Auditory Pitch Perception in Autism Spectrum Disorder: A Systematic Review and Meta-Analysis.

This research combined results from 22 studies involving 464 autistic people to understand how they process pitch (musical tones and sounds). The findings showed that autistic people have slightly better pitch perception abilities than non-autistic people. Age and thinking skills affected these abilities. This suggests autistic brains develop differently for processing sounds, which could be important for understanding language and social communication.

This systematic review and meta-analysis examined auditory pitch perception abilities in autism spectrum disorder (ASD) using nonspeech stimuli. Analyzing 22 studies with 464 ASD participants, researchers found a small-to-medium positive effect size (0.26) indicating enhanced pitch perception in autistic individuals compared to neurotypicals. Age and nonverbal IQ significantly moderated between-study differences. The findings suggest different developmental trajectories for pitch processing between autistic and neurotypical individuals, with nonverbal ability contributing to lower-level processing differences in ASD.

The study represents the first meta-analysis on this topic and highlights the need for research under challenging listening conditions and longitudinal neurophysiological studies to understand underlying mechanisms.

Enhanced pitch perception in autism may represent an auditory strength to leverage in interventions. Age and nonverbal abilities should guide assessment approaches. Research needed on real-world applications and potential for auditory-based interventions to improve language and social functioning.

Based on nonspeech stimuli only, which may not reflect real-world auditory challenges. Need for studies under challenging listening conditions and longitudinal research to understand developmental patterns and neural mechanisms.

Pitch plays an important role in auditory perception of music and language. This study provides a systematic review with meta-analysis to investigate whether individuals with autism spectrum disorder (ASD) have enhanced pitch processing ability and to identify the potential factors associated with processing differences between ASD and neurotypicals. We conducted a systematic search through six major electronic databases focusing on the studies that used nonspeech stimuli to provide a qualitative and quantitative assessment across existing studies on pitch perception in autism. We identified potential participant- and methodology-related moderators and conducted metaregression analyses using mixed-effects models.

On the basis of 22 studies with a total of 464 participants with ASD, we obtained a small-to-medium positive effect size (= 0.26) in support of enhanced pitch perception in ASD. Moreover, the mean age and nonverbal IQ of participants were found to significantly moderate the between-studies heterogeneity. Our study provides the first meta-analysis on auditory pitch perception in ASD and demonstrates the existence of different developmental trajectories between autistic individuals and neurotypicals. In addition to age, nonverbal ability is found to be a significant contributor to the lower level/local processing bias in ASD.

We highlight the need for further investigation of pitch perception in ASD under challenging listening conditions. Future neurophysiological and brain imaging studies with a longitudinal design are also needed to better understand the underlying neural mechanisms of atypical pitch processing in ASD and to help guide auditory-based interventions for improving language and social functioning. https://doi.org/10.23641/asha.21614271.