Altered Autonomic Functions and Gut Microbiome in Individuals with Autism Spectrum Disorder (ASD): Implications for Assisting ASD Screening and Diagnosis.
Pairing heart-rate and gut bacteria data may one day give BCBAs an extra, biology-based screener for autism.
01Research in Context
What this study did
Kong et al. (2021) ran a case-control study. They compared people with autism to neurotypical peers.
The team looked at two things: autonomic nervous system signals and gut bacteria profiles. They wanted to see if the pair could help screen for autism.
What they found
The authors say the double marker set is worth testing. They did not report final accuracy numbers.
They call the idea a possible 'objective aid' beyond today’s subjective checklists.
How this fits with other research
Cai et al. (2025) extends this line. That lab used only gut microbes yet reached AUC 0.98 accuracy in preschool and elementary kids.
Baker et al. (2025) wraps both papers into one big picture. Their 2025 review says gut and metabolic markers look promising but need longer follow-up before clinics adopt them.
Zou et al. (2020) and Xie et al. (2022) are close cousins. Each found distinct gut bug patterns in Chinese children with autism, giving the target paper a firmer microbiome base.
Why it matters
You still rely on interviews and checklists. A quick heart-rate plus stool test could one day flag kids who need a full autism work-up. Until then, track emerging biomarker work and keep screening with the tools you have.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Continue using your standard screening tools, but watch for future kits that add autonomic or stool markers.
02At a glance
03Original abstract
Autism spectrum disorder (ASD) is a complex neurological and developmental disorder, and a growing body of literature suggests the presence of autonomic nervous system (ANS) dysfunction in individuals with ASD. ANS is part of the "gut brain axis", which consists of an intricate interplay between the gut microbiome, mucosal immune system, enteric nervous system, ANS, and central processes receiving input from the vagus nerve. Measurements of the gut microbiome and the autonomic indices can serve as non-invasive markers of the status of the gut-brain axis in ASD. To our knowledge, no previous studies have explored the relationship between ANS and gut microbiome in individuals with ASD. Furthermore, while previous studies investigated the use of autonomic indices and gut microbiome independently as markers of ASD-related comorbidities, such as anxiety, cardiovascular issues, and gastrointestinal dysfunction, the use of combined autonomic indices and gut microbiome factors to classify ASD and control subjects has not been explored. In this study, we characterized autonomic function of a group of individuals with ASD in comparison to their paired, first-degree relative controls. Second, we explored the ASD gut-brain-axis through the relationship between gut microbiome markers and autonomic indices, as well as the correlation between the gut-brain-axis and clinical presentation of ASD. Lastly, this study explores the predictive capability of gut-brain-axis biomarkers (including autonomic and microbiome indices) in subtyping ASD cases, serving as a starting point to investigate the possibility of assisting in ASD screening and diagnosis that still heavily relies on psychological testing, which may be based on highly subjective standards.
Journal of autism and developmental disorders, 2021 · doi:10.1016/0165-1781(93)90011-5