A Personalized Multidisciplinary Approach to Evaluating and Treating Autism Spectrum Disorder

Abstract

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder without a known cure. Current standard-of-care treatments focus on addressing core symptoms directly but have provided limited benefits. In many cases, individuals with ASD have abnormalities in multiple organs, including the brain, immune and gastrointestinal system, and multiple physiological systems including redox and metabolic systems. Additionally, multiple aspects of the environment can adversely affect children with ASD including the sensory environment, psychosocial stress, dietary limitations and exposures to allergens and toxicants. Although it is not clear whether these medical abnormalities and environmental factors are related to the etiology of ASD, there is evidence that many of these factors can modulate ASD symptoms, making them a potential treatment target for improving core and associated ASD-related symptoms and improving functional limitation. Additionally, addressing underlying biological disturbances that drive pathophysiology has the potential to be disease modifying. This article describes a systematic approach using clinical history and biomarkers to personalize medical treatment for children with ASD. This approach is medically comprehensive, making it attractive for a multidisciplinary approach. By concentrating on treatable conditions in ASD, it is possible to improve functional ability and quality of life, thus providing optimal outcomes.

Keywords: autism spectrum disorder; environment; multidisciplinary; optimal outcomes.

Figure 1

Potentially treatable abnormalities associated with Autism Spectrum Disorders (ASD). Overview of the multiple medical and associated potentially identifiably and treatable abnormalities associated with ASD. The center represents the specific organs commonly affected in ASD while the left column depicts the systematic medical abnormalities that may have widespread effects on multiple organs. The column on the right demonstrates multiple environmental factors that may modulate the severity of the underlying medical abnormalities.

Figure 2

BaS-BiSTOR (collect Baseline data, search for Symptoms, measure Biomarkers, Select Treatment, Observe for Response) flowchart.

Figure 3

Overview of the workflow through a personalized multispecialty medical clinic to comprehensively evaluate children with ASD in a personalized manner. Multiple specialists and paraprofessionals are needed to identify treatable abnormalities associated with ASD.