Complexity science forces us to see the dynamic properties of systems and the varying properties that are related to social roots
[11,12][11][12]. ASD may be considered a complex diagnosis that resists the finding of new approaches via traditional models. It would be better tackled through interdisciplinary, systems-level approaches, considering implementation science
[13,14][13][14].
Somatic health is a key point to move forward
[15]. Several important reports have alerted about the need for the serious consideration of the CMPD of ASD
[3,4,16,17,18][3][4][16][17][18] with transdisciplinary and interdisciplinary collaboration in the context of the multimorbidity
[19]. As reference
[17] cites, ASD is defined behaviorally. It includes the consideration of impairments in social behavior, stereotypic movements, and communication issues with impact on social skills, called “core symptoms of ASD”. All these symptoms significantly impair the quality of life of people diagnosed with ASD
[20,21][20][21].
Medical conditions such as gut dysbiosis
[22], non-celiac gluten sensitivity
[23], cerebral folate deficiency
[24], food allergies and intolerances
[25], gastrointestinal
[26], metabolic
[27] and biochemical issues
[28], immune dysfunction
[29], autoimmune problems
[30], mitochondrial dysfunction
[31], barrier permeabilities
[32], oxidative stress
[33], endocrine issues
[34] and more are not explored (sometimes for years) in ASD patients. The most advanced approaches have shifted the focus of the “causation search” original framework to the study of the (epi) genetic susceptibility for ASD, from the brain to the whole body
[1[1][35],
35], and to the importance of humanism in medicine
[36] as well as to the study of genes expressed in tissues outside of the brain
[37]. As Constantino recently reported, the so-called “co-morbidities” of ASD are inappropriately named if they actually contribute to (or exacerbate) the severity of autism itself
[38]. Multimorbidity affects the generation of evidence
[39] and a new Evidence Pyramid in Evidence Based Medicine was recently proposed
[40]. Multimorbidity and hyper-multimorbidity should be taken into account in the case of ASD. The field of ASD needs personalized medicine as the norm.