From impasse to insight in autism research: from behavioral symptoms to biological explanations

The incomplete interface between remediation-oriented research and basic science research has hampered progress toward gaining insight into the etiologies of autism, despite the availability of abundant research data. Investigators of these two research domains differ in their background training and primary goals, which necessarily affect their missions, perspectives, research questions posed, methodologies selected, and interpretation of data from the research. Miscommunication between the two types of researchers has brought about disagreement on nearly every aspect of the research process. We discuss both sides of the impasse: a traditional clinical practice perspective based on the requirement for finding immediate answers to the remediation question and the basic science perspective with the goal of delineating the sequence of biological changes from the initial cause(s) of abnormal development to behavioral outcome. Although remediation-oriented research aims at alleviation of symptoms for today's patients, we propose that a basic science perspective seeks insight into the triggering causes and pathogenesis of the disorder from which better diagnosis and remediation may be devised for patients in the future. We suggest that research in autism can progress beyond the impasse of disagreement and competition toward information integration and insight by means of dialogue, data exchange, discussion, collaboration, and cooperation.