Exposure to multiple languages may support the development of Theory of Mind (ToM) in neurotypical (NT) and autistic children. However, previous research mainly applied group comparisons between monolingual and bilingual children, and the underlying mechanism of the observed difference remains unclear. The present study, therefore, sheds light on the effect of bilingualism on ToM in both NT and autistic children by measuring language experiences with a continuous operationalization. We measure ToM with a behavioral, linguistically simple tablet-based task, allowing inclusive assessment in autistic children. Analyses revealed no difference between monolingual and bilingual NT and autistic children. However, more balanced exposure to different languages within contexts positively predicted first-order false belief understanding in NT children but not autistic children. Mediation analysis showed that the impact in NT children was a direct effect and not mediated via other cognitive skills.

Mirroring the general population, the number of medical students, doctors and, indeed, psychiatrists disclosing being neurodivergent is rising. These individuals commonly have a variety of strengths that can enhance their work, but these strengths may go unrecognised. All too often such individuals have been labelled ‘doctors in difficulty’. We begin this article with a review of contemporary thinking regarding neurodiversity, before considering specific issues facing neurodivergent doctors, specifically psychiatrists. We explore neurodivergent strengths and the evidence regarding career outcomes and mental health. We discuss the stigma that many neurodivergent psychiatrists face in the medical sphere and how difficulties may be reframed as unmet needs. We highlight initiatives that aim to change workplace culture, before discussing the concept of reasonable adjustments, alongside a wide range of practical suggestions of adjustments to consider, using the Autistic SPACE framework and the Royal College of Psychiatrists’ reasonable adjustments guidance. Finally, we consider how those in senior leadership roles can contribute to this field and provide role modelling and signposting to further information and support for neurodivergent doctors and their supervisors and line managers.

Social anxiety disorder (SAD) is one of the most prevalent co-occurring conditions amongst cognitively unimpaired autistic people. The evidence-based treatment for social anxiety known as cognitive therapy for SAD (CT-SAD) may to an extent be beneficial to autistic people, but adaptations for autistic people are recommended to increase its effectiveness. The present study aimed to co-produce and pilot an adapted SAD treatment protocol for autistic people based on the Clark and Wells (1995) model, including assessing its feasibility and acceptability. A bespoke 12-week CBT online group intervention was created to meet the needs of autistic people with a diagnosis of SAD. The treatment protocol was created collaboratively with autistic people. It was piloted with seven adult participants (three males, four females) with autism or self-identified autism who completed the group intervention targeting SAD symptoms. With regard to feasibility, we met our initial aims of recruiting our intended sample size of a minimum of six participants for the intervention with an attendance rate of at least 80% of sessions. The excellent completion and attendance rates, respectively 100% and 95%, indicate that the intervention was acceptable to our participants. These findings extend previous research and support the continued adaptation of CBT interventions for autistic people. Furthermore, the evidence of feasibility indicates that further study to evaluate the efficacy of this group intervention is warranted.

Key learning aims

1. (1) To reflect on social anxiety, autism and identify ways to improve the delivery of cognitive therapy for autistic people.

2. (2) To identify useful adaptations to cognitive therapy for autistic people.

3. (3) To learn how to deliver group cognitive therapy remotely for autistic people who present with social anxiety.

The transition from primary to secondary school, encompassing the pre-, during-, and post-transition stages, often poses significant challenges for students on the autism spectrum. This critical period has garnered growing research attention; however, the perspectives of Australian parents on the support their autistic children receive post-transition remain largely unexplored. Underpinned by a transcendental phenomenological epistemology and Kohler’s Taxonomy for Transition Programming, we explored Australian parents’ perspectives on the support being provided to their children on the autism spectrum and how these students experience this post-transition period. Four parents of high-school-aged children on the autism spectrum participated in interviews, conducted online via Zoom. A deductive content analysis of parents’ insights revealed overwhelming dissatisfaction with the post-transition support provided to their children on the autism spectrum, particularly surrounding home–school collaboration practices and the utilisation of personalised learning. The findings contribute a much-needed Australian perspective to the limited body of research focused on sustaining support for students on the autism spectrum beyond the initial transition to secondary school.

The Mental Health Bill, 2025, proposes to remove autism and learning disability from the scope of Section 3 of the Mental Health Act, 1983 (MHA). The present article represents a professional and carer consensus statement that raises concerns and identifies probable unintended consequences if this proposal becomes law. Our concerns relate to the lack of clear mandate for such proposals, conceptual inconsistency when considering other conditions that might give rise to a need for detention and the inconsistency in applying such changes to Part II of the MHA but not Part III. If the proposed changes become law, we anticipate that detentions would instead occur under the less safeguarded Deprivation of Liberty Safeguards framework, and that unmanaged risks will eventuate in behavioural consequences that will lead to more autistic people or those with a learning disability being sent to prison. Additionally, there is a concern that the proposed definitional breadth of autism and learning disability gives rise to a risk that people with other conditions may unintentionally be unable to be detained. We strongly urge the UK Parliament to amend this portion of the Bill prior to it becoming law.

Narratives from autistic children, children with developmental language disorder (DLD) and typically developing children were compared for attributions of intentionality in descriptions of two animations, one inviting descriptions of social events like fighting, another one inviting descriptions of physical events like orbiting planets. The analysis was based on a semantic and syntactic classification of clauses in terms of whether the verbs require their arguments to refer to beings with subjective experience, that is, intentionality attribution as a first step in the understanding of others as beings with mental states and processes. The autistic children did not have difficulties attributing intentionality to geometric figures. Moreover, the children with DLD made more intentionality attributions in their descriptions of the physical animation than the typically developing peers. Both diagnostic groups reported fewer relevant events than the typically developing children, which is interpreted as difficulties with narrative macrostructure. The results are discussed in relation to earlier studies and with respect to what they tell us about intentionality attribution and narrative structure in autism.

Previous research points to potential challenges autistic children face in constructing coherent narratives and establishing causal connections between events, although findings remain inconclusive. Furthermore, most studies focus on English-speaking children, leaving the narrative coherence skills of autistic children from other linguistic/cultural contexts underexplored. This study investigated the differences in narrative coherence between 42 autistic and 56 typically developing (TD) Spanish-speaking children matched on age (M = 8.51 years). Based on theories of rhetorical relations (RRs), which track relations between discourse units, we aimed to offer a new perspective on how coherence is achieved in children’s narratives, with an emphasis on the causal RRs established. Causal RRs were coded for the specific type of RR, presence/absence of connectives, causality domain, and mention/omission of key events. Additional coherence measures included tallying the total number of RRs (causal and non-causal) and assessing narrative macrostructure through a rating scale, in line with more standard practices in the field. Results showed that, despite producing a comparable number of causal RRs, autistic children established significantly fewer causal RRs involving characters’ intentions and key story events compared to TD children. Moreover, autistic children established fewer RRs overall and obtained lower macrostructure scores, suggesting lower narrative coherence levels.

Common neuroanatomical regions are associated with both states of anorexia nervosa (AN) and autistic characteristics, but restoration of body mass index (BMI) has been associated with decreased presentation of autistic characteristics in some individuals with AN. This study aims to examine neuroanatomical correlates associated with autistic characteristics in those with acute anorexia nervosa (ac-AN) and those previously diagnosed with AN but whose weight has been restored (WR). In total, 183 individuals (healthy controls [HCs] = 67; n[ac-AN] = 68; n[WR] = 48) from the Brain imaging of Emotion And Cognition of adolescents with Anorexia Nervosa (BEACON) study were included, with autistic characteristics determined in both ac-AN and WR individuals (n = 116). To further examine BMI, ac-AN and WR group associations were compared. Random forest regression (RFR) models examined whether autistic characteristics and morphology of the anterior cingulate cortex (ACC), middle frontal gyrus (MFG), and orbitofrontal cortex (OFC) were able to predict future levels of social anhedonia and alexithymia. Group-wise differences were identified within the volume and surface area of the MFG and OFC, which were unrelated to BMI. Autistic characteristics were inversely associated with MFG and ACC volume, with differences in associations between ac-AN and WR groups seen in the surface area of the MFG. RFR models identified moderate-to-weak performance and found that autistic characteristics were not important predictive features in a priori and exploratory models. Findings suggest that the presence of autistic characteristics in those with ac-AN are associated with the volume of the MFG and are unrelated to BMI restoration.