Autistic people have a high likelihood of developing mental health difficulties but a low chance of receiving effective mental healthcare. Therefore, there is a need to identify and examine strategies to improve mental healthcare for autistic people.

To identify strategies that have been implemented to improve access, experiences of care and mental health outcomes for autistic adults, and to examine evidence on their acceptability, feasibility and effectiveness.

A co-produced systematic review was conducted. MEDLINE, PsycINFO, CINHAL, medRxiv and PsyArXiv were searched. We included all study designs reporting acceptability or feasibility outcomes and empirical quantitative study designs reporting effectiveness outcomes. Data were synthesised using a narrative approach.

A total of 30 articles were identified. These included 16 studies of adapted mental health interventions, eight studies of service improvements and six studies of bespoke mental health interventions developed for autistic people. There was no conclusive evidence on effectiveness. However, most bespoke and adapted approaches appeared to be feasible and acceptable. Identified adaptations appeared to be acceptable and feasible, including increasing knowledge and detection of autism, providing environmental adjustments and communication accommodations, accommodating individual differences and modifying the structure and content of interventions.

Many identified strategies are feasible and acceptable, and can be readily implemented in services with the potential to make mental healthcare more suitable for autistic people, but important research gaps remain. Future research should address these and investigate a co-produced package of service improvement measures.

The difficulties in social interaction present in individuals with autism spectrum conditions may are related with the abnormal attentional processing of emotional information. Specifically, it has been hypothesized that the hypersensibility to threat shown by individuals with autism may explain an avoidance behaviour. However, this hypothesis is not supported by research and the underlying psychological mechanisms of social interaction in autism still unclear.

The aim of the present study was to examine attentional processing biases by administering a computer-based attentional task in a sample of 27 children with autism spectrum conditions and 25 typically developed participants (age 11-15 years).

The initial orienting of attention, the attention al engagement, and the attentional maintenance to different emotional scenes in competition (i.e. happy, neutral, threatening and sad) were measured by recording the eye movements during a 20 seconds free-viewing task.

The main findings were: i) children with autism spectrum conditions showed an initial orientating bias towards threatening stimuli; and ii) while typically developed children revealed an attentional engagement and attentional maintenance bias towards threatening stimuli, children with autism spectrum conditions did not.

The findings of the present study are consistent with the affective information processing theories and shed light on the underlying mechanisms of social disturbances in autism spectrum conditions.

Synesthesia is a non-pathological condition where sensory stimuli (e.g. letters or sounds) lead to additional sensations (e.g. color). It occurs more commonly in individuals diagnosed with Autism Spectrum Condition (ASC) and is associated with increased autistic traits and autism-related perceptual processing characteristics, including a more detail-focused attentional style and altered sensory sensitivity. In addition, autistic traits correlate with the degree of synesthesia (consistency of color choices on an objective synesthesia test) in non-synesthetes.

We aimed to investigate whether the degree of synesthesia for graphemes is associated with autistic traits and perceptual processing alterations within twin pairs, where all factors shared by twins (e.g. age, family background, and 50-100% genetics) are implicitly controlled for.

We investigated a predominantly non-synesthetic twin sample, enriched for ASC and other neurodevelopmental disorders (n=65, 14-34 years, 60% female), modelling the linear relationships between the degree of synesthesia and autistic traits, sensory sensitivity, and visual perception, both within-twin pairs (22 pairs) and across the entire cohort.

A higher degree of synesthesia was associated with increased autistic traits only within the attention to details domain, with sensory hyper-, but not hypo-sensitivity and with being better in identifying fragmented images. These associations were stronger within-twin pairs compared to across the sample.

Consistent with previous findings, the results support an association between the degree of synesthesia and autistic traits and autism-related perceptual features, however restricted to specific domains. Further, the results indicate that a twin design can be more sensitive for detecting these associations.

No significant relationships.

Autistic Spectrum Condition is often characterized by the presence of deficits in social interaction. An abnormal attentional processing may explain these difficulties, as it has been suggested that individuals with autism spectrum conditions may have problems with orienting attention to socially relevant stimuli and/or inhibiting their attentional responses to irrelevant ones.

The aim of the current study is to shed light on this issue by the assessment of the attentional orienting and inhibitory control to emotional stimuli (angry, happy, and neutral faces).

An antisaccade task (with both prosaccade and antisaccade blocks) was applied to a final sample of 29 children with autism spectrum conditions and 27 children with typical development.

The main findings were: i) children with autism spectrum condition committed more antisaccade error when seeing angry faces than happy or neutral faces, while children with typical development committed more antisaccade errors when seeing happy faces than neutral faces, and ii) latencies in the prosaccade and antisaccade blocks were associated with the severity of autism symptoms.

These results suggest that children with autism spectrum conditions show an impaired inhibitory control when angry faces are presented. This bias to negative high-arousal information is congruent with affective information-processing theories suggesting that threatening stimuli induce an overwhelming response in autism. From a clinical perspective, therapeutic strategies that focus on shifting attention to emotional stimuli may improve autism symptomatology and their socials functioning.