vary across cultures. Hence, the current study had two aims: (1) to determine whether significant relationships between autism acceptance, camouflaging, and mental health difficulties replicate in a cross-cultural sample of autistic adults, and (2) to compare these variables across cultures. To fulfil these aims, 306 autistic adults from eight countries (Australia, Belgium, Canada, Japan, New Zealand, South Africa, the United Kingdom, and the United States) completed a series of online questionnaires. We found that external acceptance and personal acceptance were associated with lower levels of depression but not camouflaging or stress. Higher camouflaging was associated with elevated levels of depression, anxiety, and stress. Significant differences were found across countries in external acceptance, personal acceptance, depression, anxiety, and stress, even after controlling for relevant covariates. Levels of camouflaging also differed across countries however this effect became non-significant after controlling for the covariates. These findings have significant implications, identifying priority regions for anti-stigma interventions, and highlighting countries where greater support for mental health difficulties is needed.