Anxiety, Sensory Over-Responsivity, and Gastrointestinal Problems in Children with Autism Spectrum Disorders

Abstract

Children with autism spectrum disorders (ASD) experience high rates of anxiety, sensory processing problems, and gastrointestinal (GI) problems; however, the associations among these symptoms in children with ASD have not been previously examined. The current study examined bivariate and multivariate relations among anxiety, sensory over-responsivity, and chronic GI problems in a sample of 2,973 children with ASD enrolled in the Autism Treatment Network (ages 2–17 years, 81.6 % male). Twenty-four percent of the sample experienced at least one type of chronic GI problem (constipation, abdominal pain, bloating, diarrhea, and/or nausea lasting three or more months). Children with each type of GI problem had significantly higher rates of both anxiety and sensory over-responsivity. Sensory over-responsivity and anxiety were highly associated, and each provided unique contributions to the prediction of chronic GI problems in logistic regression analyses. The results indicate that anxiety, sensory over-responsivity and GI problems are possibly interrelated phenomenon for children with ASD, and may have common underlying mechanisms.

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References

  1. Abelson, J. L., Khan, S., Liberzon, I., & Young, E. A. (2007). HPA axis activity in patients with panic disorder: review and synthesis of four studies. Depression and Anxiety, 24, 66–76.

    PubMed  Article  Google Scholar 

  2. Achenbach, T. M., & Rescorla, L. (2001). Manual for the ASEBA school-age forms & profiles: an integrated system of multi-informant assessment. Burlington: University of Vermont, Research Center for Children, Youth & Families.

    Google Scholar 

  3. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders - fourth edition, text revision. Washington, DC: American Psychiatric Association.

    Book  Google Scholar 

  4. Ashburner, J., Ziviani, J., & Rodger, S. (2008). Sensory processing and classroom emotional, behavioral, and educational outcomes in children with autism spectrum disorder. American Journal of Occupational Therapy, 62, 564–573.

    PubMed  Article  Google Scholar 

  5. Ashwood, P., Wills, S., & Van de Water, J. (2006). The immune response in autism: a new frontier for autism research. Journal of Leukocyte Biology, 80, 1–15.

    PubMed  Article  Google Scholar 

  6. Ayres, A. J. (1979). Sensory integration and the child. Los Angeles: Western Psychological Services.

    Google Scholar 

  7. Baker, A. E. Z., Lane, A., Angley, M. T., & Young, R. L. (2008). The relationship between sensory processing patterns and behavioural responsiveness in autistic disorder: a pilot study. Journal of Autism and Developmental Disorders, 38, 867–875.

    PubMed  Article  Google Scholar 

  8. Bakker, M. J., Boer, F., Benninga, M. A., Koelman, J. H., & Tijssen, M. A. (2010). Increased auditory startle reflex in children with functional abdominal pain. The Journal of Pediatrics, 156, 285–291. e1.

    PubMed  Article  Google Scholar 

  9. Bakker, M. J., van Dijk, J. G., van den Maagdenberg, A. M., & Tijssen, M. A. (2006). Startle syndromes. Lancet Neurology, 5, 513–524.

    PubMed  Article  Google Scholar 

  10. Baranek, G. T. (2002). Efficacy of sensory and motor interventions for children with autism. Journal of Autism and Developmental Disorders, 32, 397–422.

    PubMed  Article  Google Scholar 

  11. Baranek, G. T., David, F. J., Poe, M. D., Stone, W. L., & Watson, L. R. (2006). Sensory experiences questionnaire: discriminating sensory features in young children with autism, developmental delays, and typical development. Journal of Child Psychology and Psychiatry, 47, 591–601.

    PubMed  Article  Google Scholar 

  12. Bar-Haim, Y., Lamy, D., Pergamin, L., Bakermans-Kranenburg, M. J., & van Ijzendoorn, M. H. (2007). Threat-related attentional bias in anxious and nonanxious individuals: a meta-analytic study. Psychological Bulletin, 133, 1–24.

    PubMed  Article  Google Scholar 

  13. Beidel, D. C., & Turner, S. M. (2005). Childhood anxiety disorders. New York: Routledge.

    Google Scholar 

  14. Ben Shalom, D. B., Mostofsky, S. H., Hazlett, R. L., Goldberg, M. C., Landa, R. J., Faran, Y., & Hoehn-Saric, R. (2006). Normal physiological emotions but differences in expression of conscious feelings in children with high-functioning autism. Journal of Autism and Developmental Disorders, 36, 395–400.

    PubMed  Article  Google Scholar 

  15. Ben-Sasson, A., Carter, A., & Briggs-Gowan, M. (2009). Sensory over-responsivity in elementary school: prevalence and social-emotional correlates. Journal of Abnormal Child Psychology, 37, 705–716.

    PubMed  Article  Google Scholar 

  16. Ben-Sasson, A., Cermak, S. A., Orsmond, G. I., Carter, A. S., & Fogg, L. (2007a). Can we differentiate sensory over-responsivity from anxiety symptoms in toddlers? Perspectives of occupational therapists and psychologists. Infant Mental Health Journal, 28, 536–558.

    Article  Google Scholar 

  17. Ben-Sasson, A., Cermak, S. A., Orsmond, G. I., Carter, A. S., & Fogg, L. (2007b). Extreme sensory modulation behaviors in toddlers with autism. American Journal of Occupational Therapy, 61, 584–592.

    PubMed  Article  Google Scholar 

  18. Ben-Sasson, A., Cermak, S. A., Orsmond, G. I., Tager-Flusberg, H., Kadlec, M. B., & Carter, A. S. (2008). Sensory clusters of toddlers with autism spectrum disorders: differences in affective symptoms. Journal of Child Psychology and Psychiatry, 49, 817–825.

    PubMed  Article  Google Scholar 

  19. Ben-Sasson, A., Hen, L., Fluss, R., Cermak, S., Engel-Yeger, B., & Gal, E. (2009). A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 1–11.

    PubMed  Article  Google Scholar 

  20. Brock, M., Freuler, A., Baranek, G., Watson, L., Poe, M., & Sabatino, A. (2012). Temperament and sensory features of children with autism. Journal of Autism and Neurodevelopmental Disorders.

  21. Buie, T., Campbell, D. B., Fuchs, G. J., Furuta, G. T., Levy, J., VandeWater, J., & Winter, H. (2010). Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics, 125, S1–S18.

    PubMed  Article  Google Scholar 

  22. Campo, J. V., Bridge, J., Ehmann, M., Altman, S., Lucas, A., Birmaher, B., & Brent, D. A. (2004). Recurrent abdominal pain, anxiety, and depression in primary care. Pediatrics, 113, 817–824.

    PubMed  Article  Google Scholar 

  23. Chang, L., Sundaresh, S., Elliott, J., Anton, P. A., Baldi, P., Licudine, A., & Mayer, E. A. (2009). Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in irritable bowel syndrome. Neurogastroenterology and Motility, 21, 149–159.

    PubMed  Article  Google Scholar 

  24. Chrousos, G. P. (1995). The hypothalamic-pituitary-adrenal axis and immune-mediated inflammation. The New England Journal of Medicine, 332, 1351–1363.

    PubMed  Article  Google Scholar 

  25. Coolican, J., Bryson, S. E., & Zwaigenbaum, L. (2008). Brief report: data on the Stanford-Binet Intelligence Scales (5th ed.) in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 38, 190–197.

    PubMed  Article  Google Scholar 

  26. Dinan, T. G., Clarke, G., Quigley, E. M. M., Scott, L. V., Shanahan, F., Cryan, J., & Keeling, P. W. (2008). Enhanced cholinergic-mediated increase in the pro-inflammatory cytokine IL-6 in irritable bowel syndrome: role of muscarinic receptors. American Journal of Gastroenterology, 103, 2570–2576.

    PubMed  Article  Google Scholar 

  27. Dinan, T. G., Quigley, E. M. M., Ahmed, S. M. M., Scully, P., O’Brien, S., O’Mahony, L., & Keeling, P. W. (2006). Hypothalamic-pituitary-gut axis dysregulation in irritable bowel syndrome: plasma cytokines as a potential biomarker? Gastroenterology, 130, 304–311.

    PubMed  Article  Google Scholar 

  28. Dufton, L. M., Dunn, M. J., & Compas, B. E. (2009). Anxiety and somatic complaints in children with recurrent abdominal pain and anxiety disorders. Journal of Pediatric Psychology, 34, 176–186.

    PubMed  Article  Google Scholar 

  29. Dufton, L. M., Dunn, M. J., Slosky, L. S., & Compas, B. E. (2011). Self-reported and laboratory-based responses to stress in children with recurrent pain and anxiety. Journal of Pediatric Psychology, 36, 95–105.

    PubMed  Article  Google Scholar 

  30. Dunn, W. (1997). The impact of sensory processing abilities on the daily lives of young children and their families: a conceptual model. Infants and Young Children, 9, 23–35.

    Article  Google Scholar 

  31. Dunn, W. (1999). The sensory profile: user’s manual. San Antonio: Psychological Corporation.

    Google Scholar 

  32. Elsenbruch, S., Rosenberger, C., Enck, P., Forsting, M., Schedlowski, M., & Gizewski, E. R. (2010). Affective disturbances modulate the neural processing of visceral pain stimuli in irritable bowel syndrome: an fMRI study. Gut, 59, 489–495.

    PubMed  Article  Google Scholar 

  33. Fox, N. A., Henderson, H. A., Rubin, K. H., Calkins, S. D., & Schmidt, L. A. (2001). Continuity and discontinuity of behavioral inhibition and exuberance: psychophysiological and behavioral influences across the first four years of life. Child Development, 72, 1–21.

    PubMed  Article  Google Scholar 

  34. Goldsmith, H., Van Hulle, C., Arneson, C., Schreiber, J., & Gernsbacher, M. (2006). A population-based twin study of parentally reported tactile and auditory defensiveness in young children. Journal of Abnormal Child Psychology, 34, 378–392.

    Article  Google Scholar 

  35. Gouze, K., Hopkins, J., LeBailly, S., & Lavigne, J. (2009). Re-examining the epidemiology of sensory regulation dysfunction and comorbid psychopathology. Journal of Abnormal Child Psychology, 37, 1077–1087.

    PubMed  Article  Google Scholar 

  36. Green, S., & Ben-Sasson, A. (2010). Anxiety disorders and sensory over-responsivity in children with autism spectrum disorders: is there a causal relationship? Journal of Autism and Developmental Disorders, 40, 1495–1504.

    PubMed  Article  Google Scholar 

  37. Greenwood-Van Meerveld, B., Gibson, M., Gunter, W., Shepard, J., Foreman, R., & Myers, D. (2001). Stereotaxic delivery of corticosterone to the amygdala modulates colonic sensitivity in rats. Brain Research, 893, 135–142.

    PubMed  Article  Google Scholar 

  38. Herman, J. P., & Cullinan, W. E. (1997). Neurocircuitry of stress: central control of the hypothalamo-pituitary-adrenocortical axis. Trends in Neurosciences, 20, 78–84.

    PubMed  Article  Google Scholar 

  39. Hoge, E. A., Brandstetter, K., Moshier, S., Pollack, M. H., Wong, K. K., & Simon, N. M. (2009). Broad spectrum of cytokine abnormalities in panic disorder and posttraumatic stress disorder. Depression and Anxiety, 26, 447–455.

    PubMed  Article  Google Scholar 

  40. Kallen, V. L., Tulen, J. H. M., Utens, E. M., Treffers, P. D., De Jong, F. H., & Ferdinand, R. F. (2008). Associations between HPA axis functioning and level of anxiety in children and adolescents with an anxiety disorder. Depression and Anxiety, 25, 131–141.

    PubMed  Article  Google Scholar 

  41. Kientz, M., & Dunn, W. (1997). A comparison of the performance of children with and without autism on the sensory profile. American Journal of Occupational Therapy, 51, 530–537.

    PubMed  Article  Google Scholar 

  42. Kim, M. J., Loucks, R. A., Palmer, A. L., Brown, A. C., Solomon, K. M., Marchante, A. N., & Whalen, P. J. (2011). The structural and functional connectivity of the amygdala: from normal emotion to pathological anxiety. Behavioural Brain Research, 223, 403–410.

    PubMed  Article  Google Scholar 

  43. Kinnealey, M., & Fuiek, M. (1999). The relationship between sensory defensiveness, anxiety, depression and perception of pain in adults. Occupational Therapy International, 6, 195–206.

    Article  Google Scholar 

  44. Koloski, N.A., Jones, M., Kalantar, J., Weltman, M., Zaguirre, J., & Talley, N.J. (2012). The brain-gut pathway in functional gastrointestinal disorders is bidirectional: a 12-year prospective population-based study. Gut.

  45. Lackner, J. M., Lou Coad, M., Mertz, H. R., Wack, D. S., Katz, L. A., Krasner, S. S., & Lockwood, C. K. (2006). Cognitive therapy for irritable bowel syndrome is associated with reduced limbic activity, GI symptoms, and anxiety. Behaviour Research and Therapy, 44, 621–638.

    PubMed  Article  Google Scholar 

  46. Lane, S.J., Reynolds, S., & Thacker, L. (2010). Sensory over-responsivity and ADHD: differentiating using electrodermal responses, cortisol, and anxiety. Frontiers in Integrative Neuroscience, 4.

  47. Liebregts, T., Adam, B., Bredack, C., Roth, A., Heinzel, S., Lester, S., & Holtmann, G. (2007). Immune activation in patients with irritable bowel syndrome. Gastroenterology, 132, 913–920.

    PubMed  Article  Google Scholar 

  48. Liss, M., Saulnier, C., Fein, D., & Kinsbourne, M. (2006). Sensory and attention abnormalities in autistic spectrum disorders. Autism, 10, 155–172.

    PubMed  Article  Google Scholar 

  49. Lopata, C., Toomey, J., Fox, J., Volker, M., Chow, S., Thomeer, M., & Smerbeck, A. M. (2010). Anxiety and depression in children with HFASDs: symptom levels and source differences. Journal of Abnormal Child Psychology, 38, 765–776.

    PubMed  Article  Google Scholar 

  50. Lord, C., DiLavorne, P. C., & Risi, S. (2002). Autism diagnostic observation schedule. Los Angeles: Western Psychological Services.

    Google Scholar 

  51. Mayer, E. A. (2011). Gut feelings: the emerging biology of gut-brain communication. Nature Reviews Neuroscience, 12, 453–466.

    PubMed  Article  Google Scholar 

  52. Mayer, E. A., Berman, S., Suyenobu, B., Labus, J., Mandelkern, M. A., Naliboff, B. D., & Chang, L. (2005). Differences in brain responses to visceral pain between patients with irritable bowel syndrome and ulcerative colitis. Pain, 115, 398–409.

    PubMed  Article  Google Scholar 

  53. Mazefsky, C. A., Kao, J., & Oswald, D. P. (2011). Preliminary evidence suggesting caution in the use of psychiatric self-report measures with adolescents with high-functioning autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 164–174.

    Article  Google Scholar 

  54. McIntosh, D. N., Miller, L. J., & Shyu, V. (1999). Development and validation of the short sensory profile. In W. Dunn (Ed.), Sensory profile manual (pp. 59–73). San Antonio: Psychological Corporation.

    Google Scholar 

  55. Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., & Osten, E. T. (2007). Concept evolution in sensory integration: a proposed nosology for diagnosis. The American Journal of Occupational Therapy, 61, 135–140.

    PubMed  Article  Google Scholar 

  56. Molloy, C. A., & Manning-Courtney, P. (2003). Prevalence of chronic gastrointestinal symptoms in children with autism and autistic spectrum disorders. Autism, 7, 165–171.

    PubMed  Article  Google Scholar 

  57. Mullen, E. M. (1995). Mullen scales of early learning. Circle Pines: American Guidance Service, Inc.

    Google Scholar 

  58. Mulvaney, S., Lambert, E. W., Garber, J., & Walker, L. S. (2006). Trajectories of symptoms and impairment for pediatric patients with functional abdominal pain: a 5-year longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 737–744.

    PubMed  Article  Google Scholar 

  59. Mussell, M., Kroenke, K., Spitzer, R. L., Williams, J. B. W., Herzog, W., & Löwe, B. (2008). Gastrointestinal symptoms in primary care: prevalence and association with depression and anxiety. Journal of Psychosomatic Research, 64, 605–612.

    PubMed  Article  Google Scholar 

  60. Myers, B., & Greenwood-Van Meerveld, B. (2009). Role of anxiety in the pathophysiology of irritable bowel syndrome: importance of the amygdala. Frontiers in Neuroscience, 3.

  61. Nikolov, R., Bearss, K., Lettinga, J., Erickson, C., Rodowski, M., Aman, M., & Scahill, L. (2009). Gastrointestinal symptoms in a sample of children with pervasive developmental disorders. Journal of Autism and Developmental Disorders, 39, 405–413.

    PubMed  Article  Google Scholar 

  62. O’Donovan, A., Hughes, B. M., Slavich, G. M., Lynch, L., Cronin, M.-T., O’Farrelly, C., & Malone, K. M. (2010). Clinical anxiety, cortisol and interleukin-6: evidence for specificity in emotion-biology relationships. Brain, Behavior, and Immunity, 24, 1074–1077.

    PubMed  Article  Google Scholar 

  63. Ollendick, T. H., King, N. J., & Muris, P. (2002). Fears and phobias in children: phenomenology, epidemiology, and aetiology. Child and Adolescent Mental Health, 7, 98–106.

    Article  Google Scholar 

  64. Pandolfi, V., Magyar, C. I., & Dill, C. A. (2012). An initial psychometric evaluation of the CBCL 6–18 in a sample of youth with autism spectrum disorders. Research in Autism Spectrum Disorders, 6, 96–108.

    PubMed  Article  Google Scholar 

  65. Pfeiffer, B., Kinnealey, M., Reed, C., & Herzberg, G. (2005). Sensory modulation and affective disorders in children and adolescents with Asperger’s disorder. American Journal of Occupational Therapy, 59, 335–345.

    PubMed  Article  Google Scholar 

  66. Pfeiffer, B., Koenig, K., Kinnealey, M., Sheppard, M., & Henderson, L. (2011). Effectiveness of sensory integration interventions in children with autism spectrum disorders: a pilot study. The American Journal of Occupational Therapy, 65, 76–85.

    PubMed  Article  Google Scholar 

  67. Pine, D. S. (2007). Research review: a neuroscience framework for pediatric anxiety disorders. Journal of Child Psychology and Psychiatry, 48, 631–648.

    PubMed  Article  Google Scholar 

  68. Rasquin-Weber, A., Hyman, P. E., Cucchiara, S., Fleisher, D. R., Hyams, J. S., Milla, P. J., & Staiano, M. A. (1999). Childhood functional gastrointestinal disorders. Gut, 45, II60–II68.

    PubMed  Article  Google Scholar 

  69. Reynolds, S., & Lane, S. (2008). Diagnostic validity of sensory over-responsivity: a review of the literature and case reports. Journal of Autism and Developmental Disorders, 38, 516–529.

    PubMed  Article  Google Scholar 

  70. Reynolds, S., Lane, S. J., & Gennings, C. (2010). The moderating role of sensory overresponsivity in HPA activity: a pilot study with children diagnosed with ADHD. Journal of Attention Disorders, 13, 468–478.

    PubMed  Article  Google Scholar 

  71. Rogers, S. J., Hepburn, S., & Wehner, E. (2003). Parent reports of sensory symptoms in toddlers with autism and those with other developmental disorders. Journal of Autism and Developmental Disorders, 33, 631–642.

    PubMed  Article  Google Scholar 

  72. Roid, G. H. (2003). Stanford Binet intelligence scales (5th Edition) (5th ed.). Itasca: Riverside Publishing.

    Google Scholar 

  73. Rothbart, M. K., & Derryberry, D. (1981). Development of individual differences in temperament. In M. Lamb & A. Brown (Eds.), Advances in developmental psychology (Vol. 1, pp. 37–86). Hillsdale: Erlbaum.

    Google Scholar 

  74. SAS Institute. (2008). SAS version 9.2. Cary: SAS Institute.

    Google Scholar 

  75. Schumann, C. M., & Amaral, D. G. (2006). Stereological analysis of amygdala neuron number in autism. The Journal of Neuroscience, 26, 7674–7679.

    PubMed  Article  Google Scholar 

  76. Taylor, S. F., Liberzon, I., & Koeppe, R. A. (2000). The effect of graded aversive stimuli on limbic and visual activation. Neuropsychologia, 38, 1415–1425.

    PubMed  Article  Google Scholar 

  77. Tomchek, S. D., & Dunn, W. (2007). Sensory processing in children with and without autism: a comparative study using the short sensory profile. American Journal of Occupational Therapy, 61, 190–200.

    PubMed  Article  Google Scholar 

  78. Walker, L. S., & Greene, J. W. (1989). Children with recurrent abdominal pain and their parents: more somatic complaints, anxiety, and depression than other patient families? Journal of Pediatric Psychology, 14, 231–243.

    PubMed  Article  Google Scholar 

  79. Watling, R. L., Deitz, J., & White, O. (2001). Comparison of sensory profile scores of young children with and without autism spectrum disorders. The American Journal of Occupational Therapy, 55, 416–423.

    PubMed  Article  Google Scholar 

  80. White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29, 216–229.

    PubMed  Article  Google Scholar 

  81. Wood, J. J., Drahota, A., Sze, K., Har, K., Chiu, A., & Langer, D. A. (2009). Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial. Journal of Child Psychology and Psychiatry, 50, 224–234.

    PubMed  Article  Google Scholar 

  82. Zald, D. H. (2003). The human amygdala and the emotional evaluation of sensory stimuli. Brain Research Reviews, 41, 88–123.

    PubMed  Article  Google Scholar 

  83. Zald, D. H., & Pardo, J. V. (1997). Emotion, olfaction, and the human amygdala: amygdala activation during aversive olfactory stimulation. Proceedings of the National Academy of Sciences, 94, 4119–4124.

    Article  Google Scholar 

  84. Zald, D. H., & Pardo, J. V. (2002). The neural correlates of aversive auditory stimulation. NeuroImage, 16, 746–753.

    PubMed  Article  Google Scholar 

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Acknowledgments

The authors acknowledge the members of the Autism Speaks Autism Treatment Network (AS ATN) for use of the data. The data for the study was collected as part of the AS ATN. Further support came from a cooperative agreement (UA3 MC 11054) from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Research Program, to the Massachusetts General Hospital. The AS ATN includes these members: Clinical Coordinating Center, Mass General Hospital for Children: James Perrin, MD, Dan Coury, MD; Autism Speaks: Clara Lajonchere, PhD, Nancy Jones, PhD; EMMES Corporation: Traci Clemons, PhD; Baylor College of Medicine: Diane Treadwell-Deering, MD, Daniel Glaze, MD; Holland Bloorview Kids Rehab, Surry Place Centre & the Hospital for Sick Children: Alvin Loh, MD, Wendy Roberts, MD, Evdokia Anagnostou, MD; Cincinnati Children’s Hospital Medical Center: Patricia Manning-Courtney, MD; Columbia University Medical Center: Agnes Whitaker, MD, Reet Sidhu, MD, Maureen McSwiggan-Hardin, APRN, BC, NP-P; Alberta Health Services & Glenrose Rehabilitation Hospital: Lonnie Zwaigenbaum, MD, Carole Anne Hapchyn, MD; Children’s Hospital of Los Angeles: Michele Kipke, PhD, Larry Yin, MD; Vanderbilt University Medical School: Beth Malow, MD, MS, Nirupama Madduri, MD, Zachary Warren, PhD, Robert Steiner, MD; University of Arkansas for Medical Sciences & Arkansas Children’s Hospital: Maya Lopez, MD, Jill James, PhD; University of Colorado Denver School of Medicine & the Children’s Hospital: Ann Reynolds, MD, Cordelia Robinson, PhD, RN, Sandra Friedman, MD; University of Missouri: Kristin Sohl, MD, David Beversdorf, MD, Micah Mazurek, PhD, University of Pittsburgh: Benjamin Handen, PhD, Cynthia Johnson, PhD, Nancy Minshew, MD; University of Rochester: Susan Hyman, MD, Tristram Smith, PhD; Children’s Hospital of Philadelphia: Amanda Bennett, MD, MPH, Susan Levy, MD; Nationwide Children’s Hospital: Eric Butter, PhD, Karen Ratliff-Schaub, MD; Lurie Center/LADDERS: Margaret Bauman, MD, Ann Neumeyer, MD. The views expressed in this publication do not necessarily reflect the views of the Autism Speaks Autism Treatment Network.

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Mazurek, M.O., Vasa, R.A., Kalb, L.G. et al. Anxiety, Sensory Over-Responsivity, and Gastrointestinal Problems in Children with Autism Spectrum Disorders. J Abnorm Child Psychol 41, 165–176 (2013). https://doi.org/10.1007/s10802-012-9668-x

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Keywords

  • Autism spectrum disorders
  • Anxiety
  • Sensory over-responsivity
  • Gastrointestinal problems