Individuals with autism spectrum disorder (ASD) struggle to access high-quality health care due to the shortage of trained providers. ECHO (Extension for Community Healthcare Outcomes) Autism is a unique educational program that allows ASD experts to provide knowledge and skills to professionals in local communities to deliver evidence-based care to children with ASD and their families. The model teaches clinicians how to screen and diagnose ASD, as well as manage common co-occurring medical and mental health issues. ECHO Autism is particularly useful for addressing the complex needs of children with ASD and reducing disparities often present in rural and underserved communities. The model can be disseminated globally due to its flexibility in accommodating local and regional differences in social norms and constructs. This article provides an overview of the format of the ECHO Autism model, data supporting the model’s efficacy, and discusses future research directions.

Background: The purpose of this study is to compare and analyze research studies focused on orthorexia nervosa (ON) as a spectrum of eating disorders, and to summarize potential risk factors in different age and social groups. ON is characterized by an obsession with healthy eating, which leads to a restrictive diet and health problems. Methods: Due to a lack of comprehensive analyses, this review re-examined studies from 2006 to 2023, initially retrieving 53,134 articles. Upon refining the criteria and risk factors for eating disorders, 34 notable records were identified. These studies employed diagnostic tools such as ORTO and BOT, focusing on risk factors for ON. Results: Results indicate that individuals suffering from eating disorders, losing weight, exercising heavily, developing relationship problems, and suffering from body dysmorphic disorder are at high risk of developing ON. A significant correlation was found between ON, BMI, and gender, but not between ON and OCD. Interestingly, ON symptoms appear to overlap with those of other eating disorders, such as anorexia and bulimia, especially in terms of obsessive control over dieting and fear of gaining weight, indicating a close relationship between the two. Conclusions: Interestingly, orthorexia nervosa may serve as a coping mechanism for anorexia, providing a sense of control. However, further research on its long-term effects is required.

Background: The rising focus on dietary choices has contributed to maladaptive eating patterns, including orthorexia nervosa (ON)—a pathological preoccupation with healthy eating. This study investigated ON prevalence and correlates in two Polish young adult cohorts to address inconsistencies in the existing literature and ON’s ambiguous nosological status. We explored its complex interplay with specific lifestyle and sociodemographic factors. Methods: The study sample consisted of 412 young adults, comprising Group 1 (G1; n = 136; 95 women, 38 men, and 3 non-binary individuals) and Group 2 (G2; n = 264; 194 women, 65 men, and 5 non-binary individuals). Data collection utilized a proprietary questionnaire for sociodemographic and health, the ORTO-15 questionnaire (cut-off < 35 points) for ON risk, and the EAT-26 for eating disorder (ED) risk. Depression was self-assessed. An analysis of sociodemographic, clinical, and lifestyle data was conducted to explore the association with orthorexia risk. Results: ON risk was identified in 26.5% of participants in G1 and 76.8% in G2. Logistic regression analysis identified different, independent predictors of ON risk for each group. In G1, these were depressive symptoms (OR = 2.52) and a co-occurring risk of eating disorders (ED) (OR = 11.37). In contrast, for G2, the predictors were smoking (OR = 2.14) and, inversely, a lower ED risk (OR = 0.16). No consistent associations were found with ON risk and age, gender, education, residence, or occupational status. Conclusions: This study confirms a strong link between ON and other eating disorders. The high ON prevalence in G2, combined with low internal consistency of ORTO-15, suggests tool limitations in specific populations. These findings highlight the need for more precise ON diagnostic tools and further research into its correlates, including body image, specific lifestyle factors, and its role within eating pathology.

Background: Autism spectrum disorder (ASD) constitutes a heterogeneous neurodevelopmental condition frequently accompanied by considerable disturbances in feeding behavior and nutritional balance. These difficulties arise from complex and multifactorial mechanisms, exerting a significant impact on physical health, metabolic homeostasis, and psychosocial functioning. The present review aims to provide a critical synthesis of current evidence regarding the underlying biological and behavioral mechanisms of feeding difficulties in ASD and to delineate the spectrum of comorbid eating disorders within this population. Methods: A narrative review of the peer-reviewed scientific literature was undertaken, emphasizing studies investigating the interrelationship between ASD and nutritional functioning in pediatric and adolescent populations. Particular focus was placed on research exploring sensory processing abnormalities, gut microbiota alterations, and the clinical manifestation of eating disorders in individuals with ASD. Results: The analysis revealed that sensory hypersensitivity, behavioral inflexibility, and disturbances within the gut–brain axis constitute principal determinants of atypical eating patterns in ASD. Individuals on the autism spectrum frequently exhibit pronounced food selectivity, neophobia, and symptoms consistent with Avoidant/Restrictive Food Intake Disorder (ARFID). Furthermore, an increased prevalence of anorexia nervosa and orthorexia nervosa has been documented, likely reflecting shared cognitive and behavioral features with ASD. “Emotional eating” tendencies and a marked preference for high-caloric, energy-dense foods—often potentiated by psychopharmacological treatment and reduced physical activity—further contribute to an elevated risk of overweight and obesity. Conclusions: Children and adolescents with ASD display a bimodal distribution of body mass, encompassing both undernutrition and obesity, indicative of a multifaceted interplay among sensory, behavioral, cognitive, and metabolic determinants. A comprehensive understanding of this heterogeneity is crucial for the development of individualized, evidence-based interventions integrating nutritional management with behavioral and psychotherapeutic approaches.

Autism spectrum disorders are a group of neurodevelopmental disorders associated with deficits in social, communication and behavioural functions. It is estimated that 1–2% of the global population is affected by autism spectrum disorders, with girls and women still representing a highly underestimated group of autistic patients. Patients with autism spectrum disorder require comprehensive care and often have difficulty accessing high-quality healthcare services due to the shortage of well-trained specialists. Extension for Community Healthcare Outcomes (ECHO) Autism is a global program that allows autism spectrum disorder experts to share their knowledge and skills with professionals in local communities. The ECHO project is a mentoring model in which an interdisciplinary team of experts plays a supreme role and provides practical information to specialists in local communities. ECHO Autism is not a form of telemedicine but a telementoring model, where specialised knowledge is delivered to local specialists. Experts teach how to investigate and diagnose autism spectrum disorder as well as how to deal with co-occurring conditions in these patients. ECHO Autism is useful in meeting the complex needs of patients with autism spectrum disorders from their childhood to late adulthood. It provides the best possible care for these patients and their families, expands practical knowledge and awareness of the disorder, while reducing the inequalities that often occur in rural and neglected communities. The ECHO Autism model is disseminated globally due to its flexibility in adapting to local and regional differences in social norms and constructs. The model is now for the first time introduced in the field of medicine in Europe, with Poland being the first country to adopt it. The aim of this paper is to briefly present the ECHO Autism model and to announce its development in Poland.

The identification criteria of autism spectrum disorders, based on symptoms presented by patients and difficulties reported by their carers, still raise controversies and doubts. Despite more and more precise diagnostic instruments, multiple dilemmas associated with establishing a proper diagnosis are still encountered in clinical practice. These mainly concern individuals with autism spectrum who are highly functional and able to compensate for or camouflage their deficits. It also happens that a behaviour of a given person confusingly resembles autism spectrum disorders, but its cause lies in problems linked with consequences of traumatic experiences of the posttraumatic stress nature which have been present for several generations. Moreover, the coexistence of both these mechanisms, i.e. neurobiological causes and disturbed relations resulting from trauma inheritance, cannot be excluded. The article discusses the process of psychotherapy in a patient who was allowed by her family system to seek specialist help only after the occurrence of severe clinical symptoms defined by a professional diagnosis. The woman belonged to a family generation that was able to recreate its dramatic history. This helped combine the cold intellectual message with profound feelings experienced by physically and emotionally harmed women, particularly during ethnic cleansing in the Polish Eastern Borderlands and repatriation.