Some children struggle with speech development and a small minority never achieve intelligible speech. This review explores research on the use of augmentative and alternative communication (AAC) to support their development of communication and language. There is no generally accepted definition of AAC or coherent theoretical framework, and the nature of AAC is rarely discussed. Most AAC research concerns short-term interventions and studies on AAC processes and development are rare. Longitudinal studies are generally lacking and many central issues in research on spoken language development have received limited attention in AAC research, including vocabulary use, figurative language, and bimodal and bilingual development. Communication is often slow among individuals with severe speech and motor disabilities and artificial intelligence has been suggested to increase conversational speed. Most research on AAC concern intervention and typically report short-term results, while many of the issues addressed in research on spoken language are not addressed. Theoretical and empirical bases for understanding AAC development are lacking. This implies that a significant basis for AAC intervention is lacking. After 40 years of research, there are still core issues that have not been sufficiently addressed. This paper outlines these issues to inform new directions in AAC research and practice.
To review and summarize the current literature on the assessment and treatment of sexual obsessions in children and adolescents. Sexual obsessions are a subgroup of obsessive-compulsive disorder (OCD), characterized by intrusive, ego-dystonic and embarrassing thoughts and fears of engaging in inappropriate sexual behavior. A rapid review of papers published during the last 10 years reporting any aspect of sexual obsessions in pediatric OCD in four databases revealed only five papers, three of which were case reports. We present data on prevalence and phenomenology of the sexual obsession subtype of OCD in children and adolescents and review clinical recommendations for assessment and treatment, including obstacles for accurate identification of symptoms. Sexual obsessions in children and adolescents are under-studied, often under-diagnosed, and likely under-treated. They are reported in roughly 20
This review examines whether SGs and robotics improve academic performance and related cognitive skills in children and adolescents with autism and other neurodevelopmental disorders. We summarize the types of interventions used, the academic domains targeted, and the methodological quality of studies involving learners aged 6–18. Recent work highlights growing interest in digital and embodied learning tools for neurodiverse students. SGs and educational robotics show potential to enhance motivation, attention, working memory, and math skills, especially when interventions provide adaptive feedback and socially interactive elements. However, most studies rely on small samples, short intervention periods, and varied outcome measures, limiting comparability. Across 34 eligible studies, SGs and robotics demonstrated generally positive effects on academic-related outcomes in students with autism and neurodevelopmental disorders. While findings are encouraging, methodological variability and limited longitudinal evidence constrain firm conclusions. More rigorous, larger-scale studies with standardized assessments are needed to clarify long-term benefits and support broader implementation in educational settings.
The aim of this narrative review is to examine how augmentative and alternative communication (AAC) can be incorporated into digital image literacy for learners with complex communication needs. It explores how self-produced films can function as AAC-supported tools for sharing personal experiences and fostering inclusion and narrative development, with potentially transformative results. Digital image literacy offers new opportunities for the integration of AAC into the inclusive education domain, particularly as it embeds within national curricula. Widely available technologies, such as tablets and smartphones, enable today’s learners to document their lives through digital film media and photography, to create personalized resources for use in everyday story sharing. This study synthesizes theoretical and pedagogical approaches that align these multimodal media technologies with broader language education objectives for inclusive education. Learners with complex communication needs produce their own films to bridge home and school contexts, thereby fostering digital image literacy and expressive communication skills. Future research should explore multimodal media production as a form of AAC supporting inclusive language pedagogy and story sharing.
This bibliometric study aimed to map global research trends on transcranial direct current stimulation (tDCS) in autism spectrum disorder (ASD), identifying publication patterns, key contributors, and emerging themes. Analysis of 150 peer-reviewed articles (1992–2025) from Scopus revealed accelerating growth since 2015, driven by multidisciplinary collaboration among the United States, China, Italy, and Australia. Major research focuses include social cognition, theory of mind, and neuromodulation, with growing attention to individualized stimulation and cognitive enhancement. Leading journals such as Autism Research and Scientific Reports have shaped this field. tDCS-ASD research has progressed from exploratory studies to targeted, intervention-oriented investigations emphasizing cognitive and behavioral outcomes. Continued methodological refinement, standardized protocols, and global inclusivity are needed to enhance clinical translation and reproducibility. This analysis provides a comprehensive overview of the intellectual and conceptual evolution of tDCS research in autism.
The aim of this review is to summarize the current state of knowledge guiding evidence-based pharmacologic treatment of pediatric Obsessive Compulsive Disorder (OCD). Cognitive-behavioral therapy incorporating exposure and response prevention (CBT-ERP) and selective serotonin reuptake inhibitors (SSRIs) remain the first-line treatments for OCD. However, even with optimal treatment, 40–60
Despite the efficacy of exposure therapy for pediatric obsessive-compulsive disorder, a significant portion of patients fail to achieve remission, clinically significant change, or low levels of symptomatology. Thus, there is a need to more directly target treatment mechanisms in order to improve outcome. Although extinction learning and habituation are often touted as principal mechanisms of exposure therapy, numerous clinical, theoretical, and empirical errors act as barriers to effective research and implementation. The aim of the current paper is to discuss the extant basic science on extinction learning and habituation in order to elucidate common deviations that impede research and clinical practice, with the hope of stimulating more targeted psychotherapy research. Empirical studies and theoretical papers demonstrate numerous errors when attempting to target extinction learning including failing to identify unconditional stimuli, attempting extinction when there is no unconditional stimulus, and exposing patients to stimuli that are not conditional stimuli. Clinical scientists and practitioners routinely misuse the term habituation and employ methodology that has precluded our ability to understand habituation as a mechanism of exposure therapy. There are numerous theoretical errors plaguing the literature on Pavlovian extinction learning and habituation within exposure therapy.
We asked the following research questions: (1) What evidence exists that describes specific warning signs of suicide in autistic people? and (2) What gaps exist related to research on warning signs of suicide among autistic people? Following the six-step approach for scoping reviews, we identified 15 sources that described potential warning signs of suicide in autistic people. The majority of sources were published between 2020 and 2025, and most sources were books or book chapters. Only one source explicitly defined ‘warning signs’. Robust research on warning signs of suicide in autistic people is lacking. Most evidence on warning signs of suicide in autistic people exists from first-person narratives and fictional case examples. Two important next steps to advance the science and practice of suicide prevention include adopting a clear definition of warning signs consistently used by researchers and practitioners, and systematically evaluating warning signs of suicide in autistic people.
To investigate the otorhinolaryngological manifestations associated with Autism Spectrum Disorder (ASD), exploring how dysfunctions in sleep, hearing, smell, and taste may act as relevant sensory and clinical markers. This review also aims to contextualize these findings within a sensory integration framework and to discuss their clinical relevance beyond isolated peripheral alterations. Recent studies indicate a high prevalence of sleep disturbances (50–80
The purpose of this systematic review was to survey the content and structure of sexuality interventions for autistic people across the lifespan. Recent research has identified a lack of attention to autistic people’s needs when designing sexual ed interventions. Due to an increased acknowledgment of the substantial barriers to comprehensive sex education for autistic people, interventions have been implemented across settings, age groups, and methods, but there is little consistency surrounding what content should be included in these interventions. Through our systematic review, we identified 23 articles focused on sexuality and relationship interventions for autistic people. Analysis revealed coverage of a wide variety of topics in curricula, with education around consent and boundary setting or levels of intimacy/dating being the most frequently taught topics. Most interventions were implemented with autistic people, although some did focus on teaching skills to parents or caregivers, who can play an important role in education and skill development. Results provide an important foundation to understand content areas currently included in sex education interventions and identify areas that should receive more attention in future interventions developed for autistic people of all ages.
This systematic short review synthesizes recent cross-cultural research on how cultural context shapes the measurement, recognition, and formal identification of autism spectrum disorder (ASD) globally. Studies published between January 2019 and April 2025 were organized around three aims: cross-cultural performance of autism measures, sociocultural influences on recognition and reporting, and registry-based disparities in identification. A systematic search identified 3,436 records, of which 36 cross-sectional studies met inclusion criteria. Parent-report screening measures generally showed high internal consistency but limited cross-cultural equivalence, with variability in item functioning and caregiver endorsement patterns. Autism-related knowledge and explicit stigma varied across contexts, with greater interpersonal contact and socioeconomic conditions associated with more accepting attitudes. Differences in caregiver experiences, including parenting stress, affiliate stigma, and illness perceptions, were not fully explained by child clinical profiles. Variability in behavioral and cognitive findings aligned with both contextual practices and potential measurement non-equivalence. At the population level, recorded autism prevalence varied by language environment and ethnicity, with lower identification among non-dominant language groups and heterogeneous patterns across ethnic groups. Culture shapes multiple stages of the autism pathway, from interpretation of behaviors to population-level identification. Cross-cultural differences are better understood as arising from interactions among sociocultural meaning-making, measurement practices, and structural conditions, rather than uniform differences in underlying characteristics. Addressing these disparities requires culturally feasible and validated assessment approaches and improved representation of low- and middle-income contexts. Advancing equitable understanding and support will depend on inclusive, interdisciplinary, and globally collaborative research efforts.
This narrative review traces the historical trajectory of scientific narratives surrounding autism, with a particular focus on language and communication. We examined 701 studies investigating autistic language and social communication, excluding intervention research, and organized them chronologically according to evolving diagnostic criteria. Our synthesis reveals major shifts in terminology, conceptualizations of communication profiles, choice of comparison groups, and theoretical approaches over time. These changes mirror broader transformations in diagnostic frameworks and research paradigms. Collectively, they illustrate how autism discourse has been shaped by dynamic, evolving models rather than stable, essentialized traits. We argue for a critical reappraisal of entrenched views of autism and advocate for more relational and contextual interpretations of communicative difficulties. Understanding the historical foundations of autism research helps clarify current assumptions and informs ongoing debates about how categories of difference are constructed and how historical context influences the identification of neurodivergence.
This thematic review examined the existing literature on the benefits of encouraging Interpersonal Motor Synchrony (IMS) in children with autism. 15 quantitative studies from four databases met inclusion criteria. Three major themes were identified from these papers. Firstly, children with autism enjoy being in synchrony; secondly, children with autism can synchronise when the activity is familiar and supported; and thirdly, IMS skills are associated with social communication skills. Effective synchrony is observed to be more challenging for certain clinical populations, including children with autism. If IMS is associated with positive feelings towards other people and an increased feeling of connection, it may then motivate children with autism to respond more frequently to others. The themes identified in the literature suggest that encouraging children with autism to synchronise with others may be a productive intervention goal.
The aim of this systematic review is to investigate the adaptations made to existing anxiety and mood disorder measures used with autistic adults. It addresses the types of modifications made to such measures, the processes behind them, and the involvement of autistic individuals. Following PRISMA guidelines, the review searched four major databases for studies published in English since 1994 that used mood or anxiety measures with autistic adults. Out of 14,583 identified studies, 32 met the inclusion criteria for reporting adaptations. Data extraction used modified FRAME and GRIPP2 frameworks to capture the nature and justification of adaptations and the role of stakeholder involvement. The review found that only 8
Difficulties executing tasks involving movement skills are a primary feature in Developmental Coordination Disorder (DCD) and a common, but frequently overlooked feature in Autism Spectrum Disorder (ASD). This review discusses what we know about early development and the potential neurobiological underpinnings of movement skills and performance in these populations and explores the behavioural features of movement functions and performance associated with DCD and ASD, mapped to the ICF framework. How recent technological advances in motion analysis and machine learning may inform our understanding of theseissues and the implications of current knowledge for research and clinical practice are also discussed. Research suggests that motor difficulties in individuals with DCD and ASD impact participation in activities of daily living, sports and social activities. Current evidence examining DCD and ASD is equivocal with respect to early development, neurobiological contributions, and movement function and behaviour across ICF domains of motor functions, motor performance and participation in movement activities. Findings are limited by small sample sizes as well as heterogeneity within the diagnostic presentations of both DCD and ASD. Technological advances provide novel opportunities to parse the similarities and differences in movement function and behaviour of individuals with these disorders. There are few studies directly contrasting the movement functions and behaviour of children with DCD to those with ASD that allow for direct comparison of similarities and differences, which control for confounding factors. Movement difficulties are universal in DCD and can impact social participation. Arguments have been put forward that support screening for motor difficulties in autistic individuals, but there is insufficient evidence to support the inclusion of movement difficulties within the diagnostic criteria for this disorder. Recognition of the influence of motor problems on engagement in activities demanding movement and social skills for those with DCD and ASD is important in order to ensure interventions optimise opportunities for social participation in physical activities.
This article synthesizes recent empirical findings on the relationship between obsessive-compulsive disorder (OCD) and trauma, with a focus on prevalence, clinical presentation, assessment, and treatment implications. We summarize best practices for trauma-informed OCD care, with the important caveat that the literature on assessment, case formulation, and treatment for the comorbid presentation of trauma and OCD is in the beginning stages of development. Prevalence estimates of OCD and comorbid trauma range from 30 to 82
This review examines pediatric obsessive-compulsive disorder (OCD) and recommendations for telehealth exposure and response prevention (ERP). Literature is summarized along with clinical expertise to provide clinicians with suggestions to optimize pediatric OCD treatment. Over the past five years, telehealth ERP has become common. Comparable treatment outcomes to in-person services and greater access to care suggest this telehealth ERP is likely to stay. While ERP is conceptually unchanged by telehealth, significant differences compared to in-person ERP exist that require clinicians, children, and their caregivers to make relevant modifications and treatment decisions. Domains reviewed in this piece include assessment, diagnostic feedback and psychoeducation, rapport building and treatment motivation, in-session exposure practice, and considerations for hybrid models. In-person and telehealth delivered ERP are not interchangeable, and clinical expertise paired with family preferences must be considered when determining which modality is optimal for treating childhood OCD.
This systematic review examined the assessment of Character Strengths (CS) and related outcome variables in autistic people across the lifespan. 9 quantitative and 7 qualitative studies from five databases met full inclusion criteria. Parent/carer reported children’s CS using open-text questions (e.g., describe “best things” about your child) and questionnaires analogous to CS framework. Autistic adults used self-report measures such as the Values-in-Action Survey, or Temperament and Character Inventory. Parent/carer reports of CS in autistic children and young people mostly included Humanity strengths (e.g., Love, Kindness), whereas autistic adults’ self-report endorsed a greater diversity of CS (e.g., Fairness, Curiosity, Honesty). Only six studies explored the association between CS and wellbeing/life satisfaction. The use of CS-specific assessment tools in autism research is limited to date. Centred around autistic voices, future research can triangulate information from multiple informants across different contexts to further explore environmental barriers and facilitators for CS development over time, to create more opportunities for authentic strengths expression.
Since the term Tourettic OCD (TOCD) was first introduced, a growing body of research has investigated the ways in which chronic tic disorders like Tourette Syndrome (TS) and obsessive-compulsive disorder (OCD) overlap versus remain distinct. This brief review attempts to delineate findings across phenomenology and neurobiology as well as the implications results hold for TOCD assessment and treatment. Clinically, along with earlier age of onset and male predominance, the hallmark of TOCD is complex repetitive behaviors that blend premonitory sensations distinctive of tics with the “just right” anxious drives found in OCD. Neurobiologically, TOCD likely arises from dysfunction in the cortico-striato-thalamo-cortical (CSTC) circuits with neuroimaging indicating distinct but overlapping circuitry involvement compared to TS and OCD alone, adding credence to TOCD as a unique entity. Current assessment recommendations emphasize the flexible integration of established evidence based tools for TS and OCD with newer instruments that assess the range and purpose of sensory phenomena. Similarly, interventions for TOCD benefit from the blending of behavior and pharmaco-therapies for tics and OCD, with the goal of flexibly adapting techniques in an individualized manner. Taken together, current research indicates a growing recognition of TOCD as a distinct disorder with unique clinical characteristics and neurobiology. Optimal assessment and treatment approaches are still being developed with current recommendations being multi-modal in nature. Future directions point towards work on establishing formal diagnostic criteria and specific and tailored assessment and treatment protocols for TOCD.
To describe clinical strategies that can be used to enhance motivation and treatment engagement for clinicians conducting cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) for pediatric obsessive-compulsive disorder (OCD). Motivational enhancement has recently been highlighted as a key contributor to treatment outcome for pediatric patients undergoing ERP for OCD. Pediatric OCD is a chronic and impairing condition, often treated with ERP, the gold-standard behavioral intervention. While ERP is effective, its success depends heavily on engagement and adherence, which can be difficult for youth who struggle with motivation, insight, or family-related barriers. Research has increasingly focused on methods to enhance motivation in pediatric ERP, with clinical strategies such as developmentally tailored engagement methods, systemic family interventions to reduce family accommodation (FA), intensive and/or technology-enhanced delivery formats, and integration of motivational interviewing (MI) and other adjunctive treatments demonstrating efficacy and effectiveness in improving treatment outcome.
