Aug 2026· Frontiers in child and adolescent psychiatry· Vol 5· 1 citation· 33 references
Medicine
TL;DR
This manuscript proposes reframing the “autism spectrum” from a hierarchy of symptom severity to a prevention-oriented “spectrum of care” that aligns autism services with whole-child, neurodiversity-affirming, and developmentally informed care, emphasizing relational health, autonomy, and life-course participation.
Abstract
Autism care policy is at a critical inflection point. Applied behavior analysis (ABA), long established as the “gold standard” through state insurance mandates in the US, has functioned as the default reimbursable intervention for autistic children. However, advances in genomics, neuroscience, developmental psychology, and scholarship on autistic lived experience have expanded understanding of autism as a heterogeneous neurotype characterized by meaningful differences in neural organization rather than a unitary disorder. Contemporary models emphasize neurodiversity, strengths-based perspectives, and the interaction between developmental processes and environmental contexts in shaping functional outcomes. Many autistic children also meet criteria for complex care needs, requiring coordinated, interdisciplinary services across health, educational, and community systems. This manuscript proposes reframing the “autism spectrum” from a hierarchy of symptom severity to a prevention-oriented “spectrum of care.” Adapting a public health taxonomy, interventions are organized into universal, selective, and indicated levels, targeting the prevention of avoidable disability, distress, and participation barriers. This model aligns autism services with whole-child, neurodiversity-affirming, and developmentally informed care, emphasizing relational health, autonomy, and life-course participation.
Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition marked by challenges in social interaction and communication. Sensory processing differences are very common among autistic children, yet India does not currently have a unified, sensory-informed policy approach for autism care.
Policy objective: This policy proposal examines gaps in policy and service delivery for autistic individuals with sensory processing needs in India and proposes practical pathways to support holistic, system-level care.
Evidence base: A targeted search of PubMed and Google Scholar was conducted using terms such as “autism and sensory processing disorder,” “ASD with sensory processing difficulties,” and “autism policy framework,” combined with keywords related to health, education and support systems.
Proposed policy: Evidence indicates substantial sensory processing needs among autistic individuals. Persistent gaps include limited early screening, inadequate access to occupational therapy and other allied services, and weak coordination across healthcare, education and community services. The proposal links primary health centres, district hospitals, schools, community services and telehealth supports.
Conclusion: Building sensory-informed screening and early-intervention pathways, strengthening workforce capacity and improving coordination across systems are critical to reducing long-term burden for autistic individuals and their families in India.
Kunal Gaurav, Abhay Jaiswal, Hima Charan· International journal of all...· 0 citations
Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental
condition characterized by deficits in social communication and the presence of
restricted or repetitive behaviors and interests. Increasing prevalence rates underscore
the importance of early identification and timely intervention. This review
examines current and emerging diagnostic and management approaches to ASD.
Standardized diagnostic frameworks, such as the DSM-5 criteria, remain central
to clinical assessment. Recent advances in screening tools have enhanced early
detection. Due to the heterogeneity of clinical presentations, individualized care
is necessary. Management strategies commonly integrate behavioral and developmental
interventions, educational support, family involvement, and, when appropriate,
pharmacological treatment for associated symptoms. Functional outcomes
are further improved by strategies, such as executive function training, occupational
therapy, technology-assisted therapies, and caregiver-mediated programs.
Research indicates that extensive family involvement and coordinated, interdisciplinary
care lead to improved long-term outcomes. To maximise functioning,
engagement, and quality of life, the existing literature generally supports a
comprehensive, flexible, and person-centred approach that takes into account
each person's unique needs and strengths.
D. I. Khan, Sana Jameel· Current Psychiatry Research...· 0 citations
It is argued that AI’s most important contribution to autism care is unlikely to lie in marginal improvements in classification accuracy alone, and its potential value lies in expanding access, supporting task-sharing, shortening diagnostic pathways, enabling population-oriented screening, and reaching under-recognised groups.
Xugao Han, Lingyan Weng, Houxi Xu· Frontiers in Public Health· 0 citations
Autism intervention systems remain organized around observable behavior, reflecting frameworks established before network neuroscience reshaped how the condition is understood. Meanwhile, adult outcomes in employment, independent living, and social participation remain poor, and intervention trials have rarely followed children far enough to know whether they change. Differences in large-scale brain network organization appear to have reproducible implications for how autistic individuals experience participation, regulate arousal, process internal states, and sustain adaptive performance. This suggests that observable behavior is the downstream expression of network-level organization rather than its primary explanatory locus, with sustained compensatory efforts such as masking and camouflaging carrying measurable costs, including elevated risk for anxiety, burnout, and suicidality. Using joint attention as a case study, this article argues that behavioral description and neural mechanism are not interchangeable, and that training behavioral surface forms without supporting the underlying neural integration may produce assessment-satisfying performance while leaving core developmental functions unaddressed. Rather than asserting a new model of care, the article poses a translational challenge to the pediatric community: to examine whether these network differences should inform the next evolution of autism care, incorporating regulatory capacity, interoceptive awareness, and executive burden as clinical considerations alongside—not merely in service of—observable behavior.
Steven Merahn· Frontiers in Pediatrics· 0 citations
As global diagnostic capabilities for Autism Spectrum Disorder (ASD) advance, a structural demographic shift has emerged: millions of autistic children are transitioning into adulthood. While early intervention has historically received significant public health funding, adult infrastructure remains severely underdeveloped, particularly in the Global South. One of the most profound yet under-recognized concerns facing families is the question often expressed by ageing parents: "What will happen to my child after I die?" This question encapsulates a growing humanitarian and public policy crisis. Across the world, millions of parents continue to provide lifelong care for autistic sons and daughters who require varying levels of support for daily living, healthcare, communication, financial management and social participation. This primary concern among aging parents of autistic adults is the "What after us?" dilemma, the profound anxiety regarding who will care for their high-support children once the primary caregivers pass away. This paper provides a comparative analysis of adult autism services, contrasting the structured, state-supported residential models found in high-income (First World) nations with the highly fragmented, private-dependent infrastructure in India. This paper analyses the architectural, economic, and ethical requirements needed to construct viable vocational and residential frameworks for autistic adults with high support needs. This also paper maps the implementation of comprehensive adult autism support onto the United Nations Sustainable Development Goals (SDGs), arguing that lifelong care is not merely a welfare initiative, but an essential component of global sustainable development. This paper argues for a paradigm shift toward long-term vocational support systems and neuro-inclusive, community-integrated residential frameworks to ensure equity, bodily autonomy and systemic dignity.
Mitu De, Santi Ranjan Dey· International Journal of Sus...· 0 citations
This review systematically summarizes the conceptual definition and clinical phenotypes of profound autism and emphasizes the need to shift the intervention focus toward managing serious comorbidities and establishing augmentative and alternative communication systems.
Yang Xue, Fei-yong Jia· Zhongguo dang dai er ke za z...· 0 citations
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