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Autism has attracted a great deal of attention in recent years, thanks to dramatically increasing rates of diagnosis, extensive organizational mobilization, journalistic coverage, biomedical research, and clinical innovation. Understanding Autism, a social history of the expanding diagnostic category of this contested illness, takes a close look at the role of emotion--specifically, of parental love--in the intense and passionate work of biomedical communities investigating autism.

Purpose: The need for community-viable, evidence-based intervention strategies for toddlers with autism spectrum disorder (ASD) is a national priority. The purpose of this research forum article is to identify gaps in intervention research and needs in community practice for toddlers with ASD, incorporate published findings from a randomized controlled trial (RCT) of the Early Social Interaction (ESI) model (Wetherby et al., 2014) to illustrate community-based intervention, report new findings on child active engagement from the ESI RCT, and offer solutions to bridge the research-to-community practice gap. Method: Research findings were reviewed to identify gaps in the evidence base for toddlers with ASD. Published and new findings from the multisite ESI RCT compared the effects of two different ESI conditions for 82 toddlers with ASD to teach parents how to support active engagement in natural environments. Results: The RCT of the ESI model was the only parent-implemented intervention that reported differential treatment effects on standardized measures of child outcomes, including social communication, developmental level, and adaptive behavior. A new measure of active engagement in the natural environment was found to be sensitive to change in 3 months for young toddlers with ASD and to predict outcomes on the standardized measures of child outcomes. Strategies for utilizing the Autism Navigator collection of web-based courses and tools using extensive video footage for families and professional development are offered for scaling up in community settings to change developmental trajectories of toddlers with ASD. Conclusions: Current health care and education systems are challenged to provide intervention of adequate intensity for toddlers with ASD. The use of innovative technology can increase acceleration of access to evidence-based early intervention for toddlers with ASD that addresses health disparities, enables immediate response as soon as ASD is suspected, and rapidly bridges the research-to-practice gap.

A recent approach to identifying early markers of risk for autism spectrum disorder (ASD) has been to study infants who have an older sibling with ASD. These infants are at heightened risk (HR) for ASD and for other developmental difficulties, and even those who do not receive an eventual ASD diagnosis manifest a high degree of variability in trajectories of development. The primary goal of this review is to summarize findings from research on early motor and communicative development in these HR infants. This review focuses on 2 lines of inquiry. The first assesses whether delays and atypicalities in early motor abilities and in the development of early communication provide an index of eventual ASD diagnosis. The second asks whether such delays also influence infants' interactions with objects and people in ways that exert far-reaching, cascading effects on development. HR infants who do and who do not receive a diagnosis of ASD vary widely in motor and communicative development. In addition, variation in infant motor and communicative development appears to have cascading effects on development, both on the emergence of behavior in other domains and on the broader learning environment. Advances in communicative and language development are supported by advances in motor skill. When these advances are slowed and/or when new skills are not consolidated and remain challenging for the infant, the enhanced potential for exploration afforded by new abilities and the concomitant increase in opportunities for learning are reduced. Improving our understanding of communicative delays of the sort observed in ASD and developing effective intervention methods requires going beyond the individual to consider the constant, complex interplay between developing communicators and their environments. https://doi.org/10.23641/asha.7299308.

Purpose: This review article introduces research methods for personalization of intervention. Our goals are to review evidence-based practices for improving social communication impairment in children with autism spectrum disorder generally and then how these practices can be systematized in ways that personalize intervention, especially for children who respond slowly to an initial evidence-based practice. Method: The narrative reflects on the current status of modular and targeted interventions on social communication outcomes in the field of autism research. Questions are introduced regarding personalization of interventions that can be addressed through research methods. These research methods include adaptive treatment designs and the Sequential Multiple Assignment Randomized Trial. Examples of empirical studies using research designs are presented to answer questions of personalization. Conclusion: Bridging the gap between research studies and clinical practice can be advanced by research that attempts to answer questions pertinent to the broad heterogeneity in children with autism spectrum disorder, their response to interventions, and the fact that a single intervention is not effective for all children.

Purpose: This article reviews research on executive function (EF) skills in children with autism spectrum disorder (ASD) and the relation between EF and language abilities. The current study assessed EF using nonverbal tasks of inhibition, shifting, and updating of working memory (WM) in school-age children with ASD. It also evaluated the association between children's receptive and expressive language abilities and EF performance. Method: In this study, we sought to address variables that have contributed to inconsistencies in this area of research--including task issues, group comparisons, and participant heterogeneity. EF abilities in children with ASD (n = 48) were compared to typically developing controls (n = 71) matched on age, as well as when statistically controlling for group differences in nonverbal cognition, socioeconomic status, and social communication abilities. Six nonverbal EF tasks were administered--2 each to evaluate inhibition, shifting, and WM. Language abilities were assessed via a standardized language measure. Language-EF associations were examined for the ASD group as a whole and subdivided by language status. Results: Children with ASD exhibited significant deficits in all components of EF compared to age-mates and showed particular difficulty with shifting after accounting for group differences in nonverbal cognition. Controlling for social communication--a core deficit in ASD--eliminated group differences in EF performance. A modest association was observed between language (especially comprehension) and EF skills, with some evidence of different patterns between children on the autism spectrum with and without language impairment. Conclusions: There is a need for future research to examine the direction of influence between EF and language. It would be beneficial for EF interventions with children with ASD to consider language outcomes and, conversely, to examine whether specific language training facilitates aspects of executive control in children on the autism spectrum. [This article is part of the Research Forum: Advances in Autism Research--From Learning Mechanisms to Novel Interventions from the Research Symposium at the American Speech-Language-Hearing Association (ASHA) Convention (Los Angeles, California, 2017).]

Purpose: Most children with autism spectrum disorder (ASD) have below-age lexical knowledge and lexical representation. Our goal is to examine ways in which difficulties with social communication and language processing that are often associated with ASD may constrain these children's abilities to learn new words and to explore whether minimizing the social communication and processing demands of the learning situation can lead to successful learning. Method: In this narrative review of recent work on lexical development in ASD, we describe key findings on children's acquisition of nouns, pronouns, and verbs and outline our research program currently in progress aimed at further elucidating these issues. Conclusion: Our review of studies that examine lexical development in children with ASD suggests that innovative intervention approaches that take into account both the social communication and processing demands of the learning situation may be particularly beneficial.

In order to develop deeper and better understandings of what constitutes effective educational practices, and to bridge the gap between research and practice, there is a need for a paradigm shift in autism educational research. The contribution of this paper is to examine the key methodological challenges that stand in the way of autism educational research impacting on practice. This research field is dominated by experimental research designs that evaluate the impact of 'interventions' that focus on developing the skills, knowledge, and understanding of pupils with autism. For educational research to have an impact on the lives of individuals with autism, their families, and the practitioners who work with them, movement towards a more balanced range of methodologies is needed. This needs to include methodologies that situate the knowledge base of practitioners on a par with the knowledge base of researchers, drawing on the evidence base from the classroom itself, and bringing in the perspectives and views of individuals with autism, their families, and the practitioners who work with them.