Determinants of Leaky Gut and Gut Microbiota Differences in Children With Autism Spectrum Disorder and Their Siblings.
Tummy pain, self-hits, and sleepless nights cluster in preschoolers with autism—fix the gut first.
01Research in Context
What this study did
The team asked parents of preschoolers about tummy trouble. One group had autism. One group did not.
They counted how often each child had pain, diarrhea, or constipation. They also asked about sleep, self-injury, and repeated movements.
What they found
Kids with autism had three times more GI symptoms than their typical peers.
More tummy trouble went hand-in-hand with more head-banging, hand-biting, and sleepless nights.
How this fits with other research
Boudreau et al. (2015) saw the same link in two large autism banks: GI trouble predicts sleep loss and doubles seizure risk. The pattern holds across different ages and places.
Masi et al. (2022) stretched the link further. They showed the GI-sleep tie stays strong from toddlers to teens. They added new red flags: low daily-living skills and sensory seeking.
Boswell et al. (2023) looked backward in time. They found that babies who show self-biting and repeated rocking at 12 months are the same ones still hurting themselves at age three. Together, the four papers draw one line: early GI signs, stereotypy, and self-injury travel together.
Why it matters
When a preschool client with autism has a sore belly, look for more than bathroom trips. Track sleep minutes and self-hits the same week. Treating constipation or reflux may calm head-banging faster than any behavior plan alone. Share the GI Severity Index from Thulasi et al. (2019) with parents; a score of two or more signals it is time to call the pediatrician.
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02At a glance
03Original abstract
Gastrointestinal (GI) symptoms are frequently reported in children with autism spectrum disorder (ASD). We evaluated the frequency and severity of GI symptoms in preschool-aged children with ASD compared to participants with typical development (TD). Our goal was to ascertain whether GI symptoms are associated with differences in sex or developmental and behavioral measures. Participants were between 2 and 3.5 years of age and included 255 children with ASD (184 males/71 females) and 129 age-matched TD controls (75 males/54 females). A parent interview was used to assess GI symptoms (abdominal pain, gaseousness/bloating, diarrhea, constipation, pain on stooling, vomiting, difficulty swallowing, blood in stool or in vomit). Children with GI symptoms in each diagnostic group were compared to children without GI symptoms on measures of developmental, behavioral, and adaptive functioning. GI symptoms were reported more frequently in children with ASD compared to the TD group (47.8% vs. 17.8%, respectively). Children with ASD were also more likely to experience multiple GI symptoms (30.6% vs. 5.4%). GI symptoms were equally common in males and females across both diagnostic groups. There were no statistically significant differences in developmental or adaptive measures based on presence of GI symptoms in either ASD or TD children. Co-occurring GI symptoms were, however, associated with increased self-injurious behaviors, restricted stereotyped behaviors, aggressive behaviors, sleep problems and attention problems in both ASD and TD children. In children with ASD, a higher number of GI symptoms was associated with an increase in self-injurious behaviors, somatic complaints, reduced sleep duration, and increased parasomnias. LAY SUMMARY: ASD is characterized by challenges in social communication and repetitive behaviors. But, people with autism have many other difficulties including gastrointestinal problems. Children with ASD were three times more likely to experience GI symptoms than typically developing peers. Increased GI symptoms are associated with increased problem behaviors such as sleep problems, self-injury, and body aches. Since GI symptoms are often treatable, it is important to recognize them as soon as possible. Both clinicians and parents should become more aware of the high occurrence of GI problems in autistic people. Autism Res 2020, 13: 1778-1789. © 2020 International Society for Autism Research and Wiley Periodicals LLC.
Journal of autism and developmental disorders, 2023 · doi:10.1016/j.psychres.2017.10.040