Autism & Developmental

Gastrointestinal dysfunction in children with autism spectrum disorders.

Kang et al. (2014) · Autism research : official journal of the International Society for Autism Research 2014
★ The Verdict

Half of kids with autism have chronic GI pain that scopes often miss—screen with parent questions, not cameras.

✓ Read this if BCBAs doing intake or behavior plans for school-age clients with autism.
✗ Skip if Practitioners who only treat verbal adults or acute medical cases.

01Research in Context

01

What this study did

Kang et al. (2014) looked at 164 kids with autism in a hospital clinic. They asked parents about stomach pain, constipation, diarrhea, and reflux. Doctors also did scopes when needed.

The team wanted to know how many kids had chronic GI complaints and if test results matched what parents reported.

02

What they found

Almost half the children had long-lasting GI problems. Constipation, diarrhea, and reflux were the top complaints.

Surprise: the camera pictures rarely matched the parent reports. A child could hurt but look fine inside, or look inflamed yet feel okay.

03

How this fits with other research

Chandler et al. (2013) asked the same questions one year earlier and got the same 50% rate, but they added typical kids for comparison. The match gives you confidence the number is real.

Johnson et al. (2009) pooled 144 studies and saw GI rates anywhere from 4% to 97%. Victor’s 50% sits in the middle, showing single-clinic data can calm wild swings.

Slaughter et al. (2014) went further the same year. They linked stomach pain to worse irritability and stereotypy. Victor found no scope match; Virginia found a behavior match. Together they tell you: treat the pain even if tests look clear.

04

Why it matters

You can’t trust scopes alone. Ask about poop, reflux, and tummy pain at every intake. When behavior spikes, think gut first. Try a simple bowel log before you order costly tests. Relief might be as easy as fiber, fluids, or a diet tweak.

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Add three GI questions to your intake form: 'Any constipation, diarrhea, or reflux this month?'

02At a glance

Intervention
not applicable
Design
case series
Sample size
164
Population
autism spectrum disorder
Finding
not reported

03Original abstract

Gastrointestinal (GI) dysfunctions are frequently reported by parents of children with autism spectrum disorders (ASD) and have been recently recognized as a comorbid condition. However, the clinical significance of these GI dysfunctions remains to be delineated. This study describes the clinical characteristics, associated comorbid disorders, and endoscopic and colonoscopic evaluation of GI dysfunction in a cohort of 164 children with ASD evaluated at a pediatric neurology practice. Symptoms of GI dysfunction were prevalent: 49% of the children reported one or more chronic GI complaints, 22% exhibited diarrhea, 26% suffered from constipation. Furthermore 13% of the parents reported their children to suffer from bloating and/or being gassy and while 10% of the parents reported vomiting or gastroesophageal reflux problems. Similar rates of GI symptoms were reported among pre-school and school-aged children. Inflammation of the gut was found in 6 of the 12 subjects who underwent endoscopic and colonoscopic evaluations, however clinical symptoms did not predict the results of the evaluation. GI dysfunction was significantly associated with sleep disorders and food intolerance, but not with irritability or aggressiveness. In summary, GI dysfunction was prevalent in this cohort of children with ASD, observations consistent with the reports of parents and other clinicians. We conclude that the GI dysfunction in ASD requires proper evaluation and treatment.

Autism research : official journal of the International Society for Autism Research, 2014 · doi:10.1002/aur.1386