The Lancet Commission on the future of care and clinical research in autism

Lord, Catherine; Charman, Tony; Havdahl, Alexandra; Carbone, Paul S.; Anagnostou, Evdokia; Boyd, Brian A.; Carr, Themba; Vries, Petrus J. de; Dissanayake, Cheryl; Divan, Gauri; Freitag, Christine M.; Gotelli, Marina María; Kasari, Connie; Knapp, Martin; Mundy, Peter; Plank, Alex; Scahill, Lawrence David; Servili, Chiara; Shattuck, Paul; Simonoff, Emily; Singer, Alison; Slonims, Vicky; Wang, Paul P.; Ysrraelit, María Célica; Jellett, Rachel; Pickles, Andrew; Cusack, James; Howlin, Patricia; Szatmári, Péter; Holbrook, Alison; Toolan, Christina; McCauley, James B.

doi:10.1016/s0140-6736(21)01541-5

Cited by 456 publications

(411 citation statements)

References 381 publications

(554 reference statements)

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“…Additionally, considering the variability of how prevention measures have been implemented globally [2], local analyses of vulnerable populations may elucidate specific strategies that may mitigate some of the risks of long-term adverse effects. Autism spectrum disorder (henceforth autism) is a neurodivergent condition defined by challenges in social interaction and communication along with repetitive, restricted behaviors and interests as well sensory processing alteration causing varying functional impairment and need of support [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Effects of the Early Phase of COVID-19 on the Autistic Community in Sweden: A Qualitative Multi-Informant Study Linking to ICF

Fridell

Norrman

Girke

et al. 2022

IJERPH

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While the COVID-19 pandemic is ongoing, early outcome studies indicate severe and pervasive global effects of the pandemic and associated measures to prevent the spread of the virus. General population studies, as well as insight into the outcomes for particular groups, will be necessary in order to mitigate potentially long-term effects as well as to prepare for future epidemics or pandemics. The pandemic conditions have been marked by rapid and abrupt changes and unpredictability which are circumstances that leave the autistic population particularly vulnerable to adverse outcomes following the distinctive features of the diagnosis. Studies are only beginning to delineate the outcomes of the global autism community and the present study adds to these findings by providing a local, multi-perspective, qualitative analysis of the lived experiences of the Swedish autism community. In this study, autistic youth and adults, caregivers of autistic individuals, as well as representatives of Swedish interest organizations were interviewed. Thematic analysis was performed on the population as a whole and patterns of results were formalized according to the International Classification of Function, Disability and Health (ICF-CY). Participants report wide-ranging adverse outcomes of the pandemic relating to mental health and access to support, participation in daily activities and socialization, education, and work as well as parental resources. However, participants also report positive outcomes relating to a reduction in specific social and everyday demands, and normalization of lived experiences. Additionally, interviews outlined some strategies used to cope during pandemic conditions. Implications of these findings are discussed.

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Section: Introductionmentioning

confidence: 99%

Effects of the Early Phase of COVID-19 on the Autistic Community in Sweden: A Qualitative Multi-Informant Study Linking to ICF

Fridell

Norrman

Girke

et al. 2022

IJERPH

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“…ASD can be considered a relatively frequent disorder with a high longitudinal diagnostic stability [ 59 ], characterized by a significant individual, familial, and societal burden [ 60 ]. To date, evidence-based rehabilitative interventions can improve global outcome for some ASD people [ 61 ], but the possibility of boosting these with an easily administered supplementary treatment that acts on the gut–brain axis, with limited side effects and low costs, should be adequately explored. As shown, the studies published to date that have examined integrative treatment with probiotics and/or prebiotics, and FMT are few and show heterogeneous results.…”

Section: Discussionmentioning

confidence: 99%

Interventions on Microbiota: Where Do We Stand on a Gut–Brain Link in Autism? A Systematic Review

et al. 2022

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The alteration of the microbiota–gut–brain axis has been recently recognized as a critical modulator of neuropsychiatric health and a possible factor in the etiopathogenesis of autism spectrum disorders (ASD). This systematic review offers practitioners an overview of the potential therapeutic options to modify dysbiosis, GI symptoms, and ASD severity by modulating the microbiota–gut–brain axis in ASD, taking into consideration limits and benefits from current findings. Comprehensive searches of PubMed, Scopus, the Web of Science Core Collection, and EMBASE were performed from 2000 to 2021, crossing terms referred to ASD and treatments acting on the microbiota–gut–brain axis. A total of 1769 publications were identified, of which 19 articles met the inclusion criteria. Data were extracted independently by two reviewers using a preconstructed form. Despite the encouraging findings, considering the variability of the treatments, the samples size, the duration of treatment, and the tools used to evaluate the outcome of the examined trials, these results are still partial. They do not allow to establish a conclusive beneficial effect of probiotics and other interventions on the symptoms of ASD. In particular, the optimal species, subspecies, and dosages have yet to be identified. Considering the heterogeneity of ASD, double-blind, randomized, controlled trials and treatment tailored to ASD characteristics and host-microbiota are recommended.

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“…Within the interconnected bio-psycho-social framework, one of the most intriguing challenges in ASD deserves a mention: the enhancement of “thinking different” and the awareness that psycho-neurodiversity and disease are not the same [ 5 ]. Establishing the boundary between neurodevelopmental disorders and value of neurodiversity is essential.…”

Section: Discussionmentioning

confidence: 99%

“…The wide range of different behavioral characteristics and the degree of intellectual impairment account for the wide “spectrum” of clinical pictures and their varied impacts on major life areas [ 2 ] and quality of life [ 3 ]. This wide clinical heterogeneity highlights the need to provide personalized answers to complex and unique needs, including the empowerment and participation of individuals with ASD and their families in society and in decisions concerning them [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Dynamic and Systemic Perspective in Autism Spectrum Disorders: A Change of Gaze in Research Opens to A New Landscape of Needs and Solutions

Panisi¹,

Marini

2022

Brain Sciences

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The first step for a harmonious bio-psycho-social framework in approaching autism spectrum disorders (ASD) is overcoming the conflict between the biological and the psychosocial perspective. Biological research can provide clues for a correct approach to clinical practice, assuming that it would lead to the conceptualization of a pathogenetic paradigm able to account for epidemiologic and clinical findings. The upward trajectory in ASD prevalence and the systemic involvement of other organs besides the brain suggest that the epigenetic paradigm is the most plausible one. The embryo-fetal period is the crucial window of opportunity for keeping neurodevelopment on the right tracks, suggesting that women’s health in pregnancy should be a priority. Maladaptive molecular pathways beginning in utero, in particular, a vicious circle between the immune response, oxidative stress/mitochondrial dysfunction, and dysbiosis-impact neurodevelopment and brain functioning across the lifespan and are the basis for progressive multisystemic disorders that account for the substantial health loss and the increased mortality in ASD. Therefore, the biological complexity of ASD and its implications for health requires the enhancement of clinical skills on these topics, to achieve an effective multi-disciplinary healthcare model. Well-balanced training courses could be a promising starting point to make a change.

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The Lancet Commission on the future of care and clinical research in autism

Cited by 456 publications

References 381 publications

Effects of the Early Phase of COVID-19 on the Autistic Community in Sweden: A Qualitative Multi-Informant Study Linking to ICF

Effects of the Early Phase of COVID-19 on the Autistic Community in Sweden: A Qualitative Multi-Informant Study Linking to ICF

Interventions on Microbiota: Where Do We Stand on a Gut–Brain Link in Autism? A Systematic Review

Dynamic and Systemic Perspective in Autism Spectrum Disorders: A Change of Gaze in Research Opens to A New Landscape of Needs and Solutions

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