Gastrointestinal symptoms and behavioral problems in preschoolers with Autism Spectrum Disorder

Fulceri, Francesca; Morelli, Maria Sole; Santocchi, Elisa; Cena, Hellas; Bianco, Teresa Del; Narzisi, Antonio; Calderoni, Sara; Muratori, Filippo

doi:10.1016/j.dld.2015.11.026

Cited by 131 publications

(107 citation statements)

References 49 publications

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“…Further, other studies have reported that co-occurring conditions/symptoms tend to cluster in the same individual (Boulet et al 2009; Fulceri et al 2016; Hirata et al 2016; Levy et al 2010; Lundstrom et al 2015; Magnusdottir et al 2016; Simonoff et al 2008). Using the National Health Interview Survey data, Boulet et al (2009) found that 96% of children with ASD had one or more co-occurring developmental disabilities.…”

Section: Introductionmentioning

confidence: 97%

Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with Autism Spectrum Disorder in Selected Areas of the United States in 2010

Soke

Maenner

Christensen

et al. 2018

J Autism Dev Disord

149

153

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We compared the prevalence of various medical and behavioral co-occurring conditions/symptoms between 4- and 8-year-olds with autism spectrum disorder (ASD) from five sites in the Autism and Developmental Disabilities Monitoring Network during the 2010 survey year, accounting for sociodemographic differences. Over 95% of children had at least one co-occurring condition/symptom. Overall, the prevalence was higher in 8- than 4-year-olds for 67% of co-occurring conditions/symptoms examined. Further, our data suggested that co-occurring conditions/symptoms increased or decreased the age at which children were first evaluated for ASD. Similarly, among the 8-year-olds, the prevalence of most co-occurring conditions/symptoms was higher in children with a previous ASD diagnosis documented in their records. These findings are informative for understanding and screening co-occurring conditions/symptoms in ASD.

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Section: Introductionmentioning

confidence: 97%

Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with Autism Spectrum Disorder in Selected Areas of the United States in 2010

Soke

Maenner

Christensen

et al. 2018

J Autism Dev Disord

149

153

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“…For example, disruption of the microbiota-gut-brain axis has recently become a focus of study in ASD. 38,[43][44][45][46] The ability to examine ASD comorbidities in a population over time holds the potential to rank-order the relative importance of a specific comorbid disorder associated with ASD and to inform research. Being able to accomplish the ranked comparison, as illustrated in Table 2, in terms of the comorbidity of ASD and the main ICD-9 classes of disorder, permits more precise examination related to the comparative magnitude and prevalence of the comorbidities.…”

Section: Original Research and Contributionsmentioning

confidence: 99%

Comprehensive Description of Comorbidity for Autism Spectrum Disorder in a General Population

Cawthorpe

2017

TPJ

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Context: Few published studies of autism spectrum disorder (ASD) and comorbidity are population based.Objective: To describe the comorbidity of ASD and disorders listed in the main classes of the International Classification of Diseases, Ninth Revision (ICD-9) in a general population.Design: Direct physician billing data for the city of Calgary, Alberta, Canada, for the treatment of any presenting concern in the Calgary Health Zone (n = 763,449) from 1994 to 2009 were extracted. Diagnosed ICD-9 disorders (independent variable) were grouped into 17 categories using ICD-9 diagnosis codes. ASD (dependent variable) was classified under ICD-9 Code 299. Individuals with and without independent disorder classes were counted by the presence or absence of any ASD. Odds ratios (ORs) and 95% confidence intervals of the association were calculated.Main Outcome Measures: ORs of ASD comorbidities. Results: Annual rates of ASD increased 3.9-fold for males and 1.4-fold for females. Diagnosed disorders ranked by OR in the independent ICD-9 categories indicated that males with ASD had overall higher ORs (> 1.0) in 11 main ICD-9 classes, and females with ASD had higher ORs (> 1.0) in 12 main ICD-9 classes. Males with ASD had lower ORs in 4 main ICD-9 disease classes; females with ASD had lower ORs related only to the main class "complications of pregnancy and childbirth." Five main ICD-9 classes were not significant for males or females.Conclusions: Patients with ASD have significant comorbidity of physical disorders. This finding may inform other areas of research and assessment in clinical management.

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“…This finding has implications beyond medical status for children with ASD. Specifically, the fact that GI symptoms suggestive of CD are difficult to express in words by non-verbal or minimally-verbal preschoolers with ASD implies a possible manifestation of GI-related distress through behavioral symptoms, including increased anxiety, decreased social responsiveness, temper tantrums, opposition, sleep problems, food selectivity, aggressive and self-injurious acts [4, 41, 47, 48]. In these cases, if a diagnosis of CD is confirmed, the treatment of ASD patients for CD with a gluten-free diet may not only alleviate their CD-related symptoms, but also have a positive impact on associated behavioral problems.…”

Section: Resultsmentioning

confidence: 99%

“…The former is one of the most frequently reported GI symptoms in ASD children in several studies [5, 40] while the latter has been recently detected as one of the most common GI symptoms in a large sample of pre-schoolers with ASD [41]. Besides, half of the ASD children with CD were asymptomatic at the time of the serological screening: this prevalence could be ascribed not only to the presence of true asymptomatic forms of CD but also to the severe communication difficulties of non-verbal preschool children with ASD, making them unable to express GI and systemic symptoms suggestive of CD (e.g.…”

Section: Discussionmentioning

confidence: 99%

Serological screening for Celiac Disease in 382 pre-schoolers with Autism Spectrum Disorder

et al. 2016

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BackgroundRecent investigations suggest a possible common genetic background between Autism Spectrum Disorders (ASD) and Celiac Disease (CD). However, studies regarding this association are scarce and often limited by the small sample sizes and/or large heterogeneity among ASD groups in terms of demographic and clinical features. The present study aims to investigate the overall CD prevalence (biopsy proven-CD patients plus screening detected tTG and EMA positive cases) in a large population of pre-schoolers with ASD referred to a tertiary care University Hospital.MethodsWe retrospectively collected data about 382 children (mean age: 46.97 ± 13.55 months; age-range: 18-72 months) consecutively diagnosed as ASD (according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition criteria) over the period 2010–2013, and who performed a serological CD screening.ResultsThe overall CD prevalence was 2.62%, which is statistically significant higher to that reported in the Italian paediatric population (p = 0.0246). Half of these children had no symptoms or risk factors related to CD when they performed the serological screening.ConclusionsIf replicated, these data suggest the importance of regular screening for CD in young patients with ASD, and are of relevance for clinical and public health.

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Gastrointestinal symptoms and behavioral problems in preschoolers with Autism Spectrum Disorder

Cited by 131 publications

References 49 publications

Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with Autism Spectrum Disorder in Selected Areas of the United States in 2010

Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with Autism Spectrum Disorder in Selected Areas of the United States in 2010

Comprehensive Description of Comorbidity for Autism Spectrum Disorder in a General Population

Serological screening for Celiac Disease in 382 pre-schoolers with Autism Spectrum Disorder

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