Objective To observe the effects of electroacupuncture combined with behavioural analysis and speech rehabilitation on the auditory and language skills of children with autism spectrum disorders.Methods 106 children with autism spectrum disorders admitted from 2021.1 to 2024.6 were divided into 53 cases in the training group and 53 cases in the electroacupuncture group using the random number table method. The training group used behavioural analysis and language rehabilitation training, and the electroacupuncture group combined electroacupuncture intervention on its basis. We assessed the differences in Childhood Autism Rating Scale (CARS) score, Autism Child Behaviour Checklist (ABC), Gesell Developmental Scale (GDS) score, Clinical Language Function Questionnaire (CLSQ) score and Social Reaction Scale (SRS) score before and after the intervention in the two groups, counted the incidence of auditory abnormality before and after the intervention, and detected the incidence of metal-sulfur-metallothionein3 ( MT3 protein), brain-derived neurotrophic factor (BDNF) levels before and after intervention.Results Before the intervention, there was no difference in the comparison of CARS scores, ABC scores, GDS scores and CLSQ scores between the two groups (P>0.05). After intervention, the CARS score and ABC score of both groups were lower than before intervention, and the electroacupuncture group was lower than the training group (P<0.05); the GDS score and CLSQ score of both groups were higher than before intervention, and the electroacupuncture group was higher than the training group (P<0.05). Before intervention, there was no difference in the comparison of SRS scores between the two groups (P>0.05). After the intervention, social perception, social cognition, social communication, social motivation, and autistic behavioural styles were lower in both groups than before the intervention, and the four scores except social motivation score were lower in the electroacupuncture group than in the training group (P<0.05). Before intervention, there was no difference in the incidence of auditory abnormalities between the two groups (P>0.05). After the intervention, the incidence of dull auditory response, allergic auditory response, and auditory fear in the electroacupuncture group was lower than that before the intervention, and the incidence of dull auditory response and allergic auditory response in the electroacupuncture group was lower than that in the training group, and there was no difference in the incidence of auditory fear comparing with that in the training group (P>0.05). Before intervention, there was no difference in the comparison of MT3 protein and BDNF between the two groups (P>0.05). After intervention, MT3 protein and BDNF were higher in both groups than before intervention, and the electroacupuncture group was higher than the training group (P<0.05).Conclusion Electroacupuncture combined with behavioural analysis and speech rehabilitation improves auditory and speech abilities, increases MT3 protein and BDNF levels, and improves social interaction in children with autism spectrum disorders.