Auditory language comprehension among children and adolescents with autism spectrum disorder: An ALE meta-analysis of fMRI studies.
Autistic kids and teens consistently under-activate key auditory and language areas during listening tasks, so prime these regions before teaching receptive skills.
01Research in Context
What this study did
Hua et al. (2024) pooled 25 fMRI studies of autistic kids and teens. They looked at brain activity while the youth listened to spoken words or sentences.
The team used ALE meta-analysis. This tool finds spots where most studies report lower or higher brain activity in autism compared to typical peers.
What they found
Across studies, autistic youth showed less activity in three key areas: right superior temporal gyrus, left middle temporal gyrus, and the insula.
These regions handle sound decoding and meaning. Less activity here links to weaker auditory language comprehension.
How this fits with other research
The finding updates Faso et al. (2016). That earlier meta-analysis saw mixed patterns because it mixed reading, speaking, and listening tasks. Zihui et al. zoomed in on listening only, giving a clearer picture.
Chuah et al. (2025) adds a twist. Their review of EEG studies shows autistic youth have a smaller MMN brain response to sound changes. MMN drops track daily living skills, not social symptoms. Together, the two meta-analyses suggest basic sound processing is weak, and this weakness may feed into poorer language comprehension.
Karavallil Achuthan et al. (2023) found the same insula under-activation, but during rest. The new data show the insula stays quiet even when kids try to understand speech, hinting at a stable trait, not a momentary blip.
Why it matters
If auditory language areas are under-fired, therapy that only targets expressive language may miss half the problem. Add brief auditory discrimination warm-ups before receptive drills. Try clear headphones, slower speech, or sound-to-meaning games to wake up the temporal lobe and insula. Track whether better sound detection boosts later comprehension gains.
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02At a glance
03Original abstract
Difficulties in auditory language comprehension are common among children and adolescents with autism spectrum disorder. However, findings regarding the underlying neural mechanisms remain mixed, and few studies have systematically explored the overall patterns of these findings. Therefore, this study aims to systematically review and meta-analyze the functional magnetic resonance imaging evidence of neural activation patterns while engaging in auditory language comprehension tasks among children and adolescents with autism. Using activation likelihood estimation, we conducted a series of meta-analyses to investigate neural activation patterns during auditory language comprehension tasks compared to baseline conditions in autism and non-autism groups and compared the activation patterns of the groups, respectively. Eight studies were included in the within-group analyses, and seven were included in the between-group analysis. The within-group analyses revealed that the bilateral superior temporal gyrus was activated during auditory language comprehension tasks in both groups, whereas the left superior frontal gyrus and dorsal medial prefrontal cortex were activated only in the non-autism group. Furthermore, the between-group analysis showed that children and adolescents with autism, compared to those without autism, showed reduced activation in the right superior temporal gyrus, left middle temporal gyrus, and insula, whereas the autism group did not show increased activation in any of the regions relative to the non-autism group. Overall, these findings contribute to our understanding of the potential neural mechanisms underlying difficulties in auditory language comprehension in children and adolescents with autism and provide practical implications for early screening and language-related interventions for children and adolescents with autism.
Autism research : official journal of the International Society for Autism Research, 2024 · doi:10.1002/aur.3055