Paradigm Shift: New Approaches to Understanding Autism Spectrum Disorders

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Abstract

A significant increase in the prevalence of autism spectrum disorders (ASD), both worldwide and in our country, dictates the need to search for modern and effective methods of prevention, diagnosis and medical care for such patients. At the same time, the results of numerous biomedical research in the field of autism are not reflected in practical healthcare. Aims of this work — substantiation of new approaches to the organization of medical care for people with ASD. The results of promising areas of autism research in the field of genetics, epigenetics, metabolomics, microbiome and multimorbidity, which marked a paradigm shift in the understanding of autism spectrum disorders, and requiring implementation in practice, are analyzed. Based on the concept of 7-p pediatrics (programming child development and health, preventive, predictive, personalized, participatory, multiprofessional, progressive), the necessity and possibility of implementing the results of scientific research into real clinical practice of managing children with autism are substantiated. The results of fundamental scientific research in the field of ASD, revealing their complex and multifaceted nature, allow us to talk about a paradigm shift in understanding this disorder Based on a new concept of medical care — 7P-pediatrics — the results of scientific research can be translated into real clinical practice, including diagnostic, therapeutic, preventive and rehabilitative effects on autism, as well ase programming of the optimal trajectory of the cognitive-behavioral phenotype of children with neurodevelopmental features, including ASD.

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About the authors

Natalia V. Ustinova

Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Scientific and Practical Center for Mental Health of Children and Adolescents Named after G.E. Sukhareva

Author for correspondence.
Email: ust-doctor@mail.ru
ORCID iD: 0000-0002-3167-082X

MD, PhD

Russian Federation, Moscow; Moscow

Leyla S. Namazova-Baranova

Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University

Email: orgkomitet@pediatr-russia.ru
ORCID iD: 0000-0002-2209-7531

MD, PhD, Professor, Academician of the RAS

Russian Federation, Moscow; Moscow

Alexandr A. Baranov

Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery

Email: baranov@pediatr-russia.ru
ORCID iD: 0000-0003-3987-8112

MD, PhD, Professor, Academician of the RAS

Russian Federation, Moscow

Elena A. Vishneva

Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University

Email: vishneva.e@yandex.ru
ORCID iD: 0000-0001-7398-0562

MD, PhD, Professor of the RAS

Russian Federation, Moscow; Moscow

Elena V. Kaitukova

Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University

Email: sunrise_ok@mail.ru
ORCID iD: 0000-0002-8936-3590

MD, PhD

Russian Federation, Moscow; Moscow

Tatiana V. Turti

Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University

Email: turti@mail.ru
ORCID iD: 0000-0002-4955-0121

MD, PhD

Russian Federation, Moscow; Moscow

Valeriy Yu. Albitskiy

Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery

Email: albicky1941@yandex.ru
ORCID iD: 0000-0003-4314-8366

MD, PhD, Professor

Russian Federation, Moscow

Lilia R. Selimzianova

Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University

Email: lilysir@mail.ru
ORCID iD: 0000-0002-3678-7939

MD, PhD

Russian Federation, Moscow; Moscow

Elena A. Gorbunova

Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery

Email: lema020817@gmail.ru
ORCID iD: 0009-0001-0440-2715

MD, PhD

Russian Federation, Moscow

Kamilla E. Efendieva

Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University

Email: kamillaef@inbox.ru
ORCID iD: 0000-0003-0317-2425

MD, PhD

Russian Federation, Moscow; Moscow

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Supplementary files

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2. Рис. 1. 7П-педиатрия и расстройства аутистического спектра

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3. Рис. 2. Партисипативный компонент педиатрической модели оказания медицинской помощи детям с расстройством аутистического спектра

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4. Рис. 3. Накопление коморбидной патологии с возрастом у детей с расстройством аутистического спектра

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