Developmental–behavioral profiles in children with autism spectrum disorder and co‐occurring gastrointestinal symptoms

Abstract

Gastrointestinal (GI) symptoms are frequently reported in children with autism spectrum disorder (ASD). We evaluated the frequency and severity of GI symptoms in preschool-aged children with ASD compared to participants with typical development (TD). Our goal was to ascertain whether GI symptoms are associated with differences in sex or developmental and behavioral measures. Participants were between 2 and 3.5 years of age and included 255 children with ASD (184 males/71 females) and 129 age-matched TD controls (75 males/54 females). A parent interview was used to assess GI symptoms (abdominal pain, gaseousness/bloating, diarrhea, constipation, pain on stooling, vomiting, difficulty swallowing, blood in stool or in vomit). Children with GI symptoms in each diagnostic group were compared to children without GI symptoms on measures of developmental, behavioral, and adaptive functioning. GI symptoms were reported more frequently in children with ASD compared to the TD group (47.8% vs. 17.8%, respectively). Children with ASD were also more likely to experience multiple GI symptoms (30.6% vs. 5.4%). GI symptoms were equally common in males and females across both diagnostic groups. There were no statistically significant differences in developmental or adaptive measures based on presence of GI symptoms in either ASD or TD children. Co-occurring GI symptoms were, however, associated with increased self-injurious behaviors, restricted stereotyped behaviors, aggressive behaviors, sleep problems and attention problems in both ASD and TD children. In children with ASD, a higher number of GI symptoms was associated with an increase in self-injurious behaviors, somatic complaints, reduced sleep duration, and increased parasomnias.

Feeding Problems Including Avoidant Restrictive Food Intake Disorder in Young Children With Autism Spectrum Disorder in a Multiethnic Population

“…Eating and feeding problems might in children with ASD, as in all children, be due to and/or connected to different medical causes such as food allergy, gastrointestinal disorders, disorders in oral and nasopharyngeal function, and congenital heart diseases or neurological disorders. Studies have reported a higher prevalence of gastrointestinal diseases, food allergies, and medical co-morbidities in general in children with ASD than in typically developing children (31)(32)(33). ADHD and other neurodevelopmental coexisting disorders might also affect feeding.…”

The Autism Phenome Project: Toward Identifying Clinically Meaningful Subgroups of Autism

“…This is particularly concerning because it may be more challenging for autistic children to verbalize or communicate physical pain, leading to lack of appropriate medical care. Within the APP, we evaluated parent-reported GI symptoms at Time 1 and identified a subgroup comprising 48% of autistic children who experience significant GI problems ( Restrepo et al, 2020 ). Children with significant GI problems also had higher levels of self-injurious behaviors, restricted stereotyped behaviors, sensory sensitivities, aggressive behavior, attention problems, as well as sleep problems such as shorter sleep duration, night awakenings, and parasomnia.…”

Inflammatory Bowel Disease and Patients With Mental Disorders: What Do We Know?

“…According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, ASDs are characterized by deficits in social communications and the presence of restricted interests and repetitive behaviors, including four separate disorders: autistic disorder, Asperger's syndrome, childhood disintegrative disorder and the catch-all diagnosis of pervasive developmental dis order not otherwise specified [29]. Many studies have demonstrated that children with ASD suffer frequently from gastrointestinal symptoms, such as diarrhea, constipa-tion, abdominal pain or gaseousness, mainly children with ASD and increased problem behaviors, such as social withdrawal, sleep problems and self-injuries [30,31]. According to a meta-analysis, children with ASD have three times higher risk of gastrointestinal symptoms compared to children without ASD [32].…”