Francesca Fulceri1, Mariangela Morelli2, Elisa Santocchi1, Hellas Cena3, Teresa Del Bianco4, Antonio Narzisi1, Sara Calderoni5, Filippo Muratori6. 1. IRCCS Stella Maris Foundation, Pisa, Italy. 2. Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, University of Pavia, Italy; Speciality School of Nutritional Sciences, University of Milan, Italy. 3. Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, University of Pavia, Italy. 4. ODFlab, Department of Psychology and Cognitive Science, University of Trento, Italy. 5. IRCCS Stella Maris Foundation, Pisa, Italy. Electronic address: scalderoni@fsm.unipi.it. 6. IRCCS Stella Maris Foundation, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Italy.
Abstract
BACKGROUND: Gastrointestinal (GI) symptoms are frequently reported in children with Autism Spectrum Disorder (ASD), and an impact of GI comorbidity on ASD behavioral problems has been hypothesized. AIMS: To explore the type and the prevalence of GI symptoms in ASD patients and typical development (TD) controls, and to investigate their possible association with behavioral problems. METHODS: A total of 230 preschoolers were included in this study. Specifically, four groups of children were evaluated: ASD individuals suffering from GI symptoms (ASD/GI+), ASD subjects without GI symptoms (ASD/GI-), TD peers with (TD/GI+) and without (TD/GI-) GI symptoms. Parental report of behavioral problems and GI symptoms were assessed through the Child Behavior Check List 1½-5. RESULTS: A significant higher percentage of ASD (37.4%) versus TD (14.8%) with GI symptoms was observed. 'Constipated' and 'Not-Eat' were the most frequent GI symptoms both in ASD and in TD groups, but they were evaluated as more severe in ASD patients. ASD/GI+ children had more anxiety problems, somatic complaints, externalizing and total problems than ASD/GI- individuals. TD/GI+ did not show more behavioral problems than TD/GI-. CONCLUSION: Development of evidence-based guidelines for identification of GI problems in ASD preschoolers is warranted. GI symptomatology should be accurately assessed, especially in ASD children with anxiety and/or externalizing behavioral problems.
BACKGROUND: Gastrointestinal (GI) symptoms are frequently reported in children with Autism Spectrum Disorder (ASD), and an impact of GI comorbidity on ASD behavioral problems has been hypothesized. AIMS: To explore the type and the prevalence of GI symptoms in ASDpatients and typical development (TD) controls, and to investigate their possible association with behavioral problems. METHODS: A total of 230 preschoolers were included in this study. Specifically, four groups of children were evaluated: ASD individuals suffering from GI symptoms (ASD/GI+), ASD subjects without GI symptoms (ASD/GI-), TD peers with (TD/GI+) and without (TD/GI-) GI symptoms. Parental report of behavioral problems and GI symptoms were assessed through the Child Behavior Check List 1½-5. RESULTS: A significant higher percentage of ASD (37.4%) versus TD (14.8%) with GI symptoms was observed. 'Constipated' and 'Not-Eat' were the most frequent GI symptoms both in ASD and in TD groups, but they were evaluated as more severe in ASDpatients. ASD/GI+ children had more anxiety problems, somatic complaints, externalizing and total problems than ASD/GI- individuals. TD/GI+ did not show more behavioral problems than TD/GI-. CONCLUSION: Development of evidence-based guidelines for identification of GI problems in ASD preschoolers is warranted. GI symptomatology should be accurately assessed, especially in ASDchildren with anxiety and/or externalizing behavioral problems.
Authors: Katherine R Bellesheim; Lynn Cole; Daniel L Coury; Larry Yin; Susan E Levy; Meghan A Guinnee; Kirsten Klatka; Beth A Malow; Terry Katz; Jane Taylor; Kristin Sohl Journal: Pediatrics Date: 2018-08-14 Impact factor: 7.124