Autism & Developmental

Brief Report: Association of Complicated Appendicitis in Children with Autism Spectrum Disorders.

Reeves et al. (2020) · Journal of autism and developmental disorders 2020
★ The Verdict

Suspect appendicitis early in autistic teens—they are far more likely to suffer rupture and sepsis.

✓ Read this if BCBAs who support autistic adolescents in clinics, schools, or residential settings.
✗ Skip if Practitioners working only with adults or non-autistic populations.

01Research in Context

01

What this study did

Doctors looked at hospital records for teens with appendicitis.

They compared autistic kids with same-age typical kids.

The goal was to see who got sicker before surgery.

02

What they found

Autistic teens had twice the chance of a burst appendix.

They also had triple the risk of body-wide infection.

Delays in diagnosis seem to drive the extra danger.

03

How this fits with other research

Moore (2015) warns us not to think autistic kids feel less pain.

Parents often say their child is pain-insensitive, but lab and hospital data show normal or even heightened pain signals.

That fits Kovačič et al. (2020): if pain is under-reported, doctors wait too long and the appendix bursts.

Buyuktaskin et al. (2021) add that autistic adolescents need more time to notice touch, hinting at wider sensory timing issues that could mask early belly pain.

04

Why it matters

When an autistic teen says "my stomach hurts," act fast.

Use pictures or scales to check pain every hour.

Share the higher rupture risk with emergency staff so imaging and surgery move quicker.

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Teach your client a simple belly-pain rating card and call the nurse if pain lasts more than two hours.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
292572
Population
autism spectrum disorder, neurotypical
Finding
positive
Magnitude
medium

03Original abstract

Appendicitis is the most common surgical emergency in children and can lead to significant complications. The aim of our study was to determine whether children with autism spectrum disorders (ASD) are at increased risk for appendicitis and its complications compared to neurotypical (NT) peers. From 2000 to 2013, 292,572 children were included (n = 48,762 ASD). ASD children exhibited an incidence of 8.66 appendicitis cases per 10,000 person-years, P > 0.05. There was an increased risk of perforation in ASD children age 15-17 years-old (OR 2.25; 95% CI 1.15-4.42) as well as an increased odds of sepsis (OR 3.44, 95% CI 1.43-8.27). Providers should display heightened awareness for the risk of complicated appendicitis in children with ASD.

Journal of autism and developmental disorders, 2020 · doi:10.1007/s10803-020-04499-z