Objective To evaluate gastrointestinal (GI) problems in a large, well-characterized sample of children with pervasive developmental disorders (PDDs). Methods One hundred seventy two children entering one of two trials conducted by the Research Units on Pediatric Psychopharmacology (RUPP) Autism Network were assessed comprehensively prior to starting treatment and classified with regard to GI symptoms. Results Thirty nine (22.7%) were positive for GI problems, primarily constipation and diarrhea. Those with GI problems were no different from subjects without GI problems in demographic characteristics, measures of adaptive functioning, or autism symptom severity. Compared to children without GI problems, those with GI problems showed greater symptom severity on measures of irritability, anxiety, and social withdrawal. Those with GI problems were also less likely to respond to treatment.
"Although an ASD diagnosis is defined by the American Psychiatric Association, other features, more physical or health related, are associated with an ASD diagnosis. For example, children with ASD are more likely to have headaches/migraines, respiratory and food allergies, gastrointestinal (GI) problems, and infections than typically developing children. "
[Show abstract][Hide abstract] ABSTRACT: Research indicates that some children with autism spectrum disorder (ASD) experience a developmental regression.
The study examined the percentage of children with autism, pervasive developmental disorder (PDD), ASD, and Asperger syndrome (AS) who were considered to be delayed (D), regressed (R), or delayed and later regressed (DR) and examined any relationship with autism severity, time of onset, factors associated with onset, gastrointestinal (GI) symptoms, race, age, and gender.
The study reviewed developmental and medical information based on parental reports of 135 children with a diagnosis of autism, PDD, ASD, or AS.
The number of children in the D group was 53 (39.2%) with 19 (14.1%) in the DR group and 63 (46.7%) in the R group. Thus, 82 children (60.7%) were reported to have R. In regard to onset of symptoms, there was a significant difference between the D and R groups as well as between the DR and R groups. The analyses showed that there was no significant relationship between age, gender, race, severity, or GI symptoms and membership in any group; D, DR, or R. The majority of parents reported that the regression was preceded by or was associated with vaccinations (57.3%) or another medically related event (11.0%).
The findings are consistent with previous research and reinforce our understanding of regression in those children with an ASD diagnosis.
North American Journal of Medical Sciences 01/2014; 6(1):41-7. DOI:10.4103/1947-2714.125867
"Mazurek et al. (2013) reported increased anxiety and decreased social responsiveness in patients with ASD and GI symptoms including include constipation, abdominal pain, bloating and/or nausea. Other studies have reported associations between general GI symptoms and behavioral symptoms of ASD including sleep disturbance, food selectivity, irritability, social withdrawal and anxiety (Maenner et al. 2012; Nikolov et al. 2009) but did not look for associations with specific GI symptoms. Our clinical experience suggests a possible association between rigid–compulsive behaviors and GI symptoms. "
[Show abstract][Hide abstract] ABSTRACT: Based on clinical experience, we hypothesized that rigid-compulsive behaviors are associated with severe constipation and co-occurring diarrhea or underwear staining in children with autism spectrum disorder. Using data from the Autism Treatment Network, we evaluated the association between these gastrointestinal symptoms and measures of rigid compulsive behavior in children ages 2-17. Following statistical correction, four of five primary measures were significantly associated with constipation and diarrhea or underwear staining, including parental report of repetitive behavior, parental report of compulsive behavior, clinician diagnosis of obsessive-compulsive disorder, and report of rituals observed on the autism diagnostic observation schedule. This association could point to a causal connection between these symptoms or to a common biological pathway that impacts both gut and brain.
Journal of Autism and Developmental Disorders 11/2013; 44(6). DOI:10.1007/s10803-013-2009-2 · 3.06 Impact Factor
"This is a logical approach but does not provide an opportunity to discern which behaviors are most strongly associated with GI problems or to identify patterns of emotional and behavioral concerns that may be present in this subgroup. The two studies that did look at a variety of outcomes are difficult to compare with each other due to the use of a dichotomous measure of eight different possible behavioral manifestations in one study (Maenner et al., 2011), which might have reduced sensitivity , and use of a sample enriched for psychopathology from a psychopharmacology clinic for the other study (Nikolov et al., 2009). The primary aim of the current study was to explore the association between GI symptoms and emotional and behavioral concerns in a community-based sample of children with high-functioning autism. "
[Show abstract][Hide abstract] ABSTRACT: This study investigated the association between gastrointestinal symptoms and a broad set of emotional and behavioral concerns in 95 children with high-functioning autism and IQ scores ≥ 80. Gastrointestinal symptoms were assessed via the Autism Treatment Network's Gastrointestinal Symptom Inventory, and data were gathered on autism symptom severity, adaptive behavior, and multiple internalizing and externalizing problems. The majority (61%) of children had at least one reported gastrointestinal symptom. Emotional and behavioral problems were also common but with a high degree of variability. Children with and without gastrointestinal problems did not differ in autism symptom severity, adaptive behavior, or total internalizing or externalizing problem scores. However, participants with gastrointestinal problems had significantly higher levels of affective problems. This finding is consistent with a small body of research noting a relationship between gastrointestinal problems, irritability, and mood problems in autism spectrum disorder. More research to identify the mechanisms underlying this relationship in autism spectrum disorder is warranted. Future research should include a medical assessment of gastrointestinal concerns, longitudinal design, and participants with a range of autism spectrum disorder severity in order to clarify the directionality of this relationship and to identify factors that may impact heterogeneity in the behavioral manifestation of gastrointestinal concerns.
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