Intended for healthcare professionals

Clinical Review State of the Art Review

Autism spectrum disorder: advances in diagnosis and evaluation

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1674 (Published 21 May 2018) Cite this as: BMJ 2018;361:k1674

Re: Autism spectrum disorder: advances in diagnosis and evaluation- thank you. A few points, if I may

I thank the Commissioning Editor and the authors for a thoughtful and thought provoking order. ( Though as yet, from England, only Mr Stone and I have commented.

1, The authors refer to African Americans. At first glance you might assume that the term embraces ALL Americans who are descended from Africans or are migrants from Africa. This assumption misses the biological fact that, say a Kikuyo is as different from an Ibo as chalk is from cheese. You would not lump together the Norse and the Catalans.

2. The “African Americans are not homogeneous culturally either.

3. First Nations. Sioux of Alberta ( even though with some mixture with later arrivals, still are different from the Nova Scotians.

4. Homing in on the English scene, as Mr John Stone has repeatedly pointed out, the government is ignoring the rising numbers, thus ignoring the burden on the social services and on educational facilities, AS WELL AS on mental health services. Is it not obvious then, that the families of these children, adolescents and adults are shattered? I would like to know how Alberta is coping.

5. Aetiological factors.
a) One rapid response from the USA, suggests that certain animal fractions may have a protective effect. Would our MRC care to explore?
b) Another rapid response from the USA suggests that autoimmune antibodies may be responsible. This too ought to be explored by the English immnologists. And if it is the case, what are precipitating factors? Are we, somehow, distorting or overwhelming some immunological processess?
Would our neurologists and immunologists be kind enough o help?
Has the Dept of Health any views? Has its agent - NHS ENGLAND any views?

Competing interests: No competing interests

10 August 2018
JK Anand
Retired doctor
Free spirit
Peterborough