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image of Navigating the Complex Landscape of Autism Spectrum Disorder: Challenges and Opportunities in Diagnosis, Treatment, and Supports

Abstract

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by persistent deficits in social communication and interaction, as well as restricted, repetitive patterns of behaviour, interests, or activities. Despite advancements in our understanding of ASD, identification, screening, diagnosing, and treating this condition present significant challenges. This review article comprehensively examines the current diagnostic and treatment landscape for ASD, addressing key issues and opportunities for improvement. The diagnostic criteria for ASD, as outlined in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), provide a framework for identifying the condition. Still, the heterogeneity of presentation and the presence of comorbidities contribute to diagnostic complexity. Early intervention is crucial for improving outcomes in individuals with ASD; however, accessing timely and appropriate interventions can be challenging. A diverse range of interventions exists for individuals with ASD, including behavioural therapies, pharmacological treatments, gene expression, and alternative therapies. However, the efficacy and accessibility of these treatments vary, and navigating the treatment landscape can be daunting for caregivers and clinicians alike. Moreover, due to the persistence of healthcare disparities,, underserved populations face barriers to diagnosis and treatment. Transitioning to adulthood poses unique challenges for individuals with ASD, including finding employment and accessing support services. Additionally, ASD affects not only individuals diagnosed with the condition but also their families and caregivers. Addressing caregiver stress and burnout is essential for providing holistic care to individuals with ASD and their families. This review also identifies areas needing further research, such as personalized medicine and healthcare disparities, and discusses policy implications for enhancing ASD care and support. By highlighting research needs and policy considerations, this review aims to inform future efforts to improve ASD Screening, diagnosis, and treatment, ultimately striving to enhance outcomes for individuals with ASD and their families.

This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
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2025-07-24
2025-09-29
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References

  1. de Leeuw A. Happé F. Hoekstra R.A. A conceptual framework for understanding the cultural and contextual factors on autism across the globe. Autism Res. 2020 13 7 1029 1050 10.1002/aur.2276 32083402
    [Google Scholar]
  2. Hus Y. Segal O. Challenges surrounding the diagnosis of autism in children. Neuropsychiatr. Dis. Treat. 2021 17 3509 3529 10.2147/NDT.S282569 34898983
    [Google Scholar]
  3. Singh M. Chauhan A. Sahu J.K. Prevalence of autism spectrum disorder in Indian children: A systematic review and meta-analysis. Neurol. India 2019 67 1 100 104 10.4103/0028‑3886.253970 30860104
    [Google Scholar]
  4. Issac A. Halemani K. Shetty A. The global prevalence of autism spectrum disorder in children: A systematic review and meta-analysis. Osong Public Health Res. Perspect. 2025 16 1 3 27 10.24171/j.phrp.2024.0286 39933560
    [Google Scholar]
  5. Zwaigenbaum L. Bauman M.L. Choueiri R. Early intervention for children with autism spectrum disorder under 3 years of age: Recommendations for practice and research. Pediatrics 2015 136 Suppl. 1 S60 S81 10.1542/peds.2014‑3667E 26430170
    [Google Scholar]
  6. Howes A.E. Burns M.E. Surtees A.D.R. Barriers, facilitators, and experiences of the autism assessment process: A systematic review of qualitative research with health professionals. Prof. Psychol. Res. Pr. 2021 52 5 449 460 10.1037/pro0000413
    [Google Scholar]
  7. Anuyah O. Conrado A-M. Carlson C. Gilbride H. Metoyer R. Exploring the barriers and potential opportunities of technology integration in Community-Based social service organizations. ACM J Comput Sustain Soc 2023 1 1 1 28 10.1145/3610720
    [Google Scholar]
  8. Ball J.R. Miller B.T. Balogh E.P. Improving diagnosis in health care. US Washington (DC) National Academies Press 2015
    [Google Scholar]
  9. Hirota T. King B.H. Autism spectrum disorder: A review. JAMA 2023 329 2 157 168 10.1001/jama.2022.23661 36625807
    [Google Scholar]
  10. Corsello C.M. Early intervention in autism. Infants Young Child. 2005 18 2 74 85 10.1097/00001163‑200504000‑00002
    [Google Scholar]
  11. Hollis C. Remschmidt H. Diagnosis and differential diagnosis. In: Schizophrenia in children and adolescents. Cambridge University Press 2001 82 118 10.1017/CBO9780511526800.006
    [Google Scholar]
  12. Constantino J.N. Charman T. Diagnosis of autism spectrum disorder: Reconciling the syndrome, its diverse origins, and variation in expression. Lancet Neurol. 2016 15 3 279 291 10.1016/S1474‑4422(15)00151‑9 26497771
    [Google Scholar]
  13. Watkins L. Kuhn M. Ledbetter-Cho K. Gevarter C. O’Reilly M. Evidence-based social communication interventions for children with autism spectrum disorder. Indian J. Pediatr. 2017 84 1 68 75 10.1007/s12098‑015‑1938‑5 26581197
    [Google Scholar]
  14. Leekam S.R. Prior M.R. Uljarevic M. Restricted and repetitive behaviors in autism spectrum disorders: A review of research in the last decade. Psychol. Bull. 2011 137 4 562 593 10.1037/a0023341 21574682
    [Google Scholar]
  15. Ursano A.M. Kartheiser P.H. Barnhill L.J. Disorders usually first diagnosed in infancy, childhood, or adolescence. In: Essentials of Psychiatry. American Psychiatric Publishing 2011 325 381
    [Google Scholar]
  16. Moeschler J.B. Shevell M. Moeschler J.B. Comprehensive evaluation of the child with intellectual disability or global developmental delays. Pediatrics 2014 134 3 e903 e918 10.1542/peds.2014‑1839 25157020
    [Google Scholar]
  17. McCarty P. Frye R.E. Early detection and diagnosis of autism spectrum disorder: Why is it so difficult? In: Seminars in Pediatric Neurology. Elsevier 2020 10.1016/j.spen.2020.100831
    [Google Scholar]
  18. Bauman M.L. Medical comorbidities in autism: Challenges to diagnosis and treatment. Neurotherapeutics 2010 7 3 320 327 10.1016/j.nurt.2010.06.001 20643385
    [Google Scholar]
  19. Simonoff E. Pickles A. Charman T. Chandler S. Loucas T. Baird G. Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. J. Am. Acad. Child Adolesc. Psychiatry 2008 47 8 921 929 10.1097/CHI.0b013e318179964f 18645422
    [Google Scholar]
  20. Baldacchino A. Corkery J. Comorbidity: Perspectives across Europe. European Collaborating Centres in Addiction Studies London 2006
    [Google Scholar]
  21. Burgoon J.K. Bacue A.E. Nonverbal communication skills. In: Handbook of communication and social interaction skills. Routledge 2003
    [Google Scholar]
  22. Wolfberg P Buron KD Learners on the Autism Spectrum: Preparing Educators and Related Practitioners. 2023 10.4324/9781003373193
    [Google Scholar]
  23. Rapee R.M. Bőgels S.M. van der Sluis C.M. Craske M.G. Ollendick T. Annual Research Review: Conceptualising functional impairment in children and adolescents. J. Child Psychol. Psychiatry 2012 53 5 454 468 10.1111/j.1469‑7610.2011.02479.x 22067073
    [Google Scholar]
  24. Robins D.L. Dumont-Mathieu T.M. Early screening for autism spectrum disorders: Update on the modified checklist for autism in toddlers and other measures. J. Dev. Behav. Pediatr. 2006 27 2 S111 S119 10.1097/00004703‑200604002‑00009 16685177
    [Google Scholar]
  25. Towle P.O. Patrick P.A. Autism spectrum disorder screening instruments for very young children: A systematic review. Autism Res. Treat. 2016 2016 1 1 29 10.1155/2016/4624829 28116159
    [Google Scholar]
  26. Duttge G. The right to know and not to know: Predictive genetic diagnosis and non-diagnosis. In: Ethical challenges in cancer diagnosis and therapy recent results in cancer research. Cham Springer 2021 67 83 10.1007/978‑3‑030‑63749‑1_6
    [Google Scholar]
  27. De Smith M.J. Goodchild M.F. Longley P. Geospatial analysis: A comprehensive guide to principles, techniques and software tools. Troubador publishing ltd 2007
    [Google Scholar]
  28. Tick B. Bolton P. Happé F. Rutter M. Rijsdijk F. Heritability of autism spectrum disorders: A meta‐analysis of twin studies. J. Child Psychol. Psychiatry 2016 57 5 585 595 10.1111/jcpp.12499 26709141
    [Google Scholar]
  29. Bach S. Shovlin S. Moriarty M. Bardoni B. Tropea D. Rett syndrome and fragile X syndrome: Different etiology with common molecular dysfunctions. Front. Cell. Neurosci. 2021 15 764761 10.3389/fncel.2021.764761 34867203
    [Google Scholar]
  30. Reddy K.S. Cytogenetic abnormalities and fragile-x syndrome in Autism Spectrum Disorder. BMC Med. Genet. 2005 6 1 3 10.1186/1471‑2350‑6‑3 15655077
    [Google Scholar]
  31. Krumm N. O’Roak B.J. Shendure J. Eichler E.E. A de novo convergence of autism genetics and molecular neuroscience. Trends Neurosci. 2014 37 2 95 105 10.1016/j.tins.2013.11.005 24387789
    [Google Scholar]
  32. Zhang Y. Liu X. Guo R. Biological implications of genetic variations in autism spectrum disorders from genomics studies. Biosci. Rep. 2021 41 7 BSR20210593 10.1042/BSR20210593 34240107
    [Google Scholar]
  33. Tordjman S. Somogyi E. Coulon N. Gene × Environment interactions in autism spectrum disorders: Role of epigenetic mechanisms. Front. Psychiatry 2014 5 53 10.3389/fpsyt.2014.00053 25136320
    [Google Scholar]
  34. Ornoy A. Weinstein-Fudim L. Ergaz Z. Prenatal factors associated with autism spectrum disorder (ASD). Reprod. Toxicol. 2015 56 155 169 10.1016/j.reprotox.2015.05.007 26021712
    [Google Scholar]
  35. Hadjkacem I. Ayadi H. Turki M. Prenatal, perinatal and postnatal factors associated with autism spectrum disorder. J. Pediatr. 2016 92 6 595 601 10.1016/j.jped.2016.01.012 27526988
    [Google Scholar]
  36. Rani P. Dhok A. Effects of pollution on pregnancy and infants. Cureus 2023 15 1 33906 10.7759/cureus.33906 36819435
    [Google Scholar]
  37. Cheroni C. Caporale N. Testa G. Autism spectrum disorder at the crossroad between genes and environment: Contributions, convergences, and interactions in ASD developmental pathophysiology. Mol. Autism 2020 11 1 69 10.1186/s13229‑020‑00370‑1 32912338
    [Google Scholar]
  38. Beauchaine T.P. Neuhaus E. Brenner S.L. Gatzke-Kopp L. Ten good reasons to consider biological processes in prevention and intervention research. Dev Psychopathol 2008 20 3 745 74 10.1017/S0954579408000369 18606030
    [Google Scholar]
  39. Miles J.H. Autism spectrum disorders-A genetics review. Genet. Med. 2011 13 4 278 294 10.1097/GIM.0b013e3181ff67ba 21358411
    [Google Scholar]
  40. Sysoeva O.V. Neurophysiological markers that link genes and behavior in humans: Examples from rare genetic syndromes associated with autism spectrum disorders. Genes Cells 2023 18 4 297 307 10.23868/gc567774
    [Google Scholar]
  41. Klei L. McClain L.L. Mahjani B. How rare and common risk variation jointly affect liability for autism spectrum disorder. Mol. Autism 2021 12 1 66 10.1186/s13229‑021‑00466‑2 34615521
    [Google Scholar]
  42. Grafodatskaya D. Chung B. Szatmari P. Weksberg R. Autism spectrum disorders and epigenetics. J. Am. Acad. Child Adolesc. Psychiatry 2010 49 8 794 809 10.1016/j.jaac.2010.05.005 20643313
    [Google Scholar]
  43. Yoon S. Choi J. Lee W. Do J. Genetic and epigenetic etiology underlying autism spectrum disorder. J. Clin. Med. 2020 9 4 966 10.3390/jcm9040966 32244359
    [Google Scholar]
  44. Sandin S. Schendel D. Magnusson P. Autism risk associated with parental age and with increasing difference in age between the parents. Mol. Psychiatry 2016 21 5 693 700 10.1038/mp.2015.70 26055426
    [Google Scholar]
  45. Amnuaylojaroen T. Parasin N. Saokaew S. Exploring the association between early-life air pollution exposure and autism spectrum disorders in children: A systematic review and meta-analysis. Reprod. Toxicol. 2024 125 108582 10.1016/j.reprotox.2024.108582 38556115
    [Google Scholar]
  46. Xiang A.H. Wang X. Martinez M.P. Association of maternal diabetes with autism in offspring. JAMA 2015 313 14 1425 1434 10.1001/jama.2015.2707 25871668
    [Google Scholar]
  47. Ye W. Luo C. Zhou J. Association between maternal diabetes and neurodevelopmental outcomes in children: A systematic review and meta-analysis of 202 observational studies comprising 56·1 million pregnancies. Lancet Diabetes Endocrinol. 2025 13 6 494 504 10.1016/S2213‑8587(25)00036‑1 40209722
    [Google Scholar]
  48. Ritchie H.E. Oakes D.J. Kennedy D. Polson J.W. Early gestational hypoxia and adverse developmental outcomes. Birth Defects Res. 2017 109 17 1358 1376 10.1002/bdr2.1136 29105381
    [Google Scholar]
  49. Gabis L.V. Attia O.L. Goldman M. The myth of vaccination and autism spectrum. Eur. J. Paediatr. Neurol. 2022 36 151 158 10.1016/j.ejpn.2021.12.011 34996019
    [Google Scholar]
  50. Guzelian P.S. Victoroff M.S. Halmes N.C. James R.C. Guzelian C.P. Evidence-based toxicology: A comprehensive framework for causation. Hum. Exp. Toxicol. 2005 24 4 161 201 10.1191/0960327105ht517oa 15957536
    [Google Scholar]
  51. Matson J.L. Minshawi N.F. Early intervention for autism spectrum disorders: A critical analysis. Elsevier Science 2006
    [Google Scholar]
  52. Allen G. Early intervention: The next steps, an independent report to Her Majesty’s government by Graham Allen MP. The Stationery Office 2011
    [Google Scholar]
  53. Baird G. Norbury C.F. Social (pragmatic) communication disorders and autism spectrum disorder. Arch. Dis. Child. 2016 101 8 745 751 10.1136/archdischild‑2014‑306944 26699538
    [Google Scholar]
  54. Park H.S.L. Lynch S.A. Evidence-based practices for addressing classroom behavior problems. Young Except. Child. 2014 17 3 33 47 10.1177/1096250613496957
    [Google Scholar]
  55. Bailey J.S. Burch M.R. Research methods in applied behavior analysis. Routledge 2017 10.4324/9781315543369
    [Google Scholar]
  56. Rogers S.J. Dawson G. Early Start Denver Model for young children with autism: Promoting language, learning, and engagement. Guilford Press 2010
    [Google Scholar]
  57. Rogers S.J. Vivanti G. Rocha M. Helping young children with autism spectrum disorder develop social ability: The Early Start Denver Model approach. In: Handbook of social skills and autism spectrum disorder: Assessment, curricula, and intervention. Cham Springer 2017
    [Google Scholar]
  58. Wagner A.L. Wallace K.S. Rogers S.J. Developmental approaches to treatment of young children with autism spectrum disorder. In: handbook of early intervention for autism spectrum disorders Springer York, NY 2014 393 427
    [Google Scholar]
  59. Wood D. Pivotal response therapy to initiate play in students with autism: A single case design. California State University Dominguez Hills 2017
    [Google Scholar]
  60. Robinson R. Nohelty K. Interventions to improve social and play skills for autistic children. In: Handbook of early intervention for autism spectrum disorders autism and child psychopathology series. Cham Springer 2024 379 393 10.1007/978‑3‑031‑64499‑3_19
    [Google Scholar]
  61. Prizant B.M. Wetherby A.M. Rubin E. Laurent A.C. The SCERTS model. Infants Young Child. 2003 16 4 296 316 10.1097/00001163‑200310000‑00004
    [Google Scholar]
  62. Maksimović S. Marisavljević M. Stanojević N. Importance of early intervention in reducing autistic symptoms and speech-language deficits in children with autism spectrum disorder. Children 2023 10 1 122 10.3390/children10010122 36670672
    [Google Scholar]
  63. Leahy M.M. Therapy talk: Analyzing therapeutic discourse. Lang. Speech Hear. Serv. Sch. 2004 35 1 70 81 10.1044/0161‑1461(2004/008) 15049421
    [Google Scholar]
  64. Smet N. Occupational therapy view of child development. In: Case-Smith’s occupational therapy for children and adolescents. Elsevier 2019 76 121
    [Google Scholar]
  65. May-Benson T.A. Koomar J.A. Systematic review of the research evidence examining the effectiveness of interventions using a sensory integrative approach for children. Am. J. Occup. Ther. 2010 64 3 403 414 10.5014/ajot.2010.09071 20608272
    [Google Scholar]
  66. Stahmer A.C. Vejnoska S. Iadarola S. Caregiver voices: Cross-cultural input on improving access to autism services. J. Racial Ethn. Health Disparities 2019 6 4 752 773 10.1007/s40615‑019‑00575‑y 30859514
    [Google Scholar]
  67. Kumpfer K. Magalhães C. Xie J. Cultural adaptation and implementation of family evidence-based interventions with diverse populations. Prev. Sci. 2017 18 6 649 659 10.1007/s11121‑016‑0719‑3 27757773
    [Google Scholar]
  68. Treadway S. Cultural schemas as cultural capital: The Fuerza and flexibility of Latino family values. WWU Graduate School Collection 2017 556
    [Google Scholar]
  69. Grinker R.R. Yeargin-Allsopp M. Boyle C. Culture and autism spectrum disorders: The impact on prevalence and recognition. In: Autism spectrum disorders New York Oxford Academic 2011 112136 10.1093/med/9780195371826.003.0008
    [Google Scholar]
  70. Moore S.M. Pérez-Méndez C. Working with linguistically diverse families in early intervention: Misconceptions and missed opportunities. Semin. Speech Lang. 2006 27 3 187 198 10.1055/s‑2006‑948229 16941289
    [Google Scholar]
  71. Cheng J.H. Wang C. Jhaveri V. Morrow E. Li S.T.T. Rosenthal J.L. Health care provider practices and perceptions during family-centered rounds with limited English-proficient families. Acad. Pediatr. 2021 21 7 1223 1229 10.1016/j.acap.2020.12.010 33434699
    [Google Scholar]
  72. Marshall J. Harding S. Roulstone S. Language development, delay and intervention-the views of parents from communities that speech and language therapy managers in England consider to be under-served. Int. J. Lang. Commun. Disord. 2017 52 4 489 500 10.1111/1460‑6984.12288 27995697
    [Google Scholar]
  73. Albin M. Micsinszki S. Phoenix M. Cultural adaptation of parent-implemented early communication interventions: A scoping review. Am. J. Speech Lang. Pathol. 2022 31 5 2229 2247 10.1044/2022_AJSLP‑21‑00286 35926193
    [Google Scholar]
  74. Dawson-McClure S. Calzada E.J. Brotman L.M. Engaging parents in preventive interventions for young children: Working with cultural diversity within low-income, urban neighborhoods. Prev. Sci. 2017 18 6 660 670 10.1007/s11121‑017‑0763‑7 28293777
    [Google Scholar]
  75. Aburayya A. Alshurideh M. Albqaeen A. Alawadhi D. A’yadeh I.A. An investigation of factors affecting patients waiting time in primary health care centers: An assessment study in Dubai. Manag Sci Lett 2020 10 6 1265 1276 10.5267/j.msl.2019.11.031
    [Google Scholar]
  76. Bailey D.B. Aytch L.S. Odom S.L. Symons F. Wolery M. Early intervention as we know it. Ment. Retard. Dev. Disabil. Res. Rev. 1999 5 1 11 20 10.1002/(SICI)1098‑2779(1999)5:1<11::AID‑MRDD2>3.0.CO;2‑U
    [Google Scholar]
  77. Bailey D.B. Hebbeler K. Scarborough A. Spiker D. Mallik S. First experiences with early intervention: A national perspective. Pediatrics 2004 113 4 887 896 10.1542/peds.113.4.887 15060241
    [Google Scholar]
  78. Fatahi N. Krupic F. Factors beyond the language barrier in providing health care to immigrant patients. Med. Arch. 2016 70 1 61 65 10.5455/medarh.2016.70.61‑65 26980935
    [Google Scholar]
  79. Ospina M.B. Krebs Seida J. Clark B. Behavioural and developmental interventions for autism spectrum disorder: A clinical systematic review. PLoS One 2008 3 11 3755 10.1371/journal.pone.0003755 19015734
    [Google Scholar]
  80. Trump C.E. Pennington R.C. Travers J.C. Ringdahl J.E. Whiteside E.E. Ayres K.M. Applied behavior analysis in special education: Misconceptions and guidelines for use. Teach. Except. Child. 2018 50 6 381 393 10.1177/0040059918775020
    [Google Scholar]
  81. Fujii C. Renno P. McLeod B.D. Intensive cognitive behavioral therapy for anxiety disorders in school-aged children with autism: A preliminary comparison with treatment-as-usual. School Ment. Health 2013 5 1 25 37 10.1007/s12310‑012‑9090‑0
    [Google Scholar]
  82. Bender W.N. Differentiating instruction for students with learning disabilities: Best teaching practices for general and special educators. Corwin Press 2008
    [Google Scholar]
  83. DiClemente RJ Salazar LF Crosby RA Health behavior theory for public health: Principles, foundations, and applications. 2013
    [Google Scholar]
  84. Chen I. Behaviorism. In: Encyclopedia of Distance Learning. IGI Global 2005 127 147
    [Google Scholar]
  85. Vernon T. Pivotal response treatment: Empirically supported strategies to target social competencies and motivation in individuals with ASD. In: Handbook of Social Skills and Autism Spectrum Disorder Autism and Child Psychopathology Series. Cham Springer 2017 187 196 10.1007/978‑3‑319‑62995‑7_12
    [Google Scholar]
  86. Hogarty G.E. Personal therapy for schizophrenia and related disorders: A guide to individualized treatment. Guilford Press 2002
    [Google Scholar]
  87. Rispoli K.M. Mathes N.E. Malcolm A.L. Characterizing the parent role in school-based interventions for autism: A systematic literature review. Sch. Psychol. 2019 34 4 444 457 10.1037/spq0000283 31294601
    [Google Scholar]
  88. Dueñas A.D. Plavnick J.B. Goldstein H. Effects of a multicomponent peer mediated intervention on social communication of preschoolers with autism spectrum disorder. Except. Child. 2021 87 2 236 257 10.1177/0014402920953761
    [Google Scholar]
  89. Greenberg M.T. Weissberg R.P. O’Brien M.U. Enhancing school-based prevention and youth development through coordinated social, emotional, and academic learning. Am. Psychol. 2003 58 6-7 466 474 10.1037/0003‑066X.58.6‑7.466 12971193
    [Google Scholar]
  90. Kasari C. Smith T. Interventions in schools for children with autism spectrum disorder: Methods and recommendations. Autism 2013 17 3 254 267 10.1177/1362361312470496 23592848
    [Google Scholar]
  91. Jacobs B. Ir P. Bigdeli M. Annear P.L. Van Damme W. Addressing access barriers to health services: An analytical framework for selecting appropriate interventions in low-income Asian countries. Health Policy Plan. 2012 27 4 288 300 10.1093/heapol/czr038 21565939
    [Google Scholar]
  92. Webster-Stratton C. Herman K.C. Disseminating Incredible Years Series early‐intervention programs: Integrating and sustaining services between school and home. Psychol. Sch. 2010 47 1 36 54 10.1002/pits.20450
    [Google Scholar]
  93. Givertz C.S.M. Methods of social skills training and development. In: Handbook of communication and social interaction skills. Routledge 2003 153 194
    [Google Scholar]
  94. Turygin N. Matson J.L. Konst M. Williams L. The relationship of early communication concerns to developmental delay and symptoms of autism spectrum disorders. Dev. Neurorehabil. 2013 16 4 230 236 10.3109/17518423.2012.756950 23586902
    [Google Scholar]
  95. Shepherd J. Ivey C. Assessment and treatment of activities of daily living, sleep, rest, and sexuality. Case-Smith's Occupational Therapy for Children and Adolescents-E-Book 2019 267
    [Google Scholar]
  96. Wright J.H. Cognitive-behavior therapy. American Psychiatric Publishing 2004
    [Google Scholar]
  97. Lamy M. Erickson C.A. Pharmacological management of behavioral disturbances in children and adolescents with autism spectrum disorders. Curr. Probl. Pediatr. Adolesc. Health Care 2018 48 10 250 264 10.1016/j.cppeds.2018.08.015 30262163
    [Google Scholar]
  98. Rentz E.A. Autism spectrum disorders: Developmental, individual-difference, relationship-based (DIR)/Floortime outcomes. ETD Collection for Fordham University 2015
    [Google Scholar]
  99. Svavarsdóttir S. Teacch: Treatment and education of autistic and communication handicapped children. 1995 Available from: https://www.autismtruths.org/index.php?p=TreatmentandEducation
  100. Aucoin M. LaChance L. Cooley K. Kidd S. Diet and psychosis: A scoping review. Neuropsychobiology 2020 79 1 20 42 10.1159/000493399 30359969
    [Google Scholar]
  101. Edyburn D.L. Assistive technology and students with mild disabilities. Focus Except. Child 2017 32 9 10.17161/foec.v32i9.6776
    [Google Scholar]
  102. Maniram J. Karrim S.B.S. Oosthuizen F. Wiafe E. Pharmacological management of core symptoms and comorbidities of autism spectrum disorder in children and adolescents: A systematic review. Neuropsychiatr. Dis. Treat. 2022 18 1629 1644 10.2147/NDT.S371013 35968512
    [Google Scholar]
  103. Lamy M. Pedapati E.V. Dominick K.L. Wink L.K. Erickson C.A. Recent advances in the pharmacological management of behavioral disturbances associated with autism spectrum disorder in children and adolescents. Paediatr. Drugs 2020 22 5 473 483 10.1007/s40272‑020‑00408‑0 32686015
    [Google Scholar]
  104. Dell’Osso L. Bonelli C. Giovannoni F. Available treatments for autism Spectrum disorder: From old strategies to new options. Pharmaceuticals 2025 18 3 324 10.3390/ph18030324 40143102
    [Google Scholar]
  105. Gupta N. Gupta M. Off-label psychopharmacological interventions for autism spectrum disorders: Strategic pathways for clinicians. CNS Spectr. 2024 29 1 10 25 10.1017/S1092852923002389 37539695
    [Google Scholar]
  106. Sani G. Serra G. Kotzalidis G.D. The role of memantine in the treatment of psychiatric disorders other than the dementias: A review of current preclinical and clinical evidence. CNS Drugs 2012 26 8 663 690 10.2165/11634390‑000000000‑00000 22784018
    [Google Scholar]
  107. Kleijer K.T.E. Schmeisser M.J. Krueger D.D. Neurobiology of autism gene products: Towards pathogenesis and drug targets. Psychopharmacology 2014 231 6 1037 1062 10.1007/s00213‑013‑3403‑3 24419271
    [Google Scholar]
  108. Schaefer T.L. Davenport M.H. Erickson C.A. Emerging pharmacologic treatment options for fragile X syndrome. Appl. Clin. Genet. 2015 8 75 93 10.2147/TACG.S35673 25897255
    [Google Scholar]
  109. Ravizza T. Scheper M. Di Sapia R. Gorter J. Aronica E. Vezzani A. mTOR and neuroinflammation in epilepsy: Implications for disease progression and treatment. Nat. Rev. Neurosci. 2024 25 5 334 350 10.1038/s41583‑024‑00805‑1 38531962
    [Google Scholar]
  110. Utpal B.K. Resveratrol: A natural compound targeting the PI3K/] Akt/mTOR pathway in neurological diseases. Mol. Neurobiol. 2024 62 5 5579 5608 10.1007/s12035‑024‑04608‑4 39578340
    [Google Scholar]
  111. Loth E. Does the current state of biomarker discovery in autism reflect the limits of reductionism in precision medicine? Suggestions for an integrative approach that considers dynamic mechanisms between brain, body, and the social environment. Front. Psychiatry 2023 14 1085445 10.3389/fpsyt.2023.1085445 36911126
    [Google Scholar]
  112. Ghosh A. Michalon A. Lindemann L. Fontoura P. Santarelli L. Drug discovery for autism spectrum disorder: Challenges and opportunities. Nat. Rev. Drug Discov. 2013 12 10 777 790 10.1038/nrd4102 24080699
    [Google Scholar]
  113. Rapport M.D. Moffitt C. Attention deficit/hyperactivity disorder and methylphenidate. Clin. Psychol. Rev. 2002 22 8 1107 1131 10.1016/S0272‑7358(02)00129‑0 12436807
    [Google Scholar]
  114. Cheer S.M. Goa K.L. Fluoxetine: A review of its therapeutic potential in the treatment of depression associated with physical illness. Drugs 2001 61 1 81 110 10.2165/00003495‑200161010‑00010 11217873
    [Google Scholar]
  115. Citrome L. A review of the pharmacology, efficacy and tolerability of recently approved and upcoming oral antipsychotics: An evidence-based medicine approach. CNS Drugs 2013 27 11 879 911 10.1007/s40263‑013‑0105‑7 24062193
    [Google Scholar]
  116. Kavirajan H. Memantine: A comprehensive review of safety and efficacy. Expert Opin. Drug Saf. 2009 8 1 89 109 10.1517/14740330802528420 19236221
    [Google Scholar]
  117. Balestrino R. Losa M. Albano L. Barzaghi L.R. Mortini P. Intranasal oxytocin as a treatment for obesity: Safety and efficacy. Expert Rev. Endocrinol. Metab. 2023 18 4 295 306 10.1080/17446651.2023.2216794 37232186
    [Google Scholar]
  118. Bhandari R. Kuhad A. Positioning of vasopressin V1A receptor antagonists in the therapy of autism spectrum disorders. Drugs Future 2021 46 4 10.1358/dof.2021.46.4.3168448
    [Google Scholar]
  119. Salwen-Deremer J.K. Godzik C.M. Jagielski C.H. Siegel C.A. Smith M.T. Patients with IBD want to talk about sleep and treatments for insomnia with their gastroenterologist. Dig. Dis. Sci. 2023 68 6 2291 2302 10.1007/s10620‑023‑07883‑8 36840812
    [Google Scholar]
  120. Clough S. Duff M.C. The role of gesture in communication and cognition: Implications for understanding and treating neurogenic communication disorders. Front. Hum. Neurosci. 2020 14 323 10.3389/fnhum.2020.00323 32903691
    [Google Scholar]
  121. Demoly P. Adkinson N.F. Brockow K. International Con sensus on drug allergy. Allergy 2014 69 4 420 437 10.1111/all.12350 24697291
    [Google Scholar]
  122. Choudhury P.R. Lahiri S. Rajamma U. Glutamate mediated signaling in the pathophysiology of autism spectrum disorders. Pharmacol. Biochem. Behav. 2012 100 4 841 849 10.1016/j.pbb.2011.06.023 21756930
    [Google Scholar]
  123. Heinrichs M. von Dawans B. Domes G. Oxytocin, vasopressin, and human social behavior. Front. Neuroendocrinol. 2009 30 4 548 557 10.1016/j.yfrne.2009.05.005 19505497
    [Google Scholar]
  124. Lofthouse N. Hendren R. Hurt E. Arnold L.E. Butter E. A review of complementary and alternative treatments for autism spectrum disorders. Autism Res. Treat. 2012 2012 1 1 21 10.1155/2012/870391 23243505
    [Google Scholar]
  125. Bernstein B. Voll A. Supplements, diets and other complementary and alternative interventions in adolescent mental health. Adolesc. Psychiatry 2015 5 2 73 83 10.2174/221067660502150430154627
    [Google Scholar]
  126. Levy S.E. Hyman S.L. Complementary and alternative medicine treatments for children with autism spectrum disorders. Child Adolesc. Psychiatr. Clin. N. Am. 2015 24 1 117 143 10.1016/j.chc.2014.09.004 25455579
    [Google Scholar]
  127. Muldoon M. Omega-3 Fatty Acids. In: Encyclopedia of Behavioral Medicine. Cham Springer 2020 1552 1555 10.1007/978‑3‑030‑39903‑0_270
    [Google Scholar]
  128. Reissmann A. Gluten-free and casein-free diets in the management of autism spectrum disorder: A systematic literature review. Movement and Nutrition in Health and Disease 2020 4
    [Google Scholar]
  129. Conner C.M. White S.W. Beck K.B. Golt J. Smith I.C. Mazefsky C.A. Improving emotion regulation ability in autism: The Emotional Awareness and Skills Enhancement (EASE) program. Autism 2019 23 5 1273 1287 10.1177/1362361318810709 30400749
    [Google Scholar]
  130. Biggs A.T. Littlejohn L.F. Looking for more than hot air. Med. Gas Res. 2022 12 4 116 124 10.4103/2045‑9912.337992 35435421
    [Google Scholar]
  131. McCracken J.T. Anagnostou E. Arango C. Drug development for Autism Spectrum Disorder (ASD): Progress, challenges, and future directions. Eur. Neuropsychopharmacol. 2021 48 3 31 10.1016/j.euroneuro.2021.05.010 34158222
    [Google Scholar]
  132. Nichter M. Thompson J.J. For my wellness, not just my illness: North Americans’ use of dietary supplements. Cult. Med. Psychiatry 2006 30 2 175 222 10.1007/s11013‑006‑9016‑0 16841188
    [Google Scholar]
  133. Zhang J. Mayton M.R. Wheeler J.J. Effectiveness of gluten-free and casein-free diets for individuals with autism spectrum disorders: An evidence-based research synthesis. Educ. Train. Autism Dev. Disabil. 2013 48 276 287
    [Google Scholar]
  134. Zafirovski K. Aleksoska M.T. Thomas J. Hanna F. Impact of gluten-free and casein-free diet on behavioural outcomes and quality of life of autistic children and adolescents: A scoping review. Children 2024 11 7 862 10.3390/children11070862 39062311
    [Google Scholar]
  135. Lange K.W. Omega-3 fatty acids and mental health. Global Health Journal 2020 4 1 18 30 10.1016/j.glohj.2020.01.004
    [Google Scholar]
  136. Peeke P. Fit to Live: The 5-Point Plan to be Lean, Strong, and Fearless for Life. Rodale Books 2007
    [Google Scholar]
  137. Taylor G.B. Vasquez T.S. Kastrinos A. Fisher C.L. Puig A. Bylund C.L. The adverse effects of meditation-interventions and mind–body practices: A systematic review. Mindfulness 2022 13 8 1839 1856 10.1007/s12671‑022‑01915‑6
    [Google Scholar]
  138. Ma B.L. Ma Y.M. Pharmacokinetic herb–drug interactions with traditional Chinese medicine: Progress, causes of conflicting results and suggestions for future research. Drug Metab. Rev. 2016 48 1 1 26 10.3109/03602532.2015.1124888 26915920
    [Google Scholar]
  139. Vogel J.H.K. Bolling S.F. Costello R.B. Integrating complementary medicine into cardiovascular medicine: A report of the american college of cardiology foundation task force on clinical expert consensus documents (writing committee to develop an expert consensus document on complementary and integrative medicine). J. Am. Coll. Cardiol. 2005 46 1 184 221 10.1016/j.jacc.2005.05.031 15992662
    [Google Scholar]
  140. Ortega M.A. Fraile-Martinez O. García-Montero C. A general overview on the hyperbaric oxygen therapy: Applications, mechanisms and translational opportunities. Medicina 2021 57 9 864 10.3390/medicina57090864 34577787
    [Google Scholar]
  141. Podgórska-Bednarz J. Perenc L. Hyperbaric oxygen therapy for children and youth with autism spectrum disorder: A review. Brain Sci. 2021 11 7 916 10.3390/brainsci11070916 34356150
    [Google Scholar]
  142. Jafarabadi M.A. Gholipour K. Shahrokhi H. Disparities in the quality of and access to services in children with autism spectrum disorders: A structural equation modeling. Arch. Public Health 2021 79 1 58 10.1186/s13690‑021‑00577‑5 33902706
    [Google Scholar]
  143. Williams D.R. Mohammed S.A. Leavell J. Collins C. Race, socioeconomic status, and health: Complexities, ongoing challenges, and research opportunities. Ann. N. Y. Acad. Sci. 2010 1186 1 69 101 10.1111/j.1749‑6632.2009.05339.x 20201869
    [Google Scholar]
  144. Leseman P. Early childhood education and care for children from low-income or minority backgrounds. OECD 2002
    [Google Scholar]
  145. Marsh A. Spagnol V. Grove R. Eapen V. Transition to school for children with autism spectrum disorder: A systematic review. World J. Psychiatry 2017 7 3 184 196 10.5498/wjp.v7.i3.184 29043156
    [Google Scholar]
  146. Brown W. Churchill C. Insurance provision in low income communities: Part II: Initial lessons from micro-Insurance experiments for the poor, USAID - Microenterprise Best Practices (MBP) Project. Bethesda, MD Development Alternatives Inc 2000
    [Google Scholar]
  147. Schouten B.C. Meeuwesen L. Cultural differences in medical communication: A review of the literature. Patient Educ. Couns. 2006 64 1-3 21 34 10.1016/j.pec.2005.11.014 16427760
    [Google Scholar]
  148. Preece D. Lessner Lištiaková I. “There isn’t really anything around here…”: Autism, education and the experience of families living in rural coastal England. Educ. Sci. 2021 11 8 397 10.3390/educsci11080397
    [Google Scholar]
  149. Bishop-Fitzpatrick L. Kind A.J.H. A scoping review of health disparities in autism spectrum disorder. J. Autism Dev. Disord. 2017 47 11 3380 3391 10.1007/s10803‑017‑3251‑9 28756549
    [Google Scholar]
  150. Daniels A.M. Halladay A.K. Shih A. Elder L.M. Dawson G. Approaches to enhancing the early detection of autism spectrum disorders: A systematic review of the literature. J. Am. Acad. Child Adolesc. Psychiatry 2014 53 2 141 152 10.1016/j.jaac.2013.11.002 24472250
    [Google Scholar]
  151. Chatterji P. Decker S.L. Markowitz S. The effects of mandated health insurance benefits for autism on out-of-pocket costs and access to treatment. J. Policy Anal. Manage. 2015 34 2 328 353 10.1002/pam.21814 25893237
    [Google Scholar]
  152. Goode T.D. Dunne M.C. Bronheim S. The evidence base for cultural and linguistic competency in health care. NY Commonwealth Fund New York 2006
    [Google Scholar]
  153. Totten A.M. Telehealth-guided provider-to-provider communication to improve rural health: A systematic review. J. Telemed. Telecare 2024 30 8 1209 1229 10.1177/1357633X221139892 36567431
    [Google Scholar]
  154. Malik-Soni N. Shaker A. Luck H. Tackling healthcare access barriers for individuals with autism from diagnosis to adulthood. Pediatr. Res. 2022 91 5 1028 1035 10.1038/s41390‑021‑01465‑y 33767375
    [Google Scholar]
  155. Halpern M.T. Ward E.M. Pavluck A.L. Schrag N.M. Bian J. Chen A.Y. Association of insurance status and ethnicity with cancer stage at diagnosis for 12 cancer sites: A retrospective analysis. Lancet Oncol. 2008 9 3 222 231 10.1016/S1470‑2045(08)70032‑9 18282806
    [Google Scholar]
  156. Schlatter K.M. What Is Mental Health and Wellness? Perspectives from Native American Youth. Teachers College, Columbia University 2018
    [Google Scholar]
  157. Sumankuuro J. Crockett J. Wang S. Perceived barriers to maternal and newborn health services delivery: A qualitative study of health workers and community members in low and middle-income settings. BMJ Open 2018 8 11 021223 10.1136/bmjopen‑2017‑021223 30413495
    [Google Scholar]
  158. Young A. Ruble L. McGrew J. Public vs. private insurance: Cost, use, accessibility, and outcomes of services for children with autism spectrum disorders. Res. Autism Spectr. Disord. 2009 3 4 1023 1033 10.1016/j.rasd.2009.06.006
    [Google Scholar]
  159. Beach M.C. Price E.G. Gary T.L. Cultural competence: A systematic review of health care provider educational interventions. Med. Care 2005 43 4 356 373 10.1097/01.mlr.0000156861.58905.96 15778639
    [Google Scholar]
  160. Ali D. O’Brien S. Hull L. Kenny L. Mandy W. ‘The key to this is not so much the technology. It’s the individual who is using the technology’: Perspectives on telehealth delivery for autistic adults during the COVID-19 pandemic. Autism 2023 27 2 552 564 10.1177/13623613221108010 35791666
    [Google Scholar]
  161. Starfield B. Shi L. The medical home, access to care, and insurance: A review of evidence. Pediatrics 2004 113 5 1493 1498 10.1542/peds.113.S4.1493 15121917
    [Google Scholar]
  162. Klimidis S. Minas H. Working with interpreters and achieving culturally competent communication. In: Handbook of Communication in Oncology and Palliative Care. Oxford Oxford Academic 2010 361 373 10.1093/acprof:oso/9780199238361.003.0031
    [Google Scholar]
  163. Reese R.M. Braun M.J. Hoffmeier S. Preliminary evidence for the integrated systems using telemedicine. Telemed. J. E Health 2015 21 7 581 587 10.1089/tmj.2014.0124 25898157
    [Google Scholar]
  164. Wei H. Li Y. Zhang Y. Awareness and knowledge of autism spectrum disorder in Western China: Promoting early identification and intervention. Front. Psychiatry 2022 13 970611 10.3389/fpsyt.2022.970611 36440386
    [Google Scholar]
  165. Kominski G.F. Nonzee N.J. Sorensen A. The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annu. Rev. Public Health 2017 38 1 489 505 10.1146/annurev‑publhealth‑031816‑044555 27992730
    [Google Scholar]
  166. Zablotsky B. Maenner M.J. Blumberg S.J. Geographic disparities in treatment for children with autism spectrum disorder. Acad. Pediatr. 2019 19 7 740 747 10.1016/j.acap.2019.02.013 30858082
    [Google Scholar]
  167. Gwyn K. Bondy M.L. Cohen D.S. Racial differences in diagnosis, treatment, and clinical delays in a population‐based study of patients with newly diagnosed breast carcinoma. Cancer 2004 100 8 1595 1604 10.1002/cncr.20169 15073845
    [Google Scholar]
  168. Lewis-Fernández R. Das A.K. Alfonso C. Weissman M.M. Olfson M. Depression in US Hispanics: Diagnostic and management considerations in family practice. J. Am. Board Fam. Med. 2005 18 4 282 296 10.3122/jabfm.18.4.282 15994474
    [Google Scholar]
  169. Cai J. Wang X. Ma A. Wang Q. Han X. Li Y. Factors associated with patient and provider delays for tuberculosis diagnosis and treatment in Asia: A systematic review and meta-analysis. PLoS One 2015 10 3 0120088 10.1371/journal.pone.0120088 25807385
    [Google Scholar]
  170. Altekruse S.F. McGlynn K.A. Dickie L.A. Kleiner D.E. Hepatocellular carcinoma confirmation, treatment, and survival in surveillance, epidemiology, and end results registries, 1992-2008. Hepatology 2012 55 2 476 482 10.1002/hep.24710 21953588
    [Google Scholar]
  171. Murphy C. Wilson C.E. Robertson D.M. Autism spectrum disorder in adults: Diagnosis, management, and health services development. Neuropsychiatr. Dis. Treat. 2016 12 1669 1686 10.2147/NDT.S65455 27462160
    [Google Scholar]
  172. Alverson C.Y. Lindstrom L.E. Hirano K.A. High school to college: Transition experiences of young adults with autism. Focus Autism Other Dev. Disabl. 2019 34 1 52 64 10.1177/1088357615611880
    [Google Scholar]
  173. Levine C. Halper D. Peist A. Gould D.A. Bridging troubled waters: Family caregivers, transitions, and long-term care. Health Aff. 2010 29 1 116 124 10.1377/hlthaff.2009.0520 20048369
    [Google Scholar]
  174. Segrin C. Taylor M. Positive interpersonal relationships mediate the association between social skills and psychological well-being. Pers. Individ. Dif. 2007 43 4 637 646 10.1016/j.paid.2007.01.017
    [Google Scholar]
  175. McDonough J.T. Revell G. Accessing employment supports in the adult system for transitioning youth with autism spectrum disorders. J. Vocat. Rehabil. 2010 32 2 89 100 10.3233/JVR‑2010‑0498
    [Google Scholar]
  176. Abbott A.C. Promoting Independence. In: Counseling Adults with Autism. Routledge 2019 182 203
    [Google Scholar]
  177. Wehman P. Lau S. Molinelli A. Supported employment for young adults with autism spectrum disorder: Preliminary data. Res. Pract. Persons Severe Disabl. 2012 37 3 160 169 10.2511/027494812804153606
    [Google Scholar]
  178. Jobe J.B. Smith D.M. Ball K. ACTIVE: A cognitive intervention trial to promote independence in older adults. Control. Clin. Trials 2001 22 4 453 479 10.1016/S0197‑2456(01)00139‑8 11514044
    [Google Scholar]
  179. Barnes S. Carson J. Gournay K. Enhanced supported living for people with severe and persistent mental health problems: A qualitative investigation. Health Soc. Care Community 2022 30 6 e4293 e4302 10.1111/hsc.13822 35524392
    [Google Scholar]
  180. Broekhuizen T.L.J. Alsem K.J. Success factors for mass customization: A conceptual model. J. Mark. Focus. Manag. 2002 5 4 309 330 10.1023/B:JMFM.0000008072.35988.ef
    [Google Scholar]
  181. King C. Merrick H. Le Couteur A. How should we support young people with ASD and mental health problems as they navigate the transition to adult life including access to adult healthcare services. Epidemiol. Psychiatr. Sci. 2020 29 90 10.1017/S2045796019000830 31915102
    [Google Scholar]
  182. Cooley W.C. Supporting the health care transition from adolescence to adulthood in the medical home. IL, USA American Academy of Pediatrics Elk Grove Village 2011 182 200
    [Google Scholar]
  183. Osgood D.W. Foster E.M. Courtney M.E. Vulnerable populations and the transition to adulthood. Future Child. 2010 20 1 209 229 10.1353/foc.0.0047 20364628
    [Google Scholar]
  184. Pillay S. Duncan M. de Vries P.J. “We are doing the best we can to bridge the gap” - Service provider perspectives of educational services for autism spectrum disorder in South Africa. Front. Psychiatry 2022 13 907093 10.3389/fpsyt.2022.907093 35928780
    [Google Scholar]
  185. Russa M.B. Matthews A.L. Owen-DeSchryver J.S. Expanding supports to improve the lives of families of children with autism spectrum disorder. J. Posit. Behav. Interv. 2015 17 2 95 104 10.1177/1098300714532134
    [Google Scholar]
  186. Manela R.W. Manela P.K. Janeczko G.L. Planning and supporting the transition of secondary school students from school to adult life. In: Sourcebook of rehabilitation and mental health practice. Springer 2004 335 350 10.1007/0‑306‑47893‑5_25
    [Google Scholar]
  187. Lindstrom L. Kahn L.G. Lindsey H. Navigating the early career years: Barriers and strategies for young adults with disabilities. J. Vocat. Rehabil. 2013 39 1 1 12 10.3233/JVR‑130637
    [Google Scholar]
  188. Garcia A. The impact of cooking groups on one individual’s transition to independent living. 2020 Available from: https://encompass.eku.edu/otdcapstones/
  189. Ma R. Mann F. Wang J. The effectiveness of interventions for reducing subjective and objective social isolation among people with mental health problems: A systematic review. Soc. Psychiatry Psychiatr. Epidemiol. 2020 55 7 839 876 10.1007/s00127‑019‑01800‑z 31741017
    [Google Scholar]
  190. Davis M. Pioneering transition programs; The establishment of programs that span the ages served by child and adult mental health. Systems and Psychosocial Advances Research Center Publications and Presentations 2007
    [Google Scholar]
  191. Mosley J.E. Keeping the lights on: How government funding concerns drive the advocacy agendas of nonprofit homeless service providers. J. Public Adm. Res. Theory 2012 22 4 841 866 10.1093/jopart/mus003
    [Google Scholar]
  192. Shivers C.M. Sonnier-Netto L. Lee G.K. Needs and experiences of family caregivers of individuals with autism spectrum disorders across the lifespan. J. Policy Pract. Intell. Disabil. 2019 16 1 21 29 10.1111/jppi.12272
    [Google Scholar]
  193. Sánchez Amate J.J. Luque de la Rosa A. The effect of autism spectrum disorder on family mental health: Challenges, emotional impact, and coping strategies. Brain Sci. 2024 14 11 1116 10.3390/brainsci14111116 39595879
    [Google Scholar]
  194. Julian M.M. Lawler J.M. Rosenblum K.L. Caregiver-child relationships in early childhood: Interventions to promote well-being and reduce risk for psychopathology. Curr. Behav. Neurosci. Rep. 2017 4 2 87 98 10.1007/s40473‑017‑0110‑0
    [Google Scholar]
  195. Werner C.D. Linting M. Vermeer H.J. Van IJzendoorn M.H. Do intervention programs in child care promote the quality of caregiver-child interactions? A meta-analysis of randomized controlled trials. Prev. Sci. 2016 17 2 259 273 10.1007/s11121‑015‑0602‑7 26411312
    [Google Scholar]
  196. Kumar P. Parent mediated intervention for children with disabilities. Libr Prog: Libr Sci Inf Technol Comput 2024 44 3 10.48165/bapas.2024.44.2.1
    [Google Scholar]
  197. Barber A.B. Swineford L. Cook C. Belew A. Effects of Project ImPACT parent-mediated intervention on the spoken language of young children with Autism Spectrum Disorder. Perspect. ASHA Spec. Interest Groups 2020 5 3 573 581 10.1044/2020_PERSP‑20‑10005
    [Google Scholar]
  198. Ross M.C. Promoting joint attention in children with visual impairment: Proposing an intervention using modified strategies from joint attention symbolic play engagement regulation (JASPER). The Ohio State University 2017
    [Google Scholar]
  199. Gulsrud A.C. Shih W. Paparella T. Kasari C. Comparative efficacy of an early intervention “parent and me” program for infants showing signs of autism: The Baby JASPER model. Infant Behav. Dev. 2024 76 101952 10.1016/j.infbeh.2024.101952 38678861
    [Google Scholar]
  200. Wong W.C.P. Chow S.L. Evaluation on the effectiveness on the implementation of WHO caregiver skills training (CST) programme in Hong Kong: A randomised controlled trial protocol. BMJ Open 2022 12 6 054099 10.1136/bmjopen‑2021‑054099 35725254
    [Google Scholar]
  201. Weiler L.M. Scafe M. Spencer R. Cavell T.A. Caregiver-initiated mentoring: Developing a working model to mitigate social isolation. Clin. Soc. Work J. 2020 48 1 6 17 10.1007/s10615‑019‑00723‑1
    [Google Scholar]
  202. Elder J.H. Brasher S. Alexander B. Identifying the barriers to early diagnosis and treatment in underserved individuals with autism spectrum disorders (ASD) and their families: A qualitative study. Issues Ment. Health Nurs. 2016 37 6 412 420 10.3109/01612840.2016.1153174 27070190
    [Google Scholar]
  203. Nakamura Y. Laberge M. Davis A. Formoso A. Barriers and strategies for specialty care access through federally qualified health centers: A scoping review. J. Health Care Poor Underserved 2019 30 3 910 933 10.1353/hpu.2019.0064 31422979
    [Google Scholar]
  204. Blackwell W.H. Rossetti Z.S. The development of individualized education programs: Where have we been and where should we go now? SAGE Open 2014 4 2 2158244014530411 10.1177/2158244014530411
    [Google Scholar]
  205. McIntyre L.L. Parent training interventions to reduce challenging behavior in children with intellectual and developmental disabilities. Int. Rev. Res. Dev. Disabil. 2013 44 245 279 10.1016/B978‑0‑12‑401662‑0.00008‑7
    [Google Scholar]
  206. Duncan A.W. Klinger L.G. Autism spectrum disorders: Building social skills in group, school, and community settings. Evidence-Based Group Work in Community Settings 2013 73 91
    [Google Scholar]
  207. Bircanin F. Challenges and opportunities in using augmentative and alternative communication (AAC) technologies: Design considerations for adults with severe disabilities. Proceedings of the 31st Australian Conference on Human-Computer-Interaction Fremantle, WA, Australia, 2019 , pp. 184-193. 10.1145/3369457.3369473
    [Google Scholar]
  208. Orwat J. Kumaria S. Dentato M.P. Financing and delivery of behavioral health in the United States. In: Behavioral and mental health care policy and practice. Routledge 2018 78 102 10.4324/9781315641379‑6
    [Google Scholar]
  209. Lushin V. O’Brien K.H. Parental mental health: Addressing the unmet needs of caregivers for children with autism spectrum] disorders. J. Am. Acad. Child Adolesc. Psychiatry 2016 55 12 1013 1015 10.1016/j.jaac.2016.09.507 27871633
    [Google Scholar]
  210. Swartz K. Collins L.G. Caregiver Care. Am. Fam. Physician 2019 99 11 699 706 31150177
    [Google Scholar]
  211. Daynes-Kearney R. Gallagher S. Online support groups for family caregivers: Scoping review. J. Med. Internet Res. 2023 25 46858 10.2196/46858 38090796
    [Google Scholar]
  212. Clark H.B. Crosland K.A. Social and life skills development: Preparing and facilitating youth for transition into young adults. In: Achieving permanence for older children and youth in foster care. Columbia University Press 2009 313 336 10.7312/kerm14688‑018
    [Google Scholar]
  213. Cohen M.D. A guide to special education advocacy: What parents, clinicians, and advocates need to know. Jessica Kingsley Publishers 2009
    [Google Scholar]
  214. Yack E. Sutton S. Aquilla P. Building bridges through sensory integration. Future Horizons 2002
    [Google Scholar]
  215. Damiano C.R. Mazefsky C.A. White S.W. Dichter G.S. Future directions for research in autism spectrum disorders. J. Clin. Child Adolesc. Psychol. 2014 43 5 828 843 10.1080/15374416.2014.945214 25216048
    [Google Scholar]
  216. Loth E. Murphy D.G. Spooren W. Defining precision medicine approaches to autism spectrum disorders: Concepts and challenges. Front. Psychiatry 2016 7 188 10.3389/fpsyt.2016.00188 27965598
    [Google Scholar]
  217. Lacey R.E. Minnis H. Practitioner Review: Twenty years of research with adverse childhood experience scores – Advantages, disadvantages and applications to practice. J. Child Psychol. Psychiatry 2020 61 2 116 130 10.1111/jcpp.13135 31609471
    [Google Scholar]
  218. Genovese A. Butler M.G. Clinical assessment, genetics, and treatment approaches in autism spectrum disorder (ASD). Int. J. Mol. Sci. 2020 21 13 4726 10.3390/ijms21134726 32630718
    [Google Scholar]
  219. García-Gutiérrez M.S. Navarrete F. Sala F. Gasparyan A. Austrich-Olivares A. Manzanares J. Biomarkers in psychiatry: Concept, definition, types and relevance to the clinical reality. Front. Psychiatry 2020 11 432 10.3389/fpsyt.2020.00432 32499729
    [Google Scholar]
  220. Rifai N. Gillette M.A. Carr S.A. Protein biomarker discovery and validation: The long and uncertain path to clinical utility. Nat. Biotechnol. 2006 24 8 971 983 10.1038/nbt1235 16900146
    [Google Scholar]
  221. Shi J. Long-term effects of mid-dose ursodeoxycholic acid in primary biliary cirrhosis: A meta-analysis of randomized controlled trials. Am. J. Gastroenterol. 2006 101 7 1529 1538 10.1111/j.1572‑0241.2006.00634.x 16863557
    [Google Scholar]
  222. Bowen S.E. Autism spectrum disorders (ASD): State of the states of services and supports for people with ASD. Washington, DC: 2014
    [Google Scholar]
  223. Grant R. State strategies to contain costs in the early intervention program: Policy and evidence. Top. Early Child. Spec. Educ. 2005 25 4 243 250 10.1177/02711214050250040501
    [Google Scholar]
  224. Dussault G. Franceschini M.C. Not enough there, too many here: Understanding geographical imbalances in the distribution of the health workforce. Hum. Resour. Health 2006 4 1 12 10.1186/1478‑4491‑4‑12 16729892
    [Google Scholar]
  225. Wallace S. Fein D. Rosanoff M. A global public health strategy for autism spectrum disorders. Autism Res. 2012 5 3 211 217 10.1002/aur.1236 22605577
    [Google Scholar]
  226. Petrović A. Jovanović M. Breaking the cycle of addiction and disease: Novel strategies for nicotine cessation and early oral cancer screening. Int J Appl Health Care Anal 2024 9 2 15 32
    [Google Scholar]
  227. Patrinos G.P. Sarhangi N. Sarrami B. Khodayari N. Larijani B. Hasanzad M. Using ChatGPT to predict the future of personalized medicine. Pharmacogenomics J. 2023 23 6 178 184 10.1038/s41397‑023‑00316‑9 37726551
    [Google Scholar]
  228. Frangogiannis N.G. Biomarkers: Hopes and challenges in the path from discovery to clinical practice. Transl. Res. 2012 159 4 197 204 10.1016/j.trsl.2012.01.023 22424424
    [Google Scholar]
  229. Sealey L.A. Hughes B.W. Sriskanda A.N. Environmental factors in the development of autism spectrum disorders. Environ. Int. 2016 88 288 298 10.1016/j.envint.2015.12.021 26826339
    [Google Scholar]
  230. Arantes L.H. Crawford J. Gascon P. A quick scoping review of efficacy, safety, economic, and health-related quality-of-life outcomes of short- and long-acting erythropoiesis-stimulating agents in the treatment of chemotherapy-induced anemia and chronic kidney disease anemia. Crit. Rev. Oncol. Hematol. 2018 129 79 90 10.1016/j.critrevonc.2018.06.010 30097240
    [Google Scholar]
  231. Walton K.M. Borowy A.R. Gordon R.A. Wainer A.L. Enhancing stakeholder roles in autism early interventions in the United States: A stakeholder-driven research agenda. Autism 2024 28 5 1120 1134 10.1177/13623613231195743 37679945
    [Google Scholar]
  232. Chang K. Gao D. Yan J. Lin L. Cui T. Lu S. Critical roles of protein arginine methylation in the central nervous system. Mol. Neurobiol. 2023 60 10 6060 6091 10.1007/s12035‑023‑03465‑x 37415067
    [Google Scholar]
  233. Bryant J.P. Heiss J. Banasavadi-Siddegowda Y.K. Arginine methylation in brain tumors: Tumor biology and therapeutic strategies. Cells 2021 10 1 124 10.3390/cells10010124 33440687
    [Google Scholar]
  234. Lin X. Wang W. Yang M. A loss-of-function mutation in human Oxidation Resistance 1 disrupts the spatial–temporal regulation of histone arginine methylation in neurodevelopment. Genome Biol. 2023 24 1 216 10.1186/s13059‑023‑03037‑1 37773136
    [Google Scholar]
  235. Wang J. Rousseau J. Kim E. Loss of oxidation resistance 1, OXR1, is associated with an autosomal-recessive neurological disease with cerebellar atrophy and lysosomal dysfunction. Am. J. Hum. Genet. 2019 105 6 1237 1253 10.1016/j.ajhg.2019.11.002 31785787
    [Google Scholar]
  236. Menezo Y.J.R. Silvestris E. Dale B. Elder K. Oxidative stress and alterations in DNA methylation: Two sides of the same coin in reproduction. Reprod. Biomed. Online 2016 33 6 668 683 10.1016/j.rbmo.2016.09.006 27742259
    [Google Scholar]
  237. Terracina S. Tarani L. Ceccanti M. The impact of oxidative stress on the epigenetics of Fetal Alcohol Spectrum Disorders. Antioxidants 2024 13 4 410 10.3390/antiox13040410 38671857
    [Google Scholar]
  238. Silvestris E. Cohen M. Menezo Y. Oxidative stress (OS) and DNA methylation errors in reproduction a place for a support of the one carbon cycle (1-C Cycle) before conception. J Women’s Health Gynecol 2016 2 4
    [Google Scholar]
  239. Thorsen M. Oxidative stress, metabolic and mitochondrial abnormalities associated with autism spectrum disorder. Prog. Mol. Biol. Transl. Sci. 2020 173 331 354 10.1016/bs.pmbts.2020.04.018 32711815
    [Google Scholar]
  240. Kalhan S.C. Marczewski S.E. Methionine, homocysteine, one carbon metabolism and fetal growth. Rev. Endocr. Metab. Disord. 2012 13 2 109 119 10.1007/s11154‑012‑9215‑7 22418620
    [Google Scholar]
  241. Rubini E. Snoek K.M. Schoenmakers S. First trimester maternal homocysteine and embryonic and fetal growth: The Rotterdam Periconception Cohort. Nutrients 2022 14 6 1129 10.3390/nu14061129 35334786
    [Google Scholar]
  242. Rubini E. Baijens I.M.M. Horánszky A. Maternal one-carbon metabolism during the periconceptional period and human foetal brain growth: A systematic review. Genes 2021 12 10 1634 10.3390/genes12101634 34681028
    [Google Scholar]
  243. Virdi S. Jadavji N.M. The impact of maternal folates on brain development and function after birth. Metabolites 2022 12 9 876 10.3390/metabo12090876 36144280
    [Google Scholar]
  244. Freedman R. Hunter S.K. Law A.J. Clark A.M. Roberts A. Hoffman M.C. Choline, folic acid, Vitamin D, and fetal brain development in the psychosis spectrum. Schizophr. Res. 2022 247 16 25 10.1016/j.schres.2021.03.008 33838984
    [Google Scholar]
  245. Hoxha B. Hoxha M. Domi E. Folic acid and autism: A systematic review of the current state of knowledge. Cells 2021 10 8 1976 10.3390/cells10081976 34440744
    [Google Scholar]
  246. Lintas C. Linking genetics to epigenetics: The role of folate and folate‐related pathways in neurodevelopmental disorders. Clin. Genet. 2019 95 2 241 252 10.1111/cge.13421 30047142
    [Google Scholar]
  247. Araszkiewicz A.F. Jańczak K. Wójcik P. MTHFR gene polymorphisms: A single gene with wide-ranging clinical implications—A review. Genes 2025 16 4 441 10.3390/genes16040441 40282401
    [Google Scholar]
  248. DeVilbiss E.A. Gardner R.M. Newschaffer C.J. Lee B.K. Maternal folate status as a risk factor for autism spectrum disorders: A review of existing evidence. Br. J. Nutr. 2015 114 5 663 672 10.1017/S0007114515002470 26243379
    [Google Scholar]
  249. Roufael M. Bitar T. Sacre Y. Andres C. Hleihel W. Folate-methionine cycle disruptions in ASD patients and possible interventions: A systematic review. Genes 2023 14 3 709 10.3390/genes14030709 36980981
    [Google Scholar]
  250. Heland S. Fields N. Ellery S.J. Fahey M. Palmer K.R. The role of nutrients in human neurodevelopment and their potential to prevent neurodevelopmental adversity. Front. Nutr. 2022 9 992120 10.3389/fnut.2022.992120 36483929
    [Google Scholar]
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