Assessment & Research

Assessing Internal Consistency of the Autism Spectrum Disorder Gastrointestinal and Related Behaviors Inventory and the Frequency and Socio-Emotional Correlates of Gastrointestinal Difficulties in Children With the Autism Spectrum Disorder: A Cross-Sectional Study.

Lestarevic et al. (2025) · Autism research : official journal of the International Society for Autism Research 2025
★ The Verdict

A new parent checklist shows GI pain in half of kids with autism and links it to worse behavior—use the tool to spot it fast.

✓ Read this if BCBAs doing intake or treatment planning for children with autism in clinic or school settings.
✗ Skip if Practitioners who only serve adults or clients without developmental diagnoses.

01Research in Context

01

What this study did

Lestarevic et al. (2025) tested a new parent checklist called the ASD-GIRBI. The tool asks about tummy pain, constipation, diarrhea, and food refusal in kids with autism.

Families at a Serbian autism center filled out the form. Researchers checked if answers stayed consistent and compared GI scores to emotional-behavior ratings.

02

What they found

The checklist held together well—parents answered similar items in the same way.

About half of the children had GI symptoms. Those kids also scored higher on irritability, anxiety, and withdrawal scales.

03

How this fits with other research

Johnson et al. (2009) reviewed 144 older papers and found GI rates anywhere from 4 % to 97 %. They said the wild spread came from using different questions each time. The new ASD-GIRBI gives everyone the same questions, so numbers should finally line up.

Chandler et al. (2013) and Slaughter et al. (2014) already saw that kids with ASD plus GI pain act more irritable. Sanja’s team repeats that link, but now with a tool that meets strict psychometric rules.

LeBlanc et al. (2003) counted only 24 % GI complaints in a Midwest sample. The higher 54 % in Sanja’s study does not cancel the old one; it simply shows what happens when you ask clearer, fuller questions.

04

Why it matters

You now have a free, 15-item parent form that reliably flags GI trouble. Add it to your intake packet. When scores are high, refer to a pediatric GI and track behavior changes after treatment. Tummy relief often brings calmer sessions and better learning.

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Print the ASD-GIRBI, give it to parents at intake, and add any high-score cases to your GI-referral list.

02At a glance

Intervention
not applicable
Design
other
Sample size
98
Population
autism spectrum disorder
Finding
positive

03Original abstract

Gastrointestinal (GI) difficulties are common in children diagnosed with autism spectrum disorder (ASD). However, these difficulties can frequently remain unrecognized. Therefore, we aimed to translate a newly developed instrument, The Autism Spectrum Disorder Gastrointestinal and Related Behaviors Inventory in Children (ASD-GIRBI), to assess its reliability and to explore the frequency of various gastrointestinal difficulties and related behaviors, as well as to explore the association of GI difficulties with the measures of social functioning and emotional and behavioral difficulties in children with ASD. A total of 98 children and adolescents (aged 4-18 [M age = 10.67 ± 3.705], 82.7% male), previously diagnosed with ASD at the Institute of Mental Health in Belgrade, Serbia, took part in this research. Their parents filled out the following questionnaires: ASD-GIRBI (an assessment of gastrointestinal and related symptoms), Stanford Social Dimensions Scale (SSDS) (a measure of social functioning) and Strengths and Difficulties Questionnaire (SDQ) (a measure of emotional and behavioral problems). Our results indicate that the ASD-GIRBI is a reliable instrument for GI difficulties assessment (Cronbach's α = 0.841) with the total score successfully discriminating between the participants with and without a GI disorder diagnosis (p = 0.040). Any gastrointestinal symptom was present in 54.1% of the participants, most commonly flatulence, diarrhea, and constipation. The severity of gastrointestinal difficulties correlated to emotional problems (r = 0.261, p < 0.01), conduct problems (r = 0.219, p < 0.05), hyperactivity (r = 0.381, p < 0.01), peer problems (r = 0.266, p < 0.01), total difficulties (r = 0.454, p < 0.01) and total difficulties impact (r = 0.321, p < 0.01). Our data emphasize the potential importance of GI difficulties for various areas of functioning of individuals with ASD.

Autism research : official journal of the International Society for Autism Research, 2025 · doi:10.1002/aur.70007