Music therapy attempts to facilitate communication and expression – core problems for autistic people – through the development of experiences and relationships mediated by music. This commentary assesses a Cochrane Review of the effects of music therapy, compared with placebo or standard care, for autistic people, and its conclusion that music therapy is probably associated with an increased chance of global improvement and perhaps a slight increase in quality of life and reduction in total autism symptom severity in the short to medium term. The review was not able to examine longer-term effects as the longest follow-up period was 12 months. The certainty of the evidence was graded from moderate to very low, and therefore the results need to be viewed with caution.

This editorial highlights increasing prevalence and treatment rates of apparently disparate disorders. We ask whether cross-disorder factors including greater mental health literacy, social media and a shift to psychiatric explanations for distress contribute to these trends. We highlight a consequence: the changing doctor–patient relationship and its impacts.

Autism spectrum disorder (ASD) is a neurodevelopmental condition. Omega-3 fatty acid insufficiency has been linked to ASD. This umbrella meta-analysis was performed to investigate the effects of omega-3 supplementation on clinical manifestations in participants with ASD. Based on the PRISMA statement, databases including Web of Science, PubMed and Scopus were systematically searched for published meta-analyses on the effect of omega-3 supplementation on ASD up to December 2023. To assess the risk of bias, the assessment of multiple systematic reviews (AMSTAR)-2 was utilised. The outcomes were core and non-core symptoms of ASD including social withdrawal/lethargy, cluttering speech, hyperactivity, irritability and stereotypy. Seven meta-analyses eventually remained in the umbrella review. The results revealed that omega-3 fatty acid supplementation caused a significant reduction in cluttering speech in studies conducted on age ≤8 years (effect size (ES) −0·30; 95% confidence interval (CI) −0·55, −0·06; P = 0·02). Omega-3 supplementation caused a significant reduction in hyperactivity in participants ≤8 years (ES −0·30; 95% CI −0·55, −0·06; P = 0·02) and in participants who received the supplements for more than 14 weeks (ES −0·30; 95% CI −0·55, −0·06; P = 0·02). A dosage of ≤1000 mg/d of omega-3 supplementation led to a significant increase in the stereotypy/restricted and repetitive interests and behaviours (ES 0·19; 95% CI 0·03, 0·35; P = 0·02). This umbrella review revealed that omega-3 fatty acid may be a beneficial supplement to control cluttering speech and hyperactivity in children with ASD who are 8 years old or younger.

The Zones of Regulation (The Zones) is an 18-lesson curriculum that is aimed at helping students develop an awareness of emotions and skills for regulation. Although used by schools globally, no peer-reviewed evidence currently exists to support the use of The Zones. The purpose of this study was to examine the experiences of teachers implementing The Zones curriculum with autistic students. Feedback was gathered from 26 teachers throughout their implementation of The Zones. In this study, we employed a qualitative methodology to analyse the feedback from teachers. Descriptive statistics were used to report on acceptability, appropriateness, and feasibility. Our findings revealed that teachers described high levels of acceptability, appropriateness, and feasibility when reflecting on the delivery of The Zones. However, teachers reported that The Zones was not suitable for all students and classrooms. For students for whom The Zones was deemed appropriate, teachers modified the lessons and required peer support to deliver these modifications. With modifications, the teachers observed growth in areas such as students’ comprehension of others’ emotions and improved language around emotions. This study highlights the importance of further research to refine and tailor interventions like The Zones to better meet the diverse needs of autistic students in educational settings.

Effective collaboration between key stakeholders increases the educational opportunities and outcomes of students with autism spectrum disorder (ASD). Although the value of collaboration between the central members of a student’s network has been widely cited, how collaboration occurs between different stakeholder groups in the education of Australian primary and secondary students with ASD is not widely known. The aim of this review was to identify the factors that influence collaborative practices between three primary stakeholder groups supporting the education of Australian students with ASD: family, school, and community. Through this lens, we analysed the intent of the collaborative practices as well as the specific details of the collaborative practices identified across the research literature published since the implementation of the Disability Standards for Education 2005 (Commonwealth of Australia, 2006). Results from this review indicate existing motivations and processes of collaboration, as well as directions for future research and practice.

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 examined deliberately performed 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.

The prevalence of autism spectrum disorder (ASD) is increasing worldwide. Youngsters with ASD demonstrate higher rates of intellectual disabilities (IDs), comorbid psychopathology and psychiatric hospitalizations, compared to children in the general population. This study characterizes the demographics and clinical parameters of adolescent psychiatric inpatients with ASD compared to inpatients without ASD, all hospitalized during the study period. Additionally, within the ASD group, those with ID were compared to those without. The rate of males among participants with ASD was significantly higher than among those without ASD, and the duration of hospitalization was longer. In contrast, the rate of cigarette smoking, major depressive disorder and suicidal thoughts among those with ASD was lower. One-third of those with ASD had moderate to severe ID, about 10% had comorbid epilepsy, and about half of them demonstrated aggressive behavior. Most ASD patients showed significant improvement upon discharge, although the extent of improvement was more prominent among ASD patients with no ID. Our findings, consistent with previous research, indicate that hospitalization is beneficial to youths with ASD, both those with and those without ID. Further studies that include long-term follow-up are needed.

Autism spectrum disorder (ASD) is a complex group of neurodevelopmental disorders characterised by impaired social communication and restricted interests/repetitive behaviours. In this regard, sensory processing difficulties and delayed oral motor skills often predispose individuals with ASD to food selectivity (FS). It is usually associated with repetitive eating patterns that can lead to multiple malnutrition conditions. The objective of this narrative review is to present an overview about the existing nutritional interventions aiming at promoting a healthy eating pattern and addressing food selectivity among individuals with ASD. Regarding the interventions targeting nutrition education, the majority of the analysed studies failed to demonstrate their effectiveness. On the other hand, many educational interventions involving taste or cooking sessions, as well as behavioural interventions for FS, demonstrated effective results. Moreover, multidisciplinary in tailoring such programmes, including psychology speech therapy and nutritional skills, is acknowledged as a key approach.

The field of developmental psychopathology tends to focus on the negative aspects of functioning. However, prosocial behavior and empathy-related responding – positive aspects of functioning– might relate to some aspects of psychopathology in meaningful ways. In this article, we review research on the relations of three types of developmental psychopathology– externalizing problems (EPs), internalizing problems (IPs), and Autism Spectrum Disorder (ASD) – to empathy-related responding (e.g., affective and cognitive empathy, sympathy, personal distress) and prosocial behavior. Empathy-related responding and prosocial behavior generally have been inversely related to EPs, although findings are sometimes reversed for young children and, for empathy, weak for reactive aggression. Some research indicates that children’s empathy (often measured as emotional contagion) and personal distress are positively related to IPs, suggesting that strong sensitivity to others’ emotions is harmful to some children. In contrast, prosocial behaviors are more consistently negatively related to IPs, although findings likely vary depending on the motivation for prosocial behavior and the recipient. Children with ASD are capable of prosocially and empathy-related responding, although parents report somewhat lower levels of these characteristics for ASD children compared to neurotypical peers. Issues in regard to measurement, motivation for prosociality, causal relations, and moderating and mediating factors are discussed.

This study aims to investigate the practice patterns used by Portuguese speech-language pathologists (SLPs) with preschool-age children with pragmatic impairment and to identify the actual need(s) perceived by SLPs in this field. A total of 351 SLPs responded. The results reveal that 81.5 per cent of the respondents (n=286) reported working or had previously worked with preschool-age children with pragmatic impairment arising from autism spectrum disorder, developmental language disorder, or both. Considering the clinical practice, similarities and differences were found, many of which are due not to the inherent characteristics of each disorder but to the scarcity of research in clinical pragmatics. These results are also reflected in the needs perceived by SLPs and the degree of confidence with which they work with these children. Implications for clinical practice and directions for future research are discussed.