Associations of Autistic Traits and Autism with Incontinence and Constipation in a UK Birth Cohort.
Social-communication delays double the odds of later incontinence and constipation—screen early.
01Research in Context
What this study did
Gyamenah et al. (2024) tracked one UK birth cohort. They looked at early social and speech skills. Then they checked for incontinence at age 9 and constipation at age 14.
The team used stats to see if poor early communication predicted later toilet trouble. They also compared kids with an autism diagnosis to kids without.
What they found
Kids who had social-communication delays doubled their odds of wetting or soiling at age 9. The same delays also raised the risk of constipation at age 14.
Children with an autism diagnosis were more likely to have daytime wetting. Speech that was hard to follow in preschool also mattered.
How this fits with other research
Chakraborty et al. (2021) saw the same gut-behavior link in younger kids. They found stomach pain went hand-in-hand with repetitive actions, not social issues. The age gap explains the difference: toddlers show different red flags than school-age kids.
Petrovic et al. (2016) followed adults from an 1980s cohort. Constipation was still a top problem decades later. Prince’s data now show the trouble starts before age 10, so you have a long window to act.
Sivertsen et al. (2012) used the same cohort style to track sleep. They showed autism-related insomnia sticks around. Prince shows toilet problems follow a similar chronic path.
Why it matters
You can add two quick questions to your intake: “Any wetting accidents?” and “How often does the child poop?” If the child also has social or speech delays, flag for medical follow-up. Early action on diet, fluids, and toilet schedules can spare years of discomfort and shame.
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02At a glance
03Original abstract
There is evidence that children with autism/autistic traits have higher risks of incontinence and constipation, but no studies have examined this in a large community-based cohort. Aim/Research question: are autistic traits and diagnosed autism prospectively associated with increased odds of incontinence and constipation in children and adolescents? This was a population-based cohort study based on data from the Avon Longitudinal Study of Parents and Children (n = 4233-4490 at age 9 years; n = 3403-3697 at age 14). We used multivariable logistic regression to examine associations of parent-reported autistic traits (sociability, repetitive behaviours, social-communication, coherence) (at ages 3-9 years) and autism with incontinence (bedwetting, daytime-wetting, soiling) and constipation (parent-reported at age 9, self-reported at age 14). We adjusted for parity, maternal age at delivery, child's sex and developmental level, maternal depression, and anxiety (antenatal and postnatal), and indicators of family socioeconomic status. Social-communication and speech coherence difficulties showed the strongest associations with incontinence, e.g., adjusted odds ratio (OR) and 95% confidence interval (CI) for the association between social-communication difficulties and daytime-wetting was 2.21 (1.47-3.32) and for coherence was 2.34 (1.60-3.43). The odds of soiling were also higher in children with social-communication (OR: 1.88, 95% CI 1.28-2.75) and coherence difficulties (OR: 2.04, 95% CI 1.43-2.93). Diagnosed autism was only associated with an increase in the odds of daytime-wetting (OR: 3.18, 95% CI 1.44-7.02). At 14 years, there was less evidence of associations between autistic traits and incontinence but there was evidence of associations between autistic traits and constipation: social-communication (OR: 1.68, 95% CI 1.13-2.49), coherence difficulties (OR: 1.64, 95% CI 1.11-2.41). Early assessment and treatment of incontinence/constipation should be considered for children with autistic traits.
Journal of autism and developmental disorders, 2024 · doi:10.1093/gastro/goab035