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Through meta-analysis and systematic review pronoun use by autistic individuals was compared to typically developing peers. It was hypothesized patterns in pronoun would be detectable across languages with similar syntactical structures that if pronoun use was distinct to diagnosis. Data were extracted from 20 selected articles to examine differences in overall pronoun usage as well as in personal, ambiguous, possessive, reflexive, and clitic pronoun usage. Summary effects indicated significant differences between individuals with autism and their typically developing peers in the use of pronouns overall as well as in ambiguous, clitic, and reflexive pronoun usage but not in personal and possessive pronoun usage. Individual outcomes appeared to be moderated by factors, including cognitive ability, first language, and overall language development.