Investigating Prosodic Focus Perception and Production in Autism Spectrum Disorder: A Systematic Review and Meta-Analysis

Purpose: Speakers of all human languages use prosodic changes to encode focus, and the ability to perceive and produce prosodic focus is crucial for developing linguistic and communicative skills. This review aims to explore the performance of prosodic focus perception and production among individuals with autism spectrum disorder (ASD) and to identify potential factors contributing to inconsistent findings in previous studies. Method: We conducted a systematic search in three electronic databases and one web search engine to identify peer-reviewed research articles that compared the perception and production of prosodic focus between individuals with ASD and typically developing (TD) individuals. Effect sizes were calculated based on random-effects models. Meta-regression analyses were conducted to assess potential individual and methodological moderators. Results: The comparison of perception accuracy between 441 individuals with ASD and 511 TD individuals revealed that individuals with ASD exhibited impaired prosodic focus perception (Hedges's g = −0.40), with no significant moderators for heterogeneity across studies. Meanwhile, we compared production accuracy between 483 individuals with ASD and 619 TD individuals, finding that production impairments in ASD were more pronounced (Hedges's g = −0.85). The moderator analysis revealed that nonverbal IQ and expressive language skills were significant moderators of production accuracy. Besides, individuals with ASD also exhibited greater pitch variation in prosodic focus production. Conclusion: Overall, these findings suggest that individuals with ASD exhibit greater difficulties in the production of prosodic focus compared to its perception, and increased pitch variation might be a prosodic feature associated with ASD. Supplemental Material: https://doi.org/10.23641/asha.31934088