An occupational therapy lens on microbiota-gut-brain modulation in ASD and ADHD

Area of Science:

• Neuroscience
• Microbiology
• Rehabilitation Science

Background:

• The gut microbiota-brain axis is increasingly linked to neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD).
• Existing research often focuses on microbial composition and neurochemical markers, with limited attention to functional participation and lived experiences.
• Translational relevance for rehabilitation remains constrained by unconfirmed causal mechanisms.

Purpose of the Study:

• To propose a reframing of microbiota-gut-brain interactions within rehabilitation sciences.
• To conceptualize these interactions as contextual physiological modulators influencing occupational readiness and regulatory capacity.
• To integrate emerging neurophysiological insights with ecological and occupation-centered models of function.

Main Methods:

• Literature review and theoretical perspective.
• Drawing on ecological models, the International Classification of Functioning (ICF) framework, and occupational therapy theories.
• Proposing a conceptual framework for understanding microbiota-gut-brain axis in rehabilitation.

Main Results:

• Microbiota-gut-brain interactions should be viewed as physiological modulators, not etiological drivers of participation restrictions.
• This reframing emphasizes their role in shaping readiness and engagement for daily functioning.
• The proposed framework supports a focus on real-world participation and ecological validity.

Conclusions:

• Repositioning microbiota-gut-brain research within a participation-focused rehabilitation framework enhances translational value.
• This approach supports function-oriented, interdisciplinary care for children with ASD and ADHD.
• Future research should prioritize participation-based outcomes and ecological validity in understanding these complex interactions.