Journal of Autism and Developmental Disorders

, Volume 47, Issue 6, pp 1673–1681 | Cite as

Association of Rigid-Compulsive Behavior with Functional Constipation in Autism Spectrum Disorder

  • Sarah Marler
  • Bradley J. Ferguson
  • Evon Batey Lee
  • Brittany Peters
  • Kent C. Williams
  • Erin McDonnell
  • Eric A. Macklin
  • Pat Levitt
  • Kara Gross Margolis
  • David Q. Beversdorf
  • Jeremy Veenstra-VanderWeeleEmail author
Original Paper


Based upon checklist data from the Autism Speaks Autism Treatment Network, we hypothesized that functional constipation (FC) would be associated with rigid-compulsive behavior in children with autism spectrum disorder (ASD). We used the Questionnaire on Pediatric Gastrointestinal Symptoms—Rome III to assess FC symptoms in 108 children with ASD. As hypothesized, FC was associated with parent ratings on the Repetitive Behavior Scales—Revised (RBS-R) Compulsive, Ritualistic, and Sameness subscales in the overall population. Of note, FC was less common in children who were not taking medications that target behavior or treat FC. In the medication-free children, rigid-compulsive behavior was not significantly associated with FC. More research is needed to understand the mechanisms underlying these associations.


Developmental Gut Enteric Medical comorbidity Obsessive compulsive disorder Serotonin Microbiome 



We would like to thank the children and families who participated in this study. We would like to thank the children and families who participated in this study.


This research was supported by the Autism Speaks Autism Treatment Network and a grant from the AS-ATN as the Autism Intervention Research Network on Physical Health by the Health Resources Services Administration (HRSA Grant# UA3MC11054).

Author Contributions

SM and BF contributed to participant recruitment, data collection, data entry, data interpretation and manuscript writing. EL, BP, KW, PL, KM, DB, and JV contributed to study design, data interpretation, and manuscript writing. EM and EM performed the statistical analysis and contributed to manuscript writing. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

Dr. Veenstra-VanderWeele has served on advisory boards for Novartis and Roche Pharmaceuticals. He has received research funding from Novartis, Roche Pharmaceuticals, Seaside Therapeutics, Forest, Sunovion, and SynapDx. Dr. Beversdorf has received research funding from Seaside Therapeutics. The other authors report no conflicts of interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review boards and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from parents of all child participants and from all adult participants included in the study. Child participants provided assent, when able. This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Sarah Marler
    • 1
  • Bradley J. Ferguson
    • 2
  • Evon Batey Lee
    • 3
  • Brittany Peters
    • 1
  • Kent C. Williams
    • 4
  • Erin McDonnell
    • 5
  • Eric A. Macklin
    • 5
  • Pat Levitt
    • 6
    • 7
  • Kara Gross Margolis
    • 8
  • David Q. Beversdorf
    • 9
  • Jeremy Veenstra-VanderWeele
    • 10
    • 11
    • 12
    Email author
  1. 1.Department of PsychiatryVanderbilt UniversityNashvilleUSA
  2. 2.Interdisciplinary Neuroscience Program, The Thompson Center for Autism and Neurodevelopmental DisordersUniversity of MissouriColumbiaUSA
  3. 3.Departments of Pediatrics, Psychology, and PsychiatryVanderbilt UniversityNashvilleUSA
  4. 4.Department of Gastroenterology, Hepatology, and NutritionNationwide Children’s HospitalColumbusUSA
  5. 5.Biostatistics CenterMassachusetts General HospitalBostonUSA
  6. 6.Institute for the Developing Mind’s Developmental NeurogeneticsChildren’s Hospital Los AngelesLos AngelesUSA
  7. 7.Departments of Neurogenetics, Pediatrics, Neuroscience, Pharmacy, Psychiatry, Pathology and Psychology, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA
  8. 8.Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and NutritionColumbia UniversityNew YorkUSA
  9. 9.Interdisciplinary Neuroscience Program, The Thompson Center for Autism and Neurodevelopmental Disorders, Departments of Radiology, Neurology, and Psychological SciencesUniversity of MissouriColumbiaUSA
  10. 10.Department of Psychiatry and Sackler Institute for Developmental PsychobiologyColumbia UniversityNew YorkUSA
  11. 11.New York State Psychiatric InstituteNew YorkUSA
  12. 12.New York Presbyterian HospitalCenter for Autism and the Developing BrainNew YorkUSA

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