Recent studies suggest a role for the microbiota in autism spectrum disorders (ASD), potentially arising from their role in modulating the immune system and gastrointestinal (GI) function or from gut–brain interactions dependent or independent from the immune system. GI problems such as chronic constipation and/or diarrhea are common in children with ASD, and significantly worsen their behavior and their quality of life. Here we first summarize previously published data supporting that GI dysfunction is common in individuals with ASD and the role of the microbiota in ASD. Second, by comparing with other publically available microbiome datasets, we provide some evidence that the shifted microbiota can be a result of westernization and that this shift could also be framing an altered immune system. Third, we explore the possibility that gut–brain interactions could also be a direct result of microbially produced metabolites.

There is a growing body of scientific evidence that the health of the microbiome (the trillions of microbes that inhabit the human host) plays an important role in maintaining the health of the host and that disruptions in the microbiome may play a role in certain disease processes. An increasing number of research studies have provided evidence that the composition of the gut (enteric) microbiome (GM) in at least a subset of individuals with autism spectrum disorder (ASD) deviates from what is usually observed in typically developing individuals. There are several lines of research that suggest that specific changes in the GM could be causative or highly associated with driving core and associated ASD symptoms, pathology, and comorbidities which include gastrointestinal symptoms, although it is also a possibility that these changes, in whole or in part, could be a consequence of underlying pathophysiological features associated with ASD. However, if the GM truly plays a causative role in ASD, then the manipulation of the GM could potentially be leveraged as a therapeutic approach to improve ASD symptoms and/or comorbidities, including gastrointestinal symptoms.

One approach to investigating this possibility in greater detail includes a highly controlled clinical trial in which the GM is systematically manipulated to determine its significance in individuals with ASD. To outline the important issues that would be required to design such a study, a group of clinicians, research scientists, and parents of children with ASD participated in an interdisciplinary daylong workshop as an extension of the 1st International Symposium on the Microbiome in Health and Disease with a Special Focus on Autism (www.microbiome-autism.com). The group considered several aspects of designing clinical studies, including clinical trial design, treatments that could potentially be used in a clinical trial, appropriate ASD participants for the clinical trial, behavioral and cognitive assessments, important biomarkers, safety concerns, and ethical considerations. Overall, the group not only felt that this was a promising area of research for the ASD population and a promising avenue for potential treatment but also felt that further basic and translational research was needed to clarify the clinical utility of such treatments and to elucidate possible mechanisms responsible for a clinical response, so that new treatments and approaches may be discovered and/or fostered in the future.

Background: Despite the high prevalence of seizure, epilepsy and abnormal electroencephalograms in individuals with autism spectrum disorder (ASD), there is little information regarding the relative effectiveness of treatments for seizures in the ASD population. In order to determine the effectiveness of traditional and non-traditional treatments for improving seizures and influencing other clinical factor relevant to ASD, we developed a comprehensive on-line seizure survey.

Methods: Announcements (by email and websites) by ASD support groups asked parents of children with ASD to complete the on-line surveys. Survey responders choose one of two surveys to complete: a survey about treatments for individuals with ASD and clinical or subclinical seizures or abnormal electroencephalograms, or a control survey for individuals with ASD without clinical or subclinical seizures or abnormal electroencephalograms. Survey responders rated the perceived effect of traditional antiepileptic drug (AED), non-AED seizure treatments and non-traditional ASD treatments on seizures and other clinical factors (sleep, communication, behavior, attention and mood), and listed up to three treatment side effects.

Results: Responses were obtained concerning 733 children with seizures and 290 controls. In general, AEDs were perceived to improve seizures but worsened other clinical factors for children with clinical seizure. Valproic acid, lamotrigine, levetiracetam and ethosuximide were perceived to improve seizures the most and worsen other clinical factors the least out of all AEDs in children with clinical seizures. Traditional non-AED seizure and non-traditional treatments, as a group, were perceived to improve other clinical factors and seizures but the perceived improvement in seizures was significantly less than that reported for AEDs. Certain traditional non-AED treatments, particularly the ketogenic diet, were perceived to improve both seizures and other clinical factors. For ASD individuals with reported subclinical seizures, other clinical factors were reported to be worsened by AEDs and improved by non-AED traditional seizure and non-traditional treatments. The rate of side effects was reportedly higher for AEDs compared to traditional non-AED treatments.

Conclusion: Although this survey-based method only provides information regarding parental perceptions of effectiveness, this information may be helpful for selecting seizure treatments in individuals with ASD.

The SARS-CoV-2 (Covid-19) virus has had severe impacts on college students' ways of life. To examine how students were coping and perceiving the Covid-19 pandemic, a secondary analysis of an online survey across the three Arizona public universities investigated students’ knowledge about Covid-19, engagement with preventive strategies, pandemic preparedness and gauged their risk perception. Results from our analysis indicate that the students were knowledgeable about Covid-19 and were changing their habits and engaging with preventive measures. Results further suggest that students were prepared for the pandemic in terms of resources and were exhibiting high-risk perceptions. The data also revealed that students who were being cautious and engaging with preventive behaviors had a higher risk-perception than individuals who were not. As for individuals who were prepared for the pandemic in terms of supplies, their risk perception was similar to those who did not have supplies. Individuals who were prepared and capable of providing a single caretaker to tend to their sick household members and isolate them in a separate room had a higher risk perception than those who could not. These results can help describe how college students will react to a future significant event, what resources students may be in need of, and how universities can take additional steps to keep their students safe and healthy. The results from this study and recommendations will provide for a stronger and more understanding campus community during times of distress and can improve upon already established university protocols for health crises and even natural disasters.

The SARS-CoV-2 (Covid-19) virus has had severe impacts on college students' ways of life. To examine how students were coping and perceiving the Covid-19 pandemic, a secondary analysis of an online survey across the three Arizona public universities investigated students’ knowledge about Covid-19, engagement with preventive strategies, pandemic preparedness and gauged their risk-perception. Results from our analysis indicate that the students were knowledgeable about Covid-19 and were changing their habits and engaging with preventive measures. Results further suggest that students were prepared for the pandemic in terms of resources and were exhibiting high-risk perceptions. The data also revealed that students who were being cautious and engaging with preventive behaviors had a higher risk-perception than individuals who were not. As for individuals who were prepared for the pandemic in terms of supplies, their risk perception was similar to those who did not have supplies. Individuals who were prepared and capable of providing a single caretaker to tend to their sick household members and isolate them in a separate room had a higher risk perception than those who could not. These results can help describe how college students will react to a future significant event, what resources students may be in need of, and how universities can take additional steps to keep their students safe and healthy. The results from this study and recommendations will provide for a stronger and more understanding campus community during times of distress and can improve upon already established university protocols for health crises and even natural disasters.