A systematic review on speech-in-noise perception in autism

Individuals with autism spectrum disorder (ASD) exhibit atypical speech-in-noise (SiN) perception, but the scope of these impairments has not been clearly defined. We conducted a systematic review of the behavioural research on SiN perception in ASD, using a comprehensive search strategy across databases (Embase, Pubmed, Web of Science, APA PsycArticles, LLBA, clinicaltrials.gov and PsyArXiv). We withheld 20 studies that generally revealed intact speech perception in stationary noise, while impairments in speech discrimination were found in temporally modulated noise, concurrent speech, and audiovisual speech perception. An association with auditory temporal processing deficits, exacerbated by suboptimal language skills, is shown. Speech-in-speech perception might be further impaired due to deficient top-down processing of speech. Further research is needed to address remaining challenges and gaps in our understanding of these impairments, including the developmental aspects of SiN processing in ASD, and the impact of gender and social attentional orienting on this ability. Our findings have important implications for improving communication in ASD, both in daily interactions and in clinical and educational settings.