Authors: Jean G Steyaert Wouter De La Marche
Publish Date: 2008/07/03
Volume: 167, Issue: 10, Pages: 1091-1101
Abstract
This review on autism spectrum disorder ASD focusses on recent insights in the clinical picture such as continuity of the phenotype and the concept of broader phenotype on epidemiology and on clinical issues relevant to physicians including new methods for early screening and diagnosis psychiatric and somatic comorbidity and the expansion of socalled complementary and alternative treatments ASD is a disorder with mainly genetic causes and recent insights show that a variety of genetic mechanisms may be involved ie single gene disorders copy number variations and polygenic mechanisms Technological advances in genetics have lead to a number of promising findings which together with other lines of fundamental research suggest that ASD may be a disorder of connectivity in the brain at least in a subgroup of patients It is possible that part of the genetic load in autism actually reflects gene–environment interaction but there is no evidence for purely environmental causes in a substantial number of cases Clinical research suggests that ASD may be a multisystem disorder in at least a subgroup of subjects affecting the gastrointestinal GI tract the immune system and perhaps other systems Behavioural treatments remain the cornerstone of management and are mainly aimed at stimulation of the domains of impaired development and reducing secondary behaviours These treatments are constantly being refined but the main progress in this area may be the increase of research on effectiveness
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