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Abstract There were associations between a variety of environmental risk factors and ASD, indicating the contribution of environmental risks factors in ASD. Merging phoniatric therapy and dietary supplements for ASD children was found to be an effective management option despite the high frequency of risk factors among the ASD participants. Recommendations and future directions • Spreading the awareness of the involvement of environmental risk factors in ASD is mandatory. • More in-depth research with larger sample size is recommended to further emphasize the link between environmental factors and ASD. • Further consideration needs be given to environmental influences that are implicated in pathologies with autism and have been shown to alter gene expression patterns. • Studying the effect of eliminating the environmental risk factors that could be eliminated on the adaptive performance of ASD children should be performed. • Early intervention should be applied when several risk factors are detected in vulnerable children. Summary Autism spectrum disorder (ASD) is a complicated disorder. Up to 50% of its variance could be related to environmental factors. In this study, variable environmental risk factors for ASD were studied and compared among cases and controls. Furthermore, the effects of some targeted intervention approaches which were chosen according to the frequency of the detected environmental risk factors on the severity of ASD and language abilities represented by language age were compared. This study was conducted on 61 autistic children (age range:3-12 years) who visited the outpatient clinic for “Children with ASD” over a period of six months (September 2021-February 2022). They were subjected to the childhood autism rating scale (CARS), and the Arabic Preschool Language Scale. The control subjects (N=62) were selected from volunteers. A questionnaire was designed for studying the environmental risk factors. Children with ASD were then divided into two groups: group a (N=30) who received phoniatric therapy; group b (N=31; had more risk factors than group a) who received phoniatric therapy and dietary supplementation. After 3 months, both groups were reassessed. Risk factors such as prematurity (91.8%), maternal exposure to disinfectants and cleaners (78.7%), moderate maternal (39.3 %) and paternal (47.5 %) educational level, pregnancy in Summer (19.6%) and delivery in Spring (19.6%) showed significant statistical difference between cases and control subjects (P=0.00,0.01,0.00,0.04 respectively). Before the intervention, the levels of CARS scores did not show significant statistical difference between the groups in contrast to the language ages which differed significantly between the groups being high in group b. Following intervention, the severity of ASD decreased (P=0.00), and the language abilities improved in both groups. There was a significant difference regarding receptive, expressive, and total language ages (P=0.00,0.01,0.00 respectively) between the two groups. There were a variety of environmental risk factors associated with ASD. Merging phoniatric therapy and dietary supplements was an effective management option for children with ASD even with the presence of high frequency of environmental risk factors. Early intervention is recommended when several risk factors are detected in vulnerable children. |