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.

PURPOSE:This study examined emotion word production on the augmentative and alternative communication devices of nonspeaking school-age autistic children classified as emerging communicators. METHOD:Emotion word vocabulary data were collected by enabling data logging on the augmentative and alternative communication devices of 11 autistic school-age children between 8-10 years of age over an 18-week period. We calculated the type and frequency of emotion words produced on participant's devices and compared the result to a previous research study investigating emotion word production in typically-developing children between 15 and 47 months of age and their mothers. RESULT:Data logging revealed that eight different emotion words (angry, excited, frustrated, happy, mad, proud, sad, and scared) were produced on participants' augmentative and alternative communication devices over the course of 126 days. The majority of these eight words emerge relatively early in development, and five of the words overlapped with the eight emotion words produced most frequently by the typically-developing children and mothers in previous research. CONCLUSION:Overall, emotion words were produced in low frequencies on the participants' devices. Limited production of emotion words on children's augmentative and alternative communication devices (whether it be modelling by an adult or child production) will most likely slow acquisition of these complex words.

Clinical and translational research is important for health care and the growth of medical specialties. Physical medicine and rehabilitation offers many opportunities for research, but research growth in physical medicine and rehabilitation is lacking, and research resources and productivity vary across academic physical medicine and rehabilitation departments across North America. The Physiatric Research Consulting Program was developed by the Association of Academic Physiatrists to provide customized recommendations to enhance research capacity and productivity in physical medicine and rehabilitation departments. This report outlines the three components of the Physiatric Research Consulting Program, including a previsit needs assessment, an in-person visit, and a postvisit follow-up final report. The report also provides a qualitative assessment of the impact of the Physiatric Research Consulting Program, with general themes of feedback, site visit evaluations, and final report evaluations. The Physiatric Research Consulting Program was found to be valuable in identifying gaps and needs for physical medicine and rehabilitation departments, providing outside perspectives, and energizing faculty toward research growth in their departments.

PURPOSE:Vocabulary selection is a critical aspect of augmentative and alternative communication implementation, but there is no clear consensus on best practices in this area. Given that experience and training have been found to impact a range of practices within augmentative and alternative communication, this study aimed to understand the impact that experience and pre-service training in one country may have on vocabulary selection and implementation for early symbolic communicators who use augmentative and alternative communication through an online survey. METHOD:One hundred seventy-six US speech-language pathologists with their certificate of clinical competence completed a survey exploring how they select and implement vocabulary training for early symbolic communicators. RESULT:The majority of speech-language pathologists (n = 172; 98%) reported that vocabulary selection is important and that caregivers should be involved with vocabulary selection (n = 169; 97%). The majority of speech-language pathologists use Just-In-Time programming (n = 112; 64%), modelling (164; 95.4%), and core vocabulary approaches (n = 150; 85.7%). CONCLUSION:Speech-language pathologists with more years of experience reported training teachers on Just-In-Time programming significantly more than those with less experience. Speech-language pathologists train stakeholders (i.e. caregivers, teachers, other support staff) in implementation strategies they are most comfortable with and train others more consistently as they gain experience.

Purpose: Linguistic entrainment (i.e., increasing linguistic similarity over time) and its positive social effects are well documented among non-autistic communicators. This study sought to, first, investigate the extent of syntactic and semantic entrainment between communication partners with matched or mixed autism status (i.e., autistic and non-autistic) and, second, explore how entrainment influences rapport development for autistic and non-autistic communicators. Method: Thirty-three autistic adults and 37 non-autistic adults were paired in either a matched or mixed condition. Pair interactions, involving two structured communication tasks (Twenty Questions and tangram identification) via video-conference, were transcribed and analyzed for syntactic and semantic entrainment. Participants also completed a survey about the rapport they experienced in the interaction. Results: Matched autistic pairs exhibited greater overall syntactic convergence across the full interaction than matched non-autistic pairs, although no significant group differences emerged at the task level. For both autistic and non-autistic participants, greater syntactic convergence was associated with stronger rapport development. For semantic convergence, the results differed: Mixed pairs significantly diverged from each other. In contrast, matched pairs showed no significant change in semantic alignment-neither converging nor diverging. Conclusions: The findings suggest that autistic communicators engage in effective linguistic entrainment through a cumulative alignment process that unfolds over the full interaction rather than within isolated tasks. This study challenges common assumptions about autistic communication based on mixed interactions and highlights the importance of considering matched-autistic communication contexts. It also supports the double empathy theory, which emphasizes mutual understanding between neurotypes, and suggests that autistic communicators possess unique strengths in interpersonal communication.

PURPOSE:Vocabulary access is important for individuals who use augmentative and alternative communication (AAC), especially for children in the early stages of language learning. This study sought to understand how accurate speech-language pathologists (SLPs), teachers, and parents are in predicting the vocabulary needed by early symbolic communicators who use AAC in three contexts. METHOD:Ten groups, each with a child who used AAC as their primary mode of communication and who was classified as an early symbolic communicator and their parent, teacher, and SLP, participated. The parents, teachers, and SLPs predicted a vocabulary list of words children who use AAC needed to participate in a dinner, a math lesson, and a speech session using the blank page method and categorical inventories technique. Children were then recorded in 15-min videos participating in the three contexts. Words were recorded and compared to the words predicted. RESULTS:There was large variability in the accuracy of percentage of words the children used that were predicted by the adults out of all the words the children used. The adults were significantly more accurate predicting the vocabulary for the math lesson than the dinner. CONCLUSIONS:Parents, teachers, and SLPs predicted much of the vocabulary of early symbolic communicators who use AAC. Implications for early vocabulary selection and alternatives to predicting vocabulary are discussed.

PURPOSE:The purpose of this study was to investigate the communication success of partners with matched or mixed neurotypes and to explore how these differences influence the identification of neurotypes during interactions. METHOD:Thirty-three autistic adults and 37 non-autistic adults were paired in either a matched-neurotype or mixed-neurotype condition and were not told their assigned condition. The pairs completed two structured communication tasks (20 questions and tangram identification), for which accuracy and efficiency of completion were measured. Participants completed a survey about rapport in their interactions and their perception of their partner's neurotype. RESULTS:Matched autistic pairs communicated significantly more accurately (p = .037) but significantly less efficiently (p = .047) than matched non-autistic pairs. Mixed-neurotype pairs reported significantly lower rapport than the matched-neurotype pair conditions (p = .023), which did not differ significantly from one another. Matched autistic pairs were significantly more accurate (p = .009) and more confident (p = .035) in their guesses about their partner's neurotype than participants in other conditions. However, participants' guesses were not significantly related to their communication success in the experimental tasks. CONCLUSIONS:Neurotype-matching is associated with stronger rapport development and greater communication success, suggesting that autistic and non-autistic communication styles differ. Autistic participants demonstrated strengths in perceiving others' neurotypes, but communication success factors were not associated with neurotype perceptions.

Purpose: Social media sites provide autistic youth a familiar space to interact that is devoid of many of the challenges that accompany face-to-face interactions. As such, it is important to determine whether the linguistic profiles observed during online interactions are consistent with face-to-face interactions. This preliminary study took a step in this direction by examining gender differences observed in autistic adolescents in an online forum to determine whether they are consistent with the emerging body of research investigating linguistic gender differences in autistic adolescents. Method: We analyzed the entries of self-identified autistic adolescents in an online forum to determine whether autistic girls ( n = 99) and boys ( n = 94) differ in their use of linguistic features as a proportion of total words produced. Transcriptions were coded across discourse, lexical, and semantic features and compared to previous research investigating linguistic gender differences in autistic people. Exploratory comparisons were also made to linguistic gender differences in neurotypical people. Results: Of the linguistic features we examined, three out of four of the gendered usage patterns observed in the online forum language samples were consistent with previous research on face-to-face communication for autistic adolescents. Only one feature out of 12 occurred in the same gender distribution as previous research on neurotypical communication. Conclusions: Autistic girls and boys demonstrate largely consistent gender differences in their language use across in-person and online communication contexts. Interestingly, most of the significant gender differences previously reported in neurotypical communicators were not seen in this sample of autistic adolescents, suggesting that perhaps autistic individuals may linguistically express gender characteristics to a different extent or in a different manner than neurotypical individuals.

OBJECTIVE:The current extent and quality of evidence based practice training for physiatrists is unclear at this time. Training of evidence-based practice is also available to residents in Canada. The extent, quality, and impact of the training were explored. DESIGN:This is a cohort study. RESULTS:About half of the Canadian programs reported a formal evidence-based practice curriculum. The most frequently reported method of providing evidence-based practice education was resident participation in journal club. CONCLUSIONS:Despite the increasing integration of evidence-based practice into residency program education, there remains a critical lack of knowledge and skills for implementation of evidence-based practice into clinical practice among Canadian physical medicine and rehabilitation residency programs.

PurposeCore vocabulary lists are frequently used to select vocabulary for early symbolic communicators who require augmentative and alternative communication (AAC). The current study extended existing work by investigating how core vocabulary lists overlap and diverge from typical language development.MethodWe investigated when the words on seven core vocabulary lists emerge in typical language development, the composition of the lists based on their parts of speech, and how the composition of the words on the lists compare to the MacArthur Bates Communication Development Inventories (CDI).ResultOn average, the words on the seven core vocabulary lists appear after the second year of life in children with typical spoken language development (25, 27, 37, 45, 47, 50, and 66 months). Verbs were the most prevalent part of speech in all but one of the core vocabulary lists. Core vocabulary words made up only a small percentage of words on the CDI.ConclusionThe words on the core vocabulary lists do not emerge until later points in typical lexical development. Focussing on core words when working with early symbolic communicators who require AAC may lead to limited and variable lexicons with wide gaps.

Purpose: Milton's theory of double empathy posits that the difference in communication styles between people of different neurotypes contributes to mutual misunderstandings. The current quasi-experimental study seeks to expand on research indicating that matched neurotype pairs tend to communicate more effectively than mixed neurotype pairs by examining communication across and within neurotypes in an expository language context. Method: Thirty autistic adults and 28 nonautistic adults were paired in either a matched neurotype or mixed neurotype condition. The pairs' interactions involved giving and listening to directions to draw an image. Interactions were recorded, transcribed, and coded for communication accuracy, rate, and clarity. Participants also completed a survey about the rapport they experienced in the interaction. Results: Matched neurotype pairs were significantly more accurate in their communication than mixed neurotype pairs. Rate was fastest among mixed neurotype pairs, but clarity did not differ significantly across conditions. Matched autistic pairs reported significantly lower rapport than other pairs. Conclusions: This finding lends further support to the neurodiversity model by demonstrating that autistic communication is not inherently deficient. Further research is necessary to investigate a variety of influences on rate, clarity, and rapport development. Clinical implications include considerations for neurodiversity-affirming communication supports for expository contexts such as classroom directions or workplace instructions.

Communicative competence for people who use augmentative and alternative communication consists of four interrelated domains: linguistic, strategic, social, and operational. Ongoing assessment and progress monitoring within these domains is crucial to (a) providing information to teach targeted skills in a manner contextualized within the curriculum, (b) determining measurable annual individualized education plan goals, and, ultimately, (c) ensuring maximal participation in the school environment. Currently, language sample analysis (LSA) is one of only three assessment techniques that provide information across each domain of communicative competence for children who use augmentative and alternative communication (AAC). As such, LSA is a valuable tool for assessing communication competence in children who use AAC in the school setting. This clinical forum describes information that may be obtained from an LSA as it relates to each domain of communicative competence and educational standards.

The purpose of this study was to 1) identify and describe the population seeking alternative and augmentative communication (AAC) evaluations at an assistive technology (AT) center in the Midwestern United States and 2) describe the AAC device features or services participants identify as most important at their initial AAC evaluations. Charts of 53 participants seeking AAC interventions at an AT center in the Midwestern United States were retrospectively reviewed. Information from the QUEST 2.0 was used to determine what AT features were identified as most important. The majority of participants seen at the AT center had progressive diseases. Across all of the participants, ease of use and effectiveness were identified as the "most important" aspects of an AAC device satisfaction. These findings highlight the importance of determining who is accessing AAC services across AT centers to determine whether barriers to AAC services exist. Moreover, patients report regarding what variables they deem as most important reflect the fact that excellent service-delivery may not overcome the importance of other variables, such as ease of use that impact AAC use.

Purpose: Intervention studies contribute to evidence-based practice in speech-language pathology. With individuals who use speech-generating devices (SGDs), it is important to determine what vocabulary to teach during intervention. However, it is unclear whether researchers are reporting the vocabulary selection techniques they used in intervention studies so that they may be replicated in clinical practice. The purpose of this scoping review was to examine the vocabulary selection techniques and other aspects of intervention studies focused on vocabulary acquisition in early symbolic communicators who use SGDs. Method: Eight databases (PsycINFO, PubMed, Scopus, Web of Science, Educational Resources Information Center, Linguistics and Language Behavior Abstracts, Educational Research Complete, and CINAHL) were systematically searched for articles that were intervention studies targeting single-word vocabulary acquisition in early symbolic communicators who use SGDs. Data were extracted from each article and charted in Excel. Results: We found 5,405 unique articles, 18 of which met the inclusion/exclusion criteria for this review. All of the studies used a single-case design with three participants on average. Approximately half took place in the child's school, and most of the interventions were conducted by members of the research team. Eight studies targeted requesting or manding, six studies used preference assessments to select vocabulary, and seven articles used adults as informants to select the vocabulary. Conclusions: There are a limited number of studies investigating vocabulary acquisition in early symbolic communicators who use SGDs. Furthermore, the studies inconsistently used a range of methods that align with best practices for vocabulary selection.

Despite emerging awareness of gender diversity in the autistic population, our understanding of autism remains limited to cisgender boys and men. We conducted a scoping review to better understand how structural language skills (i.e. syntax, semantics, narrative) differ across sex/gender within autism, and how gender diversity is incorporated in such research. Five research databases were searched for articles that have autistic participants who were not all male, present quantitative results separated by sex/gender, pertain to structural language, and were published between 2000 and 2021. Twenty-four articles met inclusion criteria. One article demonstrated awareness of gender diversity beyond the binary (i.e. girl, boy). Overall, autistic girls performed better than autistic boys but worse than nonautistic girls. Autistic girls are less likely to share the same quality and magnitude of structural language difficulties as autistic boys, which may contribute to their underdiagnosis. Comparing autistic girls to nonautistic girls is more likely to reveal areas of linguistic difference and potential intervention targets. This research provides further support for developing sex/gender-aware diagnostic and support measures for autism. Broader awareness of gender diversity, as both a concept and a prevalent feature of the autistic population, is essential for researchers to continue learning about sex/gender interactions in autism. Lay abstract Research about autism is mostly about boys and men, even though many autistic people are girls, women, and transgender/nonbinary. We wanted to learn more about how gender interacts with language skills in autistic people, so we reviewed existing research articles on this topic. We also wanted to know how this previous research talked about gender. Included articles had to measure language skills for autistic people of different genders. They also had to be published between 2000 and 2021. Twenty-four articles met these requirements. We found that autistic girls showed better language skills than autistic boys but worse skills than nonautistic girls. This may be one reason that autistic girls are underdiagnosed compared to autistic boys. If we compare autistic girls to nonautistic girls instead, we can see more language differences and possible areas to target in interventions. This study supports the need to create diagnostic and support measures for autism that take gender into account. Also, only one article mentioned autistic people who are transgender or nonbinary. Researchers who want to learn more about gender and autism need to understand gender diversity and recognize that many autistic people are transgender or nonbinary.

Little is known about how well high-tech augmentative and alternative communication (AAC) systems accommodate language variation to meet the needs of people and families who are culturally and linguistically diverse. The purpose of this study was to investigate how high-tech AAC device manufacturers consider language variation and multilingualism in device design and language files, whether there is a difference in the modifications available on default language files on a dedicated AAC device as compared to communication applications on tablets, and the availability of these modifications. A coding schema was developed to assess features available that enabled user modification of default language files across four language domains: semantics, morphosyntax, phonology, and pragmatics. The results indicated that more changes were possible in semantics and phonology on default language files. There were not significant differences between language files offered on a dedicated AAC device or an application on a tablet. There were significant differences in the capabilities of the device to make modifications and in the ease of programming, but not in the resources provided to families. Based on these findings, it appears that device manufacturers have just begun to address the needs of families and users who are culturally and linguistically diverse.

Purpose: Language learning, including on a speech-generating device (SGD), relies on having communication opportunities to use language. Yet, children who use SGDs do not consistently use their devices throughout the day. As a first step towards increasing device use, it is important to determine how the numerous contexts (e.g. recess, lunch, academic) that exist throughout the school day impact the frequency and type of communication opportunities that children have. Within this study, we used complex adaptive systems theory to investigate whether there were differences in how frequently nonspeaking autistic children classified as emerging communicators (i.e. children who do not consistently produce two-word utterances independently and do not communicate for a variety of communicative functions) used their SGDs to communicate and the type of communication they produced (i.e. spontaneous, prompted, or imitation) across different classroom contexts.Method: Fourteen autistic children who use an SGD as their primary mode of communication were videotaped up to nine times throughout different school days. The videos were coded for the type of device use (i.e. whether the child's use of the device was spontaneous, prompted, or imitation) and classroom context, which were categorised by the inherent level of support and directiveness.Result: There was a significant difference in SGD use across classroom contexts. Overall, the children communicated more and engaged in more spontaneous, prompted, and imitated communication in classroom contexts with high levels of structure (e.g. tabletop work) compared to contexts with low levels of structure and directiveness (e.g. free play).Conclusion: This study highlights the need to increase communication opportunities across all school contexts. Creating appropriate communication opportunities in all contexts, especially those with less structure, will help ensure that communication does not become context-bound.

Although outcomes are a critical component of evidence-based practice, measuring augmentative and alternative communication (AAC) outcomes remains problematic. This is, in part, because there is no consensus on how to operationally define AAC communication outcomes. To gain greater insight into AAC communication outcomes, we used the communicative competence framework to determine which areas of AAC intervention have received the greatest attention and how these outcomes are being measured. The following data were charted from the 77 studies that met the inclusion criteria for the scoping review: study design, study participants, study communication target (e.g., language, word learning, etc.), and communication outcome measurements. Across the included studies, researchers used a variety of standardized and non-standardized measures to assess outcomes. Seventy-seven percent of the studies assessed social skills and 62% assessed linguistic skills. A limited number of studies measured operational (14%), strategic (4%), and psychosocial (18%) skills. Using the communicative competence framework enabled us to identify gaps in the research that has been conducted to date.

Purpose: Knee osteoarthritis (KOA) is twice as likely to occur in post-menopausal women than in men. However, most animal studies aimed at characterizing KOA use male mice. Female mice spontaneously rejuvenate their ovarian follicles in middle-age, thus in the few studies including females, menopause is typically not considered. When KOA has been studied in the context of menopause, young animals subjected to ovariectomy (OVX) has been the most commonly used model. However, OVX results in hormonal changes that do not occur with natural menopause, including an abrupt drop in estrogen compared to the more gradual decline seen in human menopause.