Characterization of Initial Gastrointestinal Evaluation of Children with Autism Spectrum Disorder: A Descriptive Study.
Most ASD GI referrals are for constipation and feeding issues, yet over half of kids can’t finish invasive tests—so run brief, sensory-friendly screens first.
01Research in Context
What this study did
Mostafavi et al. (2025) pulled 131 medical charts of kids with autism. They wanted to see why doctors first send these kids to stomach specialists. The team counted every GI referral reason and every test the kids tried to finish.
What they found
Constipation, belly pain, and feeding problems topped the list. Six out of ten kids got a 'functional GI' label. Yet over half could not finish the full test battery. Long scopes, loud machines, and waiting rooms were too much.
How this fits with other research
Rojahn et al. (2012) warned that sleep and eating quirks are weak flags for GI trouble. Mojdeh now shows those same weak flags still drive most referrals. The signal has not improved in thirteen years.
Amore et al. (2011) proved that short, home-based ABA feeding plans work after referral. Mojdeh’s data explain why we need that next step: many kids never make it through hospital tests.
Leiva-García et al. (2019) add dental risk. Kids who avoid foods often have crooked teeth and sore gums. A feeding referral should also trigger a quick oral screen.
Why it matters
You can shorten the path. When a parent mentions constipation or picky eating, skip the full GI marathon. Start with a brief sensory-friendly visit: one abdominal X-ray, one stool check, and a dental look. If results are clear, move straight to a home feeding intervention. You save the family time, money, and stress while still protecting the child’s gut and teeth.
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02At a glance
03Original abstract
Autism spectrum disorder (ASD) is a multifactorial, pervasive neurodevelopmental disorder affecting 1 in 36 children in the United States. Given the rising prevalence and significant economic and social costs associated with ASD, it is critical that continued efforts be made towards better understanding the underlying etiology as well as management of the condition and its commonly associated comorbidities. It has been estimated that upwards of 70% of children with ASD have a positive history of gastrointestinal (GI) symptoms. In this retrospective, descriptive study, we identified 131 patients with diagnosis of autism spectrum disorder who presented for initial evaluation by pediatric gastroenterology at the Baystate Children's Specialty Center. We collected data from chart review of these patients with a particular focus on reason for referral, components of evaluation as well as results of said evaluation. Of the 131 patients, the most frequent reason for referral included constipation (42.7%), abdominal pain (27.5%), and feeding difficulties (26.7%). After completion of the evaluation, 60.3% of patients were ultimately diagnosed with a functional gastrointestinal condition. Of patients who completed endoscopic evaluation, 40% of patients were found to have grossly abnormal and 40% were found to have pathologically abnormal EGD. The majority of patients were recommended to have diagnostic evaluation; however, a large proportion of them were unable to complete said evaluation. The majority of patients were found to have abnormal testing; however, the majority of patients were additionally diagnosed with a functional gastrointestinal condition.
Journal of autism and developmental disorders, 2025 · doi:10.1097/DBP.0b013e31821bd06a