Autism & Developmental

Brief report: Association between behavioral features and gastrointestinal problems among children with autism spectrum disorder.

Maenner et al. (2012) · Journal of autism and developmental disorders 2012
★ The Verdict

Common behaviors like picky eating and poor sleep are weak but useful clues for GI and dental issues in kids with autism.

✓ Read this if BCBAs working with autistic children in clinic or school settings
✗ Skip if Practitioners serving adults or clients without GI concerns

01Research in Context

01

What this study did

Rojahn et al. (2012) asked parents about sleep, eating and behavior in kids with autism. They also asked about tummy pain, constipation and diarrhea. They wanted to see if everyday behaviors flag GI trouble.

The team compared answers from kids with and without autism. They used surveys, not lab tests. The goal was quick red flags for referral.

02

What they found

Strange sleep and picky eating were linked to GI problems, but only weakly. Oppositional behavior also showed a small link. Yet these behaviors were common in both groups.

Because the behaviors were so common, they are poor screeners. A child could show all three and still have no GI issues.

03

How this fits with other research

Mostafavi et al. (2025) extends the picture. They reviewed 131 charts and found constipation and feeding issues drive most GI referrals. Their real-world data confirm eating anomalies matter, but also show 60 % of kids could not finish full testing.

Leiva-García et al. (2019) go further. They linked food rejection in autism to worse teeth and gums. The chain is now eating issues → GI pain plus dental risk.

Martínez-Villamea et al. (2025) and Wang et al. (2025) add sleep to the chain. Poor sleep and more screen time predict pickier eating. The 2012 weak signal grows into a trio: sleep-diet-GI.

04

Why it matters

Do not wait for clear GI red flags. Ask about sleep, screen use and food variety at every visit. If any are off, add a short sensory-friendly GI checklist. Start dental and nutrition screens early. Small habits snowball into medical problems, but they are also easy targets for parent coaching.

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Add three quick parent questions to your intake: How many hours of sleep? Any food the child refuses? Tummy pain after meals? If two answers are risky, refer for GI or dental screening.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
487
Population
autism spectrum disorder
Finding
weakly positive
Magnitude
small

03Original abstract

Recent reports suggest certain behaviors among children with autism spectrum disorders (ASD) may indicate underlying gastro-intestinal (GI) problems, and that the presence of these behaviors may help alert primary care providers to the need to evaluate a child with ASD for GI problems. The purpose of this population-based study of 487 children with ASD, including 35 (7.2%) with a medically documented history of GI problems, was to compare behavioral features of children with and without a history of GI problems. Unusual sleeping or eating habits and oppositional behavior were significantly associated with GI problems. These behaviors, however, were frequent in both children with and without GI problems, suggesting they may have limited utility in a screening capacity for GI problems.

Journal of autism and developmental disorders, 2012 · doi:10.1007/s10803-011-1379-6