Gastrointestinal Problems in Children with Autism, Developmental Delays or Typical Development
To compare gastrointestinal (GI) problems among children with: (1) autism spectrum disorder (ASD), (2) developmental delay (DD) and (3) typical development (TD), GI symptom frequencies were obtained for 960 children from the CHildhood Autism Risks from Genetics and Environment (CHARGE) study. We also examined scores on five Aberrant Behavior Checklist (ABC) subscales comparing ASD children with high versus low frequency GI symptoms. Compared to TD children, those with ASD [aOR 7.92 (4.89–12.85)] and DD [aOR 4.55 (2.51–8.24)] were more likely to have at least one frequent GI symptom. Restricting to ASD children, those with frequent abdominal pain, gaseousness, diarrhea, constipation or pain on stooling scored worse on irritability, social withdrawal, stereotypy, and hyperactivity compared with children having no frequent GI symptoms. Frequent GI problems affect young children with ASD and DD more commonly than those with TD. Maladaptive behaviors correlate with GI problems, suggesting these comorbidities require attention.
KeywordsGastrointestinal problems Autism Developmental delays Maladaptive behaviors
The authors would like to thank Bill Elms and Lora Delwiche for their guidance and support with data management, Melissa Rose and the CHARGE research team. And a special thanks to all the families who took part in this research. There are no conflicts of interest to declare by any of the authors. Sponsors of this research included: National Institutes of Health, National Institute of Environmental Health Sciences; Grant numbers: 1 P01 ES11269, 2 P01 ES11269, 1 R01 ES015359, and 3 R01 ES015359-03S2; the US Environmental Protection Agency through the Science to Achieve Results (STAR) program; Grant number: R833292 and R829388; the Medical Investigations of Neurodevelopmental Disorders (M.I.N.D.) Institute; Grant Number: N/A; Autism Speaks; Grant Number: AS 7567.
- Aman, M. G., & Singh, N. N. (1994). Aberrant behavior checklist-community. East Aurora, NY: Supplementary Manual.Google Scholar
- De Theije, C. G., Wu, J., da Silva, S. L., Kamphuis, P. J., Garssen, J., Korte, S. M., et al. (2011). Pathways underlying the gut-to-brain connection in autism spectrum disorders as future targets for disease management. European Journal of Pharmacology, 666(S1), S70–s80. doi: 10.1016/j.ejphar.2011.07.013.CrossRefGoogle Scholar
- Hertz-Picciotto I, Croen L, Hansen R, Jones C, Pessah IN (2006). The CHARGE study: an epidemiologic investigation of genetic and environmental factors contributing to autism. Environmental Health Perspectives, 114(7), 1119–1125. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1513329/pdf/ehp0114-001119.pdf.
- Jyonouchi, H., Geng, L., Ruby, A., Reddy, C., & Zimmerman-Bier, B. (2005). Evaluation of an association between gastrointestinal symptoms and cytokine production against common dietary proteins in children with autism spectrum disorders. Journal of Pediatrics, 146(5), 605–610.PubMedCrossRefGoogle Scholar
- Le Couteur A, Lord C, Rutter M. (1993). The Autism Diagnostic Interview, Revised (ADI-R), Los Angeles, CA.Google Scholar
- Lord C, Rutter M, diLavore PC, Risi S. (2003). Autism Diagnostic Observation Schedule Manual, Los Angeles, CA.Google Scholar
- Maenner, M. J., Arneson, C. L., Levy, S. E., Kirby, R. S., Nicholas, J. S., & Durkin, M. S. (2012). Brief Report: Association between behavioral features and gastrointestinal problems among children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 42, 1520–1525.PubMedCrossRefGoogle Scholar
- Mullen, E. M. (1995). Mullen scales of early learning. Circle Pines, MN: American Guidance Services.Google Scholar
- Schieve, L. A., Gonzalez, V., Boulet, S. L., Visser, S. N., Rice, C. E., Braun, K. V., et al. (2012). Concurrent medical conditions and health care use and needs among children with learning and behavioral developmental disabilities, National Health Interview Survey, 2006–2010. Research in Developmental Disabilities, 33(2), 467–476.PubMedCrossRefGoogle Scholar
- Sparrow, S. S. (1984). Vineland adaptive behavior scales survey form manual. Circle Pines, MN: American Guidelines Service.Google Scholar
- Valicenti-McDermott, M., McVicar, K., Rapin, I., Wershil, B. K., Cohen, H., & Shinnar, S. (2006). Frequency of gastrointestinal symptoms in children with autistic spectrum disorders and association with family history of autoimmune disease. Journal of Developmental and Behavioral Pediatrics, 27(2 Suppl), S128–S136.PubMedCrossRefGoogle Scholar
- Wang, L. W., Tancredi, D. J., & Thomas, D. W. (2011). The prevalence of gastrointestinal problems in children across the United States with autism spectrum disorders from families with multiple affected members. Journal of Developmental and Behavioral Pediatrics, 32(5), 351–360.PubMedCrossRefGoogle Scholar