Social Communication Disorder Research Articles

Transdiagnostic considerations are critical to understanding childhood neurodevelopmental disorders

Growing dissatisfaction with the current categorical diagnostic systems has led to a movement toward transdiagnostic dimensional approaches to assessment of childhood mental health disorders. We argue that a transdiagnostic approach is especially important and appropriate when screening for neurodevelopmental disorders during early childhood. In the early childhood years, symptoms often appear in the form of developmental delays that could portend a variety of different disorders. Early intervention at this point is critical, even though a final endpoint disorder is not yet apparent. Intervening early has the potential to grow the area of weakness, possibly correcting or at least ameliorating these delays. Early intervention requires a multidisciplinary approach integrating efforts across settings and providers that monitor the development of young children. We argue here that young children’s language ability is central to the development of social cognition, and a prerequisite for adequate social functioning. Social deficits are defining features of a subset of neurodevelopmental disorders such as autism spectrum disorder and social (pragmatic) communication disorder. Critically, impairment in social functioning is common in additional neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD), learning disorders, and even motor disorders. For this reason, we argue that, at the earliest sign of a possible neurodevelopmental disorder, children should be screened for language deficits prior to initiating a focused assessment for a specific type of neurodevelopmental disorder such as ADHD. Any detected language deficits should be considered in the design and implementation of the assessment, as well as the ultimate intervention plan.

“Do You Know Where the Dragons Are?” - Introducing a Novel Enactive Framework to Map the Wide Unknown of Social Spaces With Neurodivergent Young People

Experiences of being are fundamentally different for neurodivergent young people. Differences in brain connectivity and function conferred by neurodivergence give rise to differences in construal processes underlying intersubjective engagement and shared meaning. Normative therapeutic and educational interventions refer to ‘social communication disorders’, ‘cognitive inflexibility’ and ‘social anxiety’. Peers call them ‘weird’. Parents struggle with guilt, exasperation and despair. The world demands social conformity. “Toby” (11yrs) requested a map and sword to slay the fearsome dragons lurking in the unknown spaces between himself and others- between here and there; intention and action; words and meaning; friend and foe. This paper describes a contextualizing model in a novel systematized approach to meeting the social engagement challenges of neurodivergent young people, devised in collaboration with those young people as Experts by Experience. The approach was formulated on the principle that social competence in neurodivergence should be shaped around self- discovery of authentic modes of being and relating, rather than imposed normative criteria. The 12 Social Spaces model integrates theoretical and clinical principles of Personal Construct Psychology, Enactivism, play theory, neurocognition and social competence, to provide a contextualizing framework of twelve interactional spaces to scaffold social cognition during evolving play between neurodivergent young people.

How language affects social cognition and emotional competence in typical and atypical development: A systematic review.

The ability to understand the mental state of others (social cognition), as well as language, is crucial for children to have good social adaptation. Social cognition (SC) has been shown to be a hierarchical model of three factors (Cognitive, intermediate and affective SC) interrelated with linguistic processes. Children on the autism spectrum and children with developmental language disorder (DLD) or social communication disorder (SCD) manifest language and SC difficulties, albeit in different ways. This systematic review aims to find how language and SC interact with each other and identify linguistic and socio-affective profiles in the target population. About 1593 articles were systematically reviewed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide in November 2022, obtaining, through inclusion/exclusion criteria, a total of 38 articles for qualitative assessment. The majority of them were on autism (26) or DLD (14) and to a lesser extent SCD (3). Although SC is related to all components of language, SC is strongly related to narrative and morphosyntax and partially related to lexicon. Pragmatics shows a complex relation with SC due to greater sensitivity to other factors such as age or task, and prosody appears to be more related to emotional processes. Besides, autistic, SCD and DLD children showed differences in their language and socio-affective performance. Mainstream DLD children have lower performance in general language, where autistic and SCD children have more linguistic variation and are lower in pragmatic and SC tasks, SCD children being more associated with language production difficulties and autistic children with both receptive and productive language. Each language component has a different interaction with SC. Likewise, different linguistic profiles are partially found for each disorder. These results are important for future lines of research focusing on specific components of interaction and socio-emotional processes, as well as for clinical and educational treatment. What is already known on the subject The hierarchical model of Schurz etal. (2021), divide social cognition into three brain constructs: cognitive social cognition (CSC), affective social cognition (ASC) and intermediate social cognition (ISC). They observe a large relationship between language and ISC, a fact that has been corroborated with some other studies. Studies have also found lower linguistic and socio-affective abilities in children with autism and language and communication disorders compared with children with neurotypical development, and large behavioural and neurocognitive overlaps between these disorders (Durrleman etal., 2019; Löytömäki etal., 2019). What this paper adds to existing knowledge This is the first review that relates all linguistic components (narrative, lexicon, morphosyntax, pragmatic and prosody) with the three constructs of social cognition (Cognitive, intermediate and affective). Moreover, it is the first review that studies the socio-linguistic factors comparing autism, developmental language disorder and social communication disorder with each other and with neurotypical development in children aged from 4 to 9 years. What are the potential or actual clinical implications of this work? Understanding how language and social cognition interact with each other in autism spectrum disorder, developmental language disorder and social communication disorder allows us to trace socio-linguistic profiles for each of the studied disorders, understand better children with these difficulties, and, with this, find specific potential intervention points to improve and prevent these difficulties.

Evaluation of SNP in the CDH8 and CDH10 Genes Associated with Autism Using In-Silico Tools

Autism spectrum disorder (ASD) is defined as a pervasive and multifactorial neurodevelopmental disorder (ND). It is characterized by repetitive behavioral patterns as well as symptoms of social interaction and communication disorder. The cadherin (CDH) superfamily is a large group of synaptic cell adhesion molecules and has been widely related with ND, including autism. The aim of this study is to evaluate the potentially deleterious missense single nucleotide polymorphisms (SNPs) in CDH8 and CDH10 genes, which are related with ASD and cause amino acid changes, using internet-based software tools. To identify potentially harmful missense SNPs; all SNPs were screened using SIFT, PolyPhen-2, PROVEAN, SNPs&GO, Meta-SNP, and SNAP2 software tools, and common deleterious ones were filtered out. Its effect on protein stabilization was investigated with I-Mutant 3.0 and MUpro tools. Three-dimensional models of these common damaging amino acid changes were evaluated with the HOPE software. As a result of in silico analysis of 577 missense SNPs in the CDH8 gene; The rs145143780 (Y572C) polymorphism common damaging ‎SNP has been detected by all software tools.‎ According to the results of the in silico analysis of 526 missense SNPs found in the CDH10 gene; The rs13174039 (V459G), rs147882578 (N485K), rs201423740 (Y306C), rs201956238 (F317L) and rs373340564 (R128C) common damaging SNPs have been identified in all polymorphisms by all software tools. As a result of this study, it is thought that the data obtained will make important contributions to future relevant experimental studies.

Are Communication Skills, Emotion Regulation and Theory of Mind Skills Impaired in Adolescents with Developmental Dyslexia?

ABSTRACT This study investigates pragmatic language impairment, Theory of Mind (ToM), and emotion regulation in adolescents with Developmental Dyslexia(DD). The Social Responsiveness Scale-2(SRS) and Children’s Communication Checklist-2(CCC-2) scores were found to be statistically significantly higher in the DD group than in healthy controls. DD group had lower performance in ToM skills and they have more difficulties in emotion regulation. We also found that CCC-2 and ToM scores were significantly correlated in adolescents with DD. These results may be important in understanding the difficulties experienced in social functioning and interpersonal relationships in adolescents with DD.

STRATEGI PEMBELAJARAN BAHASA ARAB BAGI ANAK BERKEBUTUHAN KHUSUS DI KELAS II SD ISLAM AL MADANI BANJARBARU

This study is a qualitative descriptive field study focusing on Arabic learning strategies for children with special needs with social communication disorders in grade II by SD Islam Al Madani Banjarbaru. The data in this study are data related to Arabic learning strategies for children with special needs and the data source is SD Islam Al Madani grade II Arabic language teachers and special tutors Banjarbaru. Data collection techniques include observation, interview, and note-taking. The results of this study in which Arabic teachers used Arabic learning strategies for children with social communication disorders in Grade II of Al Madani Islamic Primary School applied the CTL strategy and Collaborative learning strategy with an orientation towards teacher creativity and the use of diverse and creative media. The barriers that teachers face when teaching Arabic are the environment that does not support learning during the day as well as psychological and emotional factors for children with special needs when feelings of guilt and anxiety arise bad mood.

Decreased amygdala-sensorimotor connectivity mediates the association between prenatal stress and broad autism phenotype in young adults: Project Ice Storm

Studies show that prenatal maternal stress (PNMS) is related to risk for child autism, and to atypical amygdala functional connectivity in the autistic child. Yet, it remains unclear whether amygdala functional connectivity mediates the association between PNMS and autistic traits, particularly in young adult offspring. We recruited women who were pregnant during, or within 3 months of, the 1998 Quebec ice storm crisis, and assessed three aspects of PNMS: objective hardship (events experienced during the ice storm), subjective distress (post-traumatic stress symptoms experienced as a result of the ice storm) and cognitive appraisal. At age 19, 32 young adults (21 females) self-reported their autistic-like traits (i.e., aloof personality, pragmatic language impairment and rigid personality), and underwent structural MRI and resting-state functional MRI scans. Seed-to-voxel analyses were conducted to map the amygdala functional connectivity network. Mediation analyses were implemented with bootstrapping of 20,000 resamplings. We found that greater maternal objective hardship was associated with weaker functional connectivity between the left amygdala and the right postcentral gyrus, which was then associated with more pragmatic language impairment. Greater maternal subjective distress was associated with weaker functional connectivity between the right amygdala and the left precentral gyrus, which was then associated with more aloof personality. Our results demonstrate that the long-lasting effect of PNMS on offspring autistic-like traits may be mediated by decreased amygdala-sensorimotor circuits. The differences between amygdala-sensory and amygdala-motor pathways mediating different aspects of PNMS on different autism phenotypes need to be studied further.

Friendship interventions for children with neurodevelopmental needs: A systematic review and meta-analysis

Rationale Children with neurodevelopmental disorders such as attention-deficit hyperactivity disorder (ADHD), autism, developmental language disorder (DLD), intellectual disability (ID), and social (pragmatic) communication disorder (SPCD) experience difficulties with social functioning due to differences in their social, emotional and cognitive skills. Previous systematic reviews have focussed on specific aspects of social functioning rather than broader peer functioning and friendships. Objective To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that measured friendship outcomes for children with ADHD, autism, DLD, ID, and SPCD. Method Following PRISMA guidelines, we searched five electronic databases: CINAHL, Embase, Eric, PsycINFO, and PubMed. Two independent researchers screened all abstracts and disagreements were discussed with a third researcher to reach consensus. The methodological quality of studies was assessed using the Cochrane Risk of Bias Tool for Randomised Trials. Results Twelve studies involving 15 interventions were included. Studies included 683 children with a neurodevelopmental disorder and 190 typically-developing children and diagnosed with either autism or ADHD. Within-group meta-analysis showed that the pooled intervention effects for friendship across all interventions were small to moderate (z = 2.761, p = 0.006, g = 0.485). The pooled intervention effect between intervention and comparison groups was not significant (z = 1.206, p = 0.400, g = 0.215). Conclusion Findings provide evidence that some individual interventions are effective in improving social functioning and fostering more meaningful friendships between children with neurodevelopmental disorders and their peers. Effective interventions involved educators, targeted child characteristics known to moderate peer functioning, actively involved peers, and incorporated techniques to facilitate positive peer perceptions and strategies to support peers. Future research should evaluate the effectiveness of friendship interventions for children with DLD, ID and SPCD, more comprehensively assess peer functioning, include child self-report measures of friendship, and longitudinally evaluate downstream effects on friendship.

Adult Phenotype of SYNGAP1-DEE.

SYNGAP1 variants are associated with rare developmental and epileptic encephalopathies (DEEs). Although SYNGAP1-related childhood phenotypes are well characterized, the adult phenotype remains ill-defined. We sought to investigate phenotypes and outcomes in adults with SYNGAP1 variants and epilepsy. Patients 18 years or older with DEE carrying likely pathogenic and pathogenic (LP/P) SYNGAP1 variants were recruited through physicians' practices and patient organization groups. We used standardized questionnaires to evaluate current seizures, medication use, sleep, gastrointestinal symptoms, pain response, gait, social communication disorder and adaptive skills of patients. We also assessed caregiver burden. Fourteen unrelated adult patients (median: 21 years, range: 18-65 years) with SYNGAP1-DEE were identified, 11 with novel and 3 with known LP/P SYNGAP1 de novo variants. One patient with a partial exon 3 deletion had greater daily living skills and social skills than others with single-nucleotide variants. Ten of 14 (71%) patients had drug-resistant seizures, treated with a median of 2 antiseizure medications. All patients (100%) had abnormal pain processing. Sleep disturbances, social communication disorders, and aggressive/self-injurious behaviors were each reported in 86% of patients. Only half of adults could walk with minimal or no assistance. Toileting was normal in 29%, and 71% had constipation. No adult patients could read or understand verbal material at a sixth-grade level or higher. Aggressive/self-injurious behaviors were leading cause of caregiver burden. The oldest patient was aged 65 years; although nonambulant, she had walked independently when younger. Seventy-one percent of patients with SYNGAP1-DEEs continue to have seizures when adults. Nonseizure comorbidities, especially aggression and self-injurious behaviors, are major management challenges in adults with SYNGAP1-DEE. Only 50% of adults can ambulate with minimal or no assistance. Almost all adult patients depend on caregivers for many activities of daily living. Prompt diagnostic genetic testing of adults with DEE can inform clinical care and guide outcomes of precision therapies.

Usefulness of the autism spectrum quotient (AQ) in screening for autism spectrum disorder and social communication disorder

Abstract Background In the Diagnostic and Statistical Manual and Mental Disorders, Fifth Edition (DSM-5), autism spectrum disorder (ASD) and social (pragmatic) communication disorder (SCD) were described as a new category of psychiatry nosography. SCD involves impairments in social communication and social interaction but not restricted, repetitive patterns of behavior, interests, or activities. The autism spectrum quotient (AQ) was developed to screen for autism tendencies in adults with normal intelligence. However, AQ cutoff scores for screening ASD and SCD in the DSM-5 have not been established. This study examined whether the Japanese version of the AQ (AQ-J) total scores could discriminate between an ASD group, an SCD group, and a neurotypical (NT) group. Methods Participants were 127 ASD patients, 52 SCD patients, and 49 NT individuals. Receiver operating characteristic (ROC) analyses were used to examine AQ-J total score cutoff values to distinguish between ASD and NT groups, SCD and NT groups, and ASD and SCD groups. Results In the ROC analysis for the ASD and NT groups, the area under the curve (AUC) was 0.96, and the optimum cutoff value was 23 points (sensitivity 92.9%, specificity 85.7%). The AUC for the SCD and NT groups was 0.89, and the optimum cutoff value was 22 points (sensitivity 84.6%, specificity 85.7%). The AUC for the ASD and SCD groups was 0.75; the optimum cutoff value was 32 points (sensitivity 67.7%, specificity 71.2%). Conclusion Our findings suggest the usefulness of the AQ-J in screening for ASD and SCD.

An Exploratory Study of Pragmatic Language Use Across Contexts With the Pragmatic Rating Scale-School Age Among Autistic Boys and Boys With Fragile X Syndrome Plus Autism.

Autistic boys and boys with co-occurring fragile X syndrome and autism spectrum disorder (FXS + ASD) demonstrate similar pragmatic language difficulties. The Pragmatic Rating Scale-School Age (PRS-SA) captures ecologically valid metrics of pragmatic language impairments in these populations. It is traditionally scored based on the Autism Diagnostic Observation Schedule (ADOS), which may limit the use of the PRS-SA more broadly in research and clinical contexts. This study evaluated the feasibility of the PRS-SA based on a shorter, semistructured conversational context compared to the ADOS in school-age autistic boys (n = 16) and boys with FXS + ASD (n = 16), matched on ASD traits. Differences across ADOS and conversational contexts and associations with ASD-related social difficulties were evaluated. Findings revealed differences in PRS-SA scores between ADOS and conversational contexts, but only for the FXS + ASD group. Limited associations were observed between PRS-SA scores and ASD traits. Results from this study indicate the feasibility of using the PRS-SA in a shorter conversational context than the ADOS to assess pragmatic language among autistic boys. For boys with FXS + ASD, contextual differences warrant careful consideration in future work.

Speech-Language Pathologists' Implementation of Theory of Mind Concepts Within Therapy: An Exploratory Survey

Purpose: Understanding others' mental states including thoughts (cognitive theory of mind [ToM]) and feelings (affective ToM) is an important component of communication, particularly for individuals with communication challenges. Speech-language pathologists (SLPs) are critical members of the team that supports these individuals; however, little is currently known about how SLPs approach therapy involving ToM components. This exploratory study seeks to establish foundational knowledge about the current practices SLPs use when incorporating ToM. Method: SLP participants completed an online survey ( N = 86) that asked about their incorporation of ToM topics and skills into therapy with a focus on literacy activities. Results: All SLPs reported working on ToM topics to some extent, most frequently on emotional awareness in the self and others and to a lesser extent on understanding others' thoughts. They reported targeting ToM components with different clinical populations: mostly individuals with autism spectrum disorder and social communication disorder, but also those with expressive/receptive language disorders and preschool-age students. The majority of SLPs reported using books to work on ToM skills. We provide a summary of the various features of books that SLPs used in the selection process and with their reported relative importance. Conclusions: Many SLPs reported working on affective ToM and to a lesser extent cognitive ToM with children who have a variety of communication needs. Children's books were a common way in which many SLPs targeted a variety of communication goals in addition to perspective-taking or ToM topics. Understanding the current implementation of ToM topics in therapy can help guide neurodiversity-affirming intervention and literacy practices for currently practicing SLPs. Supplemental Material: https://doi.org/10.23641/asha.24175557

Exploring the Gender Differences in Various Mental Health Problems of Adolescents

Since society has growing demands on young people, the mental health of adolescents is very important in the current society. This article reviews the causes, gender differences, and effects of four psychological issues among adolescents including anxiety disorders, depression, social communication disorders, and Attention deficit hyperactivity disorder (ADHD). The study reveals that among adolescents, girls are more likely than boys to experience the three mental health issues of social disorders, depression, and anxiety, while boys are more likely to experience ADHD. Moreover, this paper analyzes three areas: family, school, and government to discuss the solution for improving these issues and the current situation. Therefore, after reviewing previous literature and summarizing their findings, this paper contributes to emphasizing that girls have more probabilities to suffer from mental health problems than boys, thereby calling for society to pay more attention and offer more help to girls. Future research can work on how to reduce these conditions and propose some applicable solutions.

Exploratory Factor Analysis of the Social Communication Disorder Screener.

Currently, there are no existing measures to screen for or diagnose Social (Pragmatic) Communication Disorder (SPCD). We conducted an exploratory factor analysis (EFA) of the Social Communication Disorder Screener (SCDS), a 14-item, parent-report measure based on the DSM-5 diagnostic criteria for SPCD. This EFA examined the internal consistency and factor structure of the SCDS for a sample of 500 parents of children, ages 5-18 years, representative of the U.S. census. Results yielded a correlated three-factor solution with good internal consistency reliability. Findings supported the presence of three subscale as well as the derivation of a total composite score reflecting overall verbal and non-verbal communication and limitations across contexts. Clinical and research implications are discussed.

The gendered framing of language impairments in criminalised young people

Young people whose language performance does not meet socially expected standards are overrepresented in the criminal justice system. Pragmatic language skills encompass the social aspects of language, which include constructing narratives, the rules of conversations, turn-taking, topic management, and non-verbal communication. Current research on pragmatic language impairments in criminalised young people – that is, on their symptomatic difficulties with social communication and language – remains inconclusive. The purpose of this study is to uncover the perceptions and framing of pragmatic language impairments in a sample of studies involving boys and girls from Australia and the United States. Drawing on content analysis of a sample of pertinent research, we expose the deeply gendered framing of pragmatic language performance and associated behaviours of criminalised young people. We demonstrate that available studies often represent female participants’ problematised use of pragmatic language as a personal choice, thus locating the problem within the individual and responsibilising girls and young women. However, for male participants, current research often presents problematised use of pragmatic language as a consequence of institutional failures. We argue that this gendered framing has political implications for criminalised young people and future research.

Pragmatic Language Impairment: A Scientometric Review

Pragmatic language impairment (PLI) is a complex and wide-ranging condition affecting numerous individuals worldwide, yet its exact prevalence and scope remain uncertain due to its interconnections with other conditions and symptoms, such as neurodevelopmental disorders, learning disabilities, developmental dysphasia, and aphasia. This study presents a comprehensive review of PLI, tracing its historical, current, and future trajectories through the lens of both bibliometric and scientometric indicators. The study analysed a substantial corpus of 3852 documents related to PLI, including sources from Scopus, Web of Science, and Lens, spanning the period from 1977 to 2022. This investigation utilised advanced software tools such as CiteSpace 5.8.R3 and VOSviewer 1.6.18 to detect patterns, connections, and bursts in scholarly works related to PLI. Key findings of this review include the identification of major clusters in the PLI literature, which include social communication disorder, traumatic brain injury, autism spectrum disorder, and inferential meaning. These clusters represent significant sub-themes within the PLI research body, with repetitive mentions of autism spectrum disorder suggesting its critical overlap with PLI. Other noteworthy clusters included Asperger’s syndrome, behavioural problems, belief reports, and diagnostic observation schedule scores, all of which contribute to the nuanced understanding of PLI. The study provides a comprehensive overview of PLI development, drawing on theoretical, historical, and empirical evidence.

A Comparative Analysis of the Full and Short Versions of the Social Responsiveness Scale in Estimating an Established Autism Risk Factor Association in ECHO: Do we Get the Same Estimates?

Prior work developed a shortened 16-item version of the Social Responsiveness Scale (SRS), a quantitative measure of social communication and autism spectrum disorder (ASD)-related traits. However, its properties for use in risk factor estimation have not been fully tested compared to the full SRS. We compared the associations between gestational age (previously established risk factor for ASD) and the 65-item "full" and 16-item "short" versions of the SRS to test the shortened version's ability to capture associations in epidemiologic analyses of ASD risk factors. We used data from participants in the Environmental influences on Child Health Outcomes (ECHO) Program (n = 2,760). SRS scores were collected via maternal/caregiver report when children were aged 2.5-18 years. We compared estimates of associations between gestational age and preterm birth between the full and short SRS using multivariable linear regression, quantile regression, and prediction methods. Overall, associations based on full and short SRS scores were highly comparable. For example, we observed positive associations between preterm birth with both full ([Formula: see text]=2.8; 95% CI [1.7, 4.0]) and short ([Formula: see text]=2.9; 95% CI [1.6, 4.3]) SRS scores. Quantile regression analyses indicated similar direction and magnitude of associations across the distribution of SRS scores between gestational age with both short and full SRS scores. The comparability in estimates obtained for full and short SRS scores with an "established" ASD risk factor suggests ability of the shortened SRS in assessing associations with potential ASD-related risk factors and has implications for large-scale research studies seeking to reduce participant burden.

Systematically Identifying Communication Deficits in Youth Under Psychiatric Care Through a Self-Report Scale

Background: Communication disorders are associated with psychopathology and social distress in adolescents, yet moderate or less severe deficits often go undiagnosed. Data from a quality improvement initiative was analyzed from the Communication Perception Estimate Scale (CoPES), a self-report scale for receptive-expressive and pragmatic language deficits in youth receiving mental health services. Objective: To identify the frequency of communication deficits (CDs) among youth in psychiatric care and identify patterns of self-reported symptoms. The scale may be used as a clinical screening tool for Language disorder and Social (Pragmatic) communication disorder. Methods: CoPES is a 31-item scale administered to 318 adolescents 11-18 years old, asking questions about receptive-expressive and pragmatic CDs. In the first 12 items, subjects identified the frequency of communication disorder symptoms using a forced-choice scale; in the following items, frustration with CDs, yes or no for earlier intervention, and current interest in getting help for CDs. Respondents are from five representative clinical services. Results: Patients were divided into self-identified groups: 14.5% significant Receptive-Expressive deficits only (R-ED); 6.6% significant Pragmatic deficits only (PD); 29.9% Both significant Receptive-Expressive and Pragmatic deficits (BCD); and 49.1% with limited or no deficits (NCD). The R-ED group expressed high rates of frustration and requests for help with Receptive-Expressive deficits. The PD group reported elevated rates of frustration in both areas. The BCD group indicated significantly more frustration and requests for help with both language areas compared to the NCD group. Conclusion: This data supports the need for greater awareness and consideration of communication disorders in youth presenting for psychiatric care.

The effect of physical exercise on disordered social communication in individuals with autism Spectrum disorder: a systematic review and meta-analysis of randomized controlled trials.

The aim of this systematic review and meta-analysis was to systematically investigate the intervention effect of physical exercise on disordered social communication in patients with autism spectrum disorders. This systematic review and meta-analysis used the PubMed, Web of Science, the Cochrane Library, and Embase electronic databases to conduct a systematic search of literature describing randomized controlled trials (RCTs) on the effect of physical exercise on disordered social communication in autistic patients from the first year of inclusion to 21 January 2023. A total of 14 RCTs including 460 autistic patients were analyzed. A meta-analysis showed that physical exercise had a positive effect on social communication disorder (SMD = 0.45, 95% CI: 0.15, 0.74, p < 0.05) in autistic patients. Subgroup analysis showed that exercise programs with multiple components (SMD = 0.73, 95% CI: 0.39, 1.06, P < 0.001), a moderate duration (SMD = 0.73, 95% CI: 0.38, 1.08, P < 0.001), a moderate-high frequency (SMD = 0.84, 95% CI: 0.53, 1.14, P < 0.001), and a long duration (SMD = 0.77, 95% CI: 0.36, 1.18, P < 0.001) led to significant improvement. Physical exercise can improve disordered social communication in patients with autism spectrum disorders. Specifically, early intervention, multi-component exercise, a moderate period, moderate and high frequency, long duration, and multi-participant programs were most effective. https://www.crd.york.ac.uk/prospero/ RecordID= CRD42023422482.

Should social pragmatic communication disorder be included in DSM-5? On uncertainties, pragmatic considerations, and the psychiatric kind debate

Should social pragmatic communication disorder be included in DSM-5? On uncertainties, pragmatic considerations, and the psychiatric kind debate