ESPA Research

ESPA Research Autism, Asperger syndrome and autism spectrum disorder (ASD) represent our core areas of research in

Through the application of experimental research, ESPA Research aims to conduct and publish research on autism and related conditions. Our research base is varied but currently includes: (1) investigations on the potential effectiveness of a gluten- and casein-free diet for people with autism; (2) metabolomic analysis for potential biomarkers aiding early diagnosis or indicative of best- or non-re

sponse of dietary intervention; (3) the application of health informatics (data mining) to autism to aid diagnosis or ascertain somatic comorbidities. Details of published works by members of ESPA Research can be found here:
www.espa-research.org.uk/linked/publications.pdf

Our latest paper: From autism to the plural ‘autisms’: evidence from differing aetiologies, developmental trajectories a...
23/03/2025

Our latest paper: From autism to the plural ‘autisms’: evidence from differing aetiologies, developmental trajectories and symptom intensity combinations https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/abs/from-autism-to-the-plural-autisms-evidence-from-differing-aetiologies-developmental-trajectories-and-symptom-intensity-combinations/4D9B0B35DCF03FDBA4E001F7DC9B02D6
Abstract: Autism spectrum disorder is defined by the presence of sustained problems in areas of social cognition and social understanding alongside repetitive and/or restricted patterns of behaviour. Behavioural presentations and developmental trajectories in autism are highly heterogeneous. For most, characteristics variably continue across the lifespan, and, for many, they overlap with numerous overrepresented comorbid combinations spanning behavioural, psychiatric and somatic domains. The current autism diagnostic systems (DSM-5, ICD-11) reflect this heterogeneity, focusing on discerning different assistance needs and symptom severity combinations. An emerging view on the pluralisation of autism – ‘the autisms’ – based on different severity levels and different developmental trajectories is gaining popularity, bolstered by the introduction of the grouping ‘profound autism’ and observations of non-persistence of autism for some. We advance the case for expanding the definition of the plural autisms based also on the numerous different aetiological routes that can lead to autism. Various genetic conditions, susceptibility to infectious agents, non-infectious environmental exposures and immune-mediated occurrences have all been observed to culminate in a diagnosis of autism. As a triad, aetiology, presentation intensity and developmental trajectory offer new ways to classify the autisms, with potentially important implications for research and practice.

From autism to the plural ‘autisms’: evidence from differing aetiologies, developmental trajectories and symptom intensity combinations

New from members of ESPA Research: Review of Elevated Para-Cresol in Autism and Possible Impact on Symptoms https://www....
17/02/2025

New from members of ESPA Research: Review of Elevated Para-Cresol in Autism and Possible Impact on Symptoms https://www.mdpi.com/1422-0067/26/4/1513 Part of a brilliant (continuing) collaboration with Adams and Flynn at ASU. A detailed look at a metabolite that crosses lots of diagnoses and lots of biological systems.

Para-cresol (p-cresol), and its primary human metabolite p-cresol sulfate (pCS), are among the most studied gut-derived metabolites relevant to autism spectrum disorder (ASD). P-cresol is produced by bacterial modification of phenylalanine or tyrosine and is one of many potentially deleterious metab...

"... a small subset of compounds, including N-acetylcysteine, folinic acid, l-carnitine, coenzyme Q10, sulforaphane, and...
31/10/2024

"... a small subset of compounds, including N-acetylcysteine, folinic acid, l-carnitine, coenzyme Q10, sulforaphane, and metformin may already be considered, with due caution, for clinical use" https://sciencedirect.com/science/article/abs/pii/S0278584624002446 The pediatric psychopharmacology of autism: the future. Yet another review of this important area atop of the other reviews e.g. https://pubmed.ncbi.nlm.nih.gov/35246237/ All based on RCTs so evidence-based...

Some medications could improve core symptoms, although this could be likely secondary to the improvement of associated symptoms. Evidence on their efficacy and safety is preliminary; therefore, routine prescription of medications for the core symptoms cannot be recommended. Trial registration PROSPE...

"... highlights the potential clinical validity of f***l microbiome to aid in ASD diagnosis" https://tandfonline.com/doi...
29/10/2024

"... highlights the potential clinical validity of f***l microbiome to aid in ASD diagnosis" https://tandfonline.com/doi/full/10.1080/19490976.2024.2418984 N = 598, ASD vs TD = 273 vs 325.

Accumulating evidence suggests that gut microbiota alterations influence brain function and could serve as diagnostic biomarkers and therapeutic targets. The potential of using f***l microbiota sig...

An Update on Microbial Interventions in Autism Spectrum Disorder with Gastrointestinal Symptoms https://preprints.org/ma...
27/10/2024

An Update on Microbial Interventions in Autism Spectrum Disorder with Gastrointestinal Symptoms https://preprints.org/manuscript/202410.1887/v1 Preprint. Quite a few RCTs in this area.

In the United States, autism spectrum disorder (ASD) affects 1 in 33 children and is characterized by atypical social interactions, communication difficulties, and intense, restricted interests. Microbial dysbiosis in the gastrointestinal (GI) tract is frequently observed in individuals with ASD, po...

I think I might be falling into an alternative universe... Risk of physical health comorbidities in autistic adults: cli...
23/10/2024

I think I might be falling into an alternative universe... Risk of physical health comorbidities in autistic adults: clinical nested cross-sectional study https://www.cambridge.org/core/journals/bjpsych-open/article/risk-of-physical-health-comorbidities-in-autistic-adults-clinical-nested-crosssectional-study/9DDB812C21B3142D29B9DA889B034F95 Large study saying what so many have been saying for years: "Many physical health conditions were significantly more common in autism." and "certain conditions are further increased in those with concurrent intellectual disability." We talked about physical health and autism years ago: e.g. Bridging the Gap Between Physical Health and Autism Spectrum Disorder https://pmc.ncbi.nlm.nih.gov/articles/PMC7335278/ But it now looks like it's all going rather mainstream. Who knows, we might even see some preferential screening for those physical health conditions soon...?

Autism spectrum disorder (ASD) is a highly complex and heterogeneous developmental disorder that affects how individuals communicate with other people and relate to the world around them. Research and clinical focus on the behavioural and cognitive ...

AST-001 versus placebo for social communication in children with autism spectrum disorder: A randomized clinical trial h...
21/10/2024

AST-001 versus placebo for social communication in children with autism spectrum disorder: A randomized clinical trial https://onlinelibrary.wiley.com/doi/10.1111/pcn.13757 AST-001 = "an L-isomer of serine" (so external source serine). Initial effectiveness but "most common adverse drug reaction was diarrhea"

Aim This study examined the efficacy of AST-001 for the core symptoms of autism spectrum disorder (ASD) in children. Methods This phase 2 clinical trial consisted of a 12-week placebo-controlled m...

"The GM of ASDs with severe autism was characterized by an increase in Veillonella, a decrease in Monoglobus pectinilyti...
14/10/2024

"The GM of ASDs with severe autism was characterized by an increase in Veillonella, a decrease in Monoglobus pectinilyticus and a higher microbial dysbiosis index (MDI) when compared to mild-moderate ASDs" https://mdpi.com/2076-2607/12/10/2041 Obviously more to do but... plural autisms.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder. Investigations of gut microbiota (GM) play an important role in deciphering disease severity and symptoms. Overall, we stratified 70 ASD patients by neuropsychological assessment, based on Calibrated Severity Scores (CSSs) of the Autis...

Pseudo Regression in an Autistic Child: A Tale of Selective Food Intake and Vitamin Deficiency https://link.springer.com...
14/10/2024

Pseudo Regression in an Autistic Child: A Tale of Selective Food Intake and Vitamin Deficiency https://link.springer.com/article/10.1007/s12098-024-05290-z "A diagnosis of scurvy was made, and she was initiated on Vitamin C along with nutritional rehabilitation and occupational therapy." Yet more on scurvy in the context of autism. Where selective eating patterns (for whatever reasons) are a feature of autism, nutritional screening should be universal. Not that difficult to do and where present, things like scurvy are treatable.

Home Indian Journal of Pediatrics Article Pseudo Regression in an Autistic Child: A Tale of Selective Food Intake and Vitamin Deficiency Correspondence Published: 12 October 2024 (2024) Cite this article Download PDF Indian Journal of Pediatrics Aims and scope Submit manuscript Pseudo Regression in....

10/10/2024

Prevalence of attention-deficit hyperactivity disorder (ADHD): systematic review and meta-analysis https://cambridge.org/core/journals/european-psychiatry/article/prevalence-of-attentiondeficit-hyperactivity-disorder-adhd-systematic-review-and-metaanalysis/CBC560705C72C55848087632C13DBD37 100+ different studies. Concluded: "the overall prevalence of ADHD in register studies was 1.6%" with other estimates up to 5%.

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Bridging the gap: neurodevelopmental disorder risks in inborn errors of immunity https://journals.lww.com/co-allergy/ful...
08/10/2024

Bridging the gap: neurodevelopmental disorder risks in inborn errors of immunity https://journals.lww.com/co-allergy/fulltext/9900/bridging_the_gap__neurodevelopmental_disorder.162.aspx Really important area. Screening implied.

rent clinical management guidelines. Recent findings An increasing number of reports have described neurodevelopmental disorders (NDDs) comorbid with immune-mediated signs. However, the prevalence of this association in IEIs remains unknown. Summary IEIs comprise a group of clinically heterogeneous....

"The ADOS CSS [calibrated severity score] total score changed for half of the sample, reflecting an increase in ASD seve...
07/10/2024

"The ADOS CSS [calibrated severity score] total score changed for half of the sample, reflecting an increase in ASD severity for 21.9% and a decrease for 29.1% of children." https://onlinelibrary.wiley.com/doi/10.1002/aur.3242 Decreasing autism severity across 3 years for coming up to a third of kids.

ASD severity changes were assessed at baseline and 3 years later in 575 children aged 2–12 diagnosed with ASD using the ADOS-2 scale. Four distinct patterns were identified: stable high, stable low, ...

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