Quantitative Analysis of Narrative Discourse by Autistic Adults of Underrepresented Genders.

Background: Narrative production is an important part of the diagnostic process for autism. Most existing research on narrative production by autistic people has focused on cisgender men and boys. Members of other genders (i.e., nonbinary people, transgender men, and trans and cisgender women) are underrepresented in the research literature. Research with non-autistic adults consistently reports gender differences in narrative production. When adults whose genders are underrepresented seek autism diagnosis as adults, they may be misdiagnosed due to misconceptions about autistic communication that are based on cisgender male speakers. Methods: Twenty autistic adults of various genders each told four narratives: two based on a picture and two about their personal experiences. Dependent variables measured narrative length, grammatical complexity, vocabulary diversity, filled pauses, and internal state terms. Researchers used nonparametric statistics to compare groups of (1) cisgender men and all other participants, (2) participants assigned male at birth and those assigned female, and (3) self-identified women, nonbinary people, and men. Results: Women used significantly less diverse vocabulary than men. Women used more terms to refer to internal states than both nonbinary people and men, but this finding was not significant after correction for multiple comparisons. All other comparisons were not statistically significant. Conclusions: Autistic narrators of diverse genders have more linguistic similarities than differences. Autistic women may be more likely to talk about emotions and other internal states than autistic men. Gender-based expectations for spoken communication about internal states should be carefully reconsidered. More research is necessary to determine whether the results of this small study will generalize to larger samples of autistic people whose genders are currently underrepresented in the research literature.

Why is this an important issue?: How a person tells stories can help clinicians diagnose autism. Only a few research studies have explored how autistic adults tell stories. Most autism research is based on cisgender boys and men. Nonbinary people, transgender people, and cisgender women are underrepresented in research. Research with non-autistic adults has shown gender differences in how people tell stories. When cisgender women, nonbinary people, and transgender people seek autism diagnosis in adulthood, they might be misdiagnosed if clinicians do not know how autistic people of their gender might tell stories. What was the purpose of this study?: The purpose of this study was to find out whether autistic people of different genders tell stories in different ways. What did the researchers do?: We recruited autistic nonbinary people, transgender people, and cisgender women and men. On a Zoom call with a researcher, each participant told two stories about a picture and two stories about their experiences. We measured how long the stories were, how long their sentences were, how many different words people used, how many words they used about emotions and thoughts, and how often they said um and uh. We made three sets of comparisons: (1) cisgender men compared with all other participants; (2) participants assigned male at birth compared with participants assigned female at birth; (3) self-identified women, nonbinary people, and men compared with each other. We used a high standard for statistical significance because we made so many comparisons. What were the results of the study?: 1.Stories told by cisgender men were the same as the stories told by everyone else, on all the measures. Stories told by participants assigned female at birth and participants assigned male at birth were the same on all the measures.2.When women, nonbinary people, and men were compared with each other, no group differences were statistically significant using our high standard. Despite this, there were two interesting patterns: Women used each different word more times in their stories than men did. Women used more words about emotions and thoughts than men did. None of the other comparisons showed gender differences. What do these findings add to what was already known?: These findings suggest that autistic women may be more likely to talk about emotions and thoughts than autistic men. Clinicians evaluating women for autism should not necessarily expect autistic women to talk about the same things that they expect autistic men to talk about. In general, autistic speakers of diverse genders had more similarities than differences, and it did not matter how we grouped their genders. What are potential weaknesses in the study?: The group of participants was small, and the gender groups were uneven. The participants were mostly white and highly educated. Repeating the study with a larger, more diverse group of people could help researchers to understand similarities and differences in autistic communication better. How will these findings help autistic adults now or in the future?: These findings can help autistic adults by teaching clinicians who diagnose autism about ways that women and nonbinary people tell stories. The findings challenge stereotypes about autistic people that are based on cisgender men.

Amplitude of low frequency fluctuations during resting state fMRI in autistic children.

Resting state fMRI (rs-fMRI) provides an excellent platform for examining the amplitude of low frequency fluctuations (ALFF) and fractional amplitude of low frequency fluctuations (fALFF), which are key indices of brain functioning. However, ALFF and fALFF have been used only sporadically to study autism. rs-fMRI data from 69 children (40 autistic, mean age = 8.47 ± 2.20 years; age range: 5.2 to 13.2; and 29 non-autistic, mean age = 9.02 ± 1.97 years; age range 5.9 to 12.9) were obtained from the Autism Brain Imaging Data Exchange (ABIDE II). ALFF and fALFF were measured using CONN connectivity toolbox and SPM12, at whole-brain & network-levels. A two-sampled t-test and a 2 Group (autistic, non-autistic) × 7 Networks ANOVA were conducted to test group differences in ALFF and fALFF. The whole-brain analysis identified significantly reduced ALFF values for autistic participants in left parietal opercular cortex, precuneus, and right insula. At the network level, there was a significant effect of diagnostic group and brain network on ALFF values, and only significant effect of network, not group, on fALFF values. Regression analyses indicated a significant effect of age on ALFF values of certain networks in autistic participants. Such intrinsically different network-level responses in autistic participants may have implications for task-level recruitment and synchronization of brain areas, which may in turn impact optimal cognitive functioning. Moreover, differences in low frequency fluctuations of key networks, such as the DMN and SN, may underlie alterations in brain responses in autism that are frequently reported in the literature.

Event related potential exploration of the organizational structure of abstract versus concrete words in neurologically intact younger adults.

The purpose of this study was to test the effects of concreteness and relationship type (similarity vs. association) on semantic processing using event-related potentials (ERP). Neurophysiological evidence has been found for the concreteness effect and for an effect of relationship type. This study replicated and extended these findings by investigating the interaction of concreteness and relationship type. Twenty-four neurologically healthy young adults performed lexical decision and semantic relatedness tasks while continuous scalp EEG was recorded. Larger N400 effects were found for concrete words in associative relationships than for concrete words in similarity relationships and abstract words in either type of relationship. The results are discussed in relation to the different representational frameworks account for abstract and concrete word processing.

Behavioral and neurobiological evidence for the effects of reading interventions on autistic children: A systematic review.

This study systematically reviewed the literature on reading interventions for autistic children. Peer-reviewed articles that reported behavioral and/or neurobiological effects of reading intervention were identified in five online databases. After screening, 15 studies met the inclusion criteria for this review. These studies focus on interventions targeted towards improving specific reading skills: comprehension, vocabulary, fluency, and phonological awareness. Studied interventions included interactive and shared reading, visualization strategies, vocabulary and main idea instruction, video modeling, and interventions supported by tablet-based technology. Overall, the studies identified in this review reported improvements to each of the targeted reading skills and changes to neural activation and connectivity. In addition, changes at the brain level were associated with improvements in reading. Specifically, frontal, temporal, and occipital regions associated with visual and language processing showed increased activation and functional connectivity following intervention. This review provides important insights into the landscape of reading intervention studies in autism and into the neurobiological underpinnings of reading skills and how interventions affect those processes.

Brief Report: Visuospatial and Spoken Language Recall in Autism: Preliminary Findings.

Challenges to verbal encoding may affect the ability of autistic individuals to express their ideas. Therefore, visuospatial expression may represent a person's knowledge and skills more accurately than spoken language. To test this hypothesis, we asked seven autistic adults to linguistically retell and visuospatially reenact several animated clips. On average, visuospatial responses contained more correct elements than spoken responses. The level of intention of the three stimulus categories did not systematically affect response accuracy. Participants who produced visuospatial responses before spoken responses and those who had watched a greater number of stimuli assigned higher intentionality to shapes in the animations that were designed to elicit mentalizing. The modality used for expression may affect accuracy of responses by autistic individuals.

Centering the family in their system: a framework to promote family-centered AAC services.

Families are the most significant communication partners for an individual with complex communication needs. Even though family-centered approaches are recommended to support augmentative and alternative communication (AAC) services for an individual, it is difficult to establish a successful plan that fits each individual's family. A framework for practitioners is proposed to effectively obtain and understand information about a family's unique dynamics as part of service delivery to positively impact AAC device uptake and long-term use. The goal of using this model is to minimize the disruption to the family while maximizing the integration of the AAC system. This paper proposes and illustrates a framework to enrich AAC services through the integration of several theoretical models of family systems theory, family paradigms, and a procedure called the self-created genogram. This paper begins by reviewing ecological family systems theory and family systems to guide and provide a framework to support effective AAC implementation. The process of self-creating genograms is then introduced as a means to obtain a rich perspective on family characteristics and dynamics that is informed by the individual who uses AAC. All of this information allows professionals to provide relevant information and tailor options for the family. As a result, the family is able to make informed decisions about AAC intervention in a manner most consistent with how they typically operate. Finally, we apply this framework to a hypothetical case of a child with autism and complex communication needs across three timepoints (preschool, late elementary/early middle school, and high school/post-secondary transition) to demonstrate how this framework can be used in clinical practice.

Development of Neural Structure and Function in Autism Spectrum Disorder: Potential Implications for Learning Language.

Purpose Neurodevelopmental processes that begin during gestation and continue throughout childhood typically support language development. Understanding these processes can help us to understand the disruptions to language that occur in neurodevelopmental conditions, such as autism spectrum disorder (ASD). Method For this tutorial, we conducted a focused literature review on typical postnatal brain development and structural and functional magnetic resonance imaging, diffusion tensor imaging, magnetoencephalography, and electroencephalography studies of the neurodevelopmental differences that occur in ASD. We then integrated this knowledge with the literature on evidence-based speech-language intervention practices for autistic children. Results In ASD, structural differences include altered patterns of cortical growth and myelination. Functional differences occur at all brain levels, from lateralization of cortical functions to the rhythmic activations of single neurons. Neuronal oscillations, in particular, could help explain disrupted language development by elucidating the timing differences that contribute to altered functional connectivity, complex information processing, and speech parsing. Findings related to implicit statistical learning, explicit task learning, multisensory integration, and reinforcement in ASD are also discussed. Conclusions Consideration of the neural differences in autistic children provides additional scientific support for current recommended language intervention practices. Recommendations consistent with these neurological findings include the use of short, simple utterances; repetition of syntactic structures using varied vocabulary; pause time; visual supports; and individualized sensory modifications.