This article is a reconsideration of how we as practitioners go about delivering treatment to youngsters with Autism Spectrum Disorder (ASD). The focus here is on the order of services to “boost” efficacy. Our paper suggests that one of several biological modifications either precede or be concurrent with an environmental modification for maximum synergistic impact. Recent research is targeting individuals on the autism spectrum ages 1.5 – 20, an expansion in age in both directions over the past several decades. Potential biological approaches center upon probiotics, diet or vitamin/mineral supplements, Microbiota Transfer Therapy (M.T.T.) aka Fecal Transfer Therapy (F.T.T.), or homeopathy, while current environmental options focus upon applied behavior analysis (ABA), Pivotal Response Training (PRT), sensory motor integration, or exercise programs.

Dean Alexander is a developmental psychologist and therapist based in the United States, affiliated with LCS Behavioral Health. He has over 30 years of experience in autism, Applied Behavior Analysis (ABA), discrete-trial training, and developmental disabilities. His professional interests include autism treatment, behavioral interventions, and the interaction between biological and environmental factors affecting treatment outcomes. He has authored research and professional articles exploring setting events and their potential role in improving autism interventions. His work considers how biological factors such as diet and the gut microbiome may complement behavioral approaches. He continues to contribute to discussions on innovative and integrated approaches to autism care and developmental support.