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Gastrointestinal Problems in Children with Autism, Developmental Delays or Typical Development.

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TLDR
Frequent GI problems affect young children with ASD and DD more commonly than those with TD, andMaladaptive behaviors correlate with GI problems, suggesting these comorbidities require attention.
Abstract
To compare gastrointestinal (GI) problems among children with: (1) autism spectrum disorder (ASD), (2) developmental delay (DD) and (3) typical development (TD), GI symptom frequencies were obtained for 960 children from the CHildhood Autism Risks from Genetics and Environment (CHARGE) study. We also examined scores on five Aberrant Behavior Checklist (ABC) subscales comparing ASD children with high versus low frequency GI symptoms. Compared to TD children, those with ASD [aOR 7.92 (4.89–12.85)] and DD [aOR 4.55 (2.51–8.24)] were more likely to have at least one frequent GI symptom. Restricting to ASD children, those with frequent abdominal pain, gaseousness, diarrhea, constipation or pain on stooling scored worse on irritability, social withdrawal, stereotypy, and hyperactivity compared with children having no frequent GI symptoms. Frequent GI problems affect young children with ASD and DD more commonly than those with TD. Maladaptive behaviors correlate with GI problems, suggesting these comorbidities require attention.

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University of Nebraska - Lincoln University of Nebraska - Lincoln
DigitalCommons@University of Nebraska - Lincoln DigitalCommons@University of Nebraska - Lincoln
Nutrition and Health Sciences -- Faculty
Publications
Nutrition and Health Sciences, Department of
2014
Gastrointestinal Problems in Children with Autism, Developmental Gastrointestinal Problems in Children with Autism, Developmental
Delays or Typical Development Delays or Typical Development
Virginia Chaidez
University of Nebraska - Lincoln
, vchaidez2@unl.edu
Robin L. Hansen
University of California, Davis School of Medicine
, rlhansen@ucdavis.edu
Irva Hertz-Picciotto
University of California, Davis
, iher@ucdavis.edu
Follow this and additional works at: https://digitalcommons.unl.edu/nutritionfacpub
Part of the Human and Clinical Nutrition Commons, Molecular, Genetic, and Biochemical Nutrition
Commons, and the Other Nutrition Commons
Chaidez, Virginia; Hansen, Robin L.; and Hertz-Picciotto, Irva, "Gastrointestinal Problems in Children with
Autism, Developmental Delays or Typical Development" (2014).
Nutrition and Health Sciences -- Faculty
Publications
. 232.
https://digitalcommons.unl.edu/nutritionfacpub/232
This Article is brought to you for free and open access by the Nutrition and Health Sciences, Department of at
DigitalCommons@University of Nebraska - Lincoln. It has been accepted for inclusion in Nutrition and Health
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Lincoln.

Gastrointestinal Problems in Children
with Autism, Developmental Delays
or Typical Development
Virginia Chaidez,
1
Robin L. Hansen,
2,3
& Irva Hertz-Picciotto
3,4







Correspondence:vchaidez2@unl.edu
Abstract
 
-



-





1
digitalcommons.unl.edu
Published in Journal of Autism and Developmental Disorders




 J Autism Dev Disord



Keywords: -

Introduction
-
-





-

studies including, but not limited to: variations in the criteria used to
-
-




-





-
-


-





 J Autism Dev Disord
-







-
-
-

-








-



-






-


-




 J Autism Dev Disord
Methods
Study Design and Sample


-







-
-

-


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Autism spectrum disorder.

TL;DR: Clinicians can make a difference by providing timely and individualised help to families navigating referrals and access to community support systems, by providing accurate information despite often unfiltered media input, and by anticipating transitions such as family changes and school entry and leaving.
Journal ArticleDOI

The Changing Epidemiology of Autism Spectrum Disorders

TL;DR: Eviologic investigations focused on nongenetic factors have established advanced parental age and preterm birth as ASD risk factors, indicated that prenatal exposure to air pollution and short interpregnancy interval are potentialrisk factors, and suggested the need for further exploration of certain prenatal nutrients, metabolic conditions, and exposure to endocrine-disrupting chemicals.
Journal ArticleDOI

Identification, Evaluation, and Management of Children With Autism Spectrum Disorder.

TL;DR: This single clinical report updates the 2007 American Academy of Pediatrics clinical reports on the evaluation and treatment of ASD in one publication with an online table of contents and section view available to help the reader identify topic areas within the report.
References
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Mullen Scales of Early Learning

TL;DR: The Mullen Scales of Early Learning (MSEL) as mentioned in this paper includes five scales that provide information on cognitive and motor ability, including Gross Motor (0-33 months only), Visual Reception, Fine Motor, Expressive Language and Receptive Language.
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The CHARGE study: an epidemiologic investigation of genetic and environmental factors contributing to autism.

TL;DR: The CHARGE (Childhood Autism Risks from Genetics and Environment) study will address a wide spectrum of chemical and biologic exposures, susceptibility factors, and their interactions, and Phenotypic variation among children with autism will be explored.
Journal ArticleDOI

Frequency of gastrointestinal symptoms in children with autistic spectrum disorders and association with family history of autoimmune disease.

TL;DR: There was no association between a family history of autoimmune disease and GI symptoms in children with ASD and the multivariate analysis, autism and food selectivity were associated with GI symptoms.
Journal ArticleDOI

Incidence of gastrointestinal symptoms in children with autism: a population-based study.

TL;DR: As constipation and feeding issues/food selectivity often have a behavioral etiology, data suggest that a neurobehavioral rather than a primary organic gastrointestinal etiology may account for the higher incidence of these gastrointestinal symptoms in children with autism.
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Q1. What contributions have the authors mentioned in the paper "Gastrointestinal problems in children with autism, developmental delays or typical development" ?

The authors also examined scores on five Aberrant Behavior Checklist ( ABC ) subscales comparing ASD children with high versus low frequency GI symptoms. Maladaptive behaviors correlate with GI problems, suggesting these comorbidities require attention. 

To investigate whether diet plays a role in the prevalence of GI problems, future studies should attempt to measure diet quality and quantity of key macronutrients with special attention to fiber, water, and fats, in addition to micronutrients such as iron, zinc, vitamin A, vitamin B12, folate and iodine. Future work examining GI problems in children with ASD and DD should standardize definitions for GI symptoms and more studies need to incorporate measures of dietary intake and nutritional status. Investigating the dual role of neurotransmitters active in both the gut and the brain in future studies may advance their understanding of underlying mechanisms important to both. One small study suggests that children with ASDs may have inadequate intakes of fiber, calcium, iron, vitamin E and vitamin D ( Herndon et al. 2009 ). 

Descriptive analyses of parental responses to related open ended GI questions indicated the most frequently reported food sensitivity or allergy for all diagnostic groups was dairy/casein (14.6 % ASD, 6.6 % DD and 5.3 % TD). 

Cell-mediated immunity plays a role in non-allergic food hypersensitivity and reactions take place several hours and even 1–2 days after the intake of the culprit (Jyonouchi et al. 2005). 

Children with ASD were at least three times more likely to experience frequent GI symptoms than children with TD: abdominal pain, pain on stooling, constipation, gaseousness/bloating, diarrhea, sensitivity to foods, as well as vomiting and difficulty swallowing, which were very rare in TD controls. 

For children with ASD, other commonly reported food allergies or sensitivities included the grains category (including gluten, 7.8 %) and nuts/soy (7 %). 

Another recent case–control population based study (n = 121 cases, n = 242 controls) in Olmstead County, Minnesota, where >95 % of medical care is provided by Olmstead Medical Center/Mayo Clinic, medical charts provided data for GI symptoms from birth to 21 years of age (Ibrahim et al. 2009). 

At least one group of researchers has demonstrated that in children with ASD, it is nonallergic food hypersensitivity to cow’s milk protein (CMP), and not casein that plays a role in GI symptoms observed in some children with ASD (Jyonouchi et al. 2005). 

It is plausible that a chronic GI symptom, which can cause pain, discomfortand anxiety, could contribute to increased irritability and social withdrawal, particularly in someone with deficits in social and communicative skills. 

Diarrhea and constipation arefrequently cited in studies examining GI symptoms in children with autism, but to date, only one has examined the role of diet in GI problems (Gorrindo et al. 2012). 

Appropriate treatment of GI symptoms may help alleviate at least some problematic behaviors and improve the quality of life in children with ASD along with their families. 

In children with ASD, four out of five behavior subscales (irritability, social withdrawal, stereotypy and hyperactivity) on the ABC were significantly higher in children with frequent occurrences of abdominal pain, gaseousness, diarrhea and constipation as compared to children with no frequent GI symptoms (Table 5). 

Vomiting is a relatively infrequent GI symptom reported, and ASD without DD had higher occurrence than ASD with DD (p = 0.02; Table 1S). 

children with DD were at least three times more likely than children with TD to experience frequent sensitivity to foods, pain on stooling, diarrhea, constipation, as well as difficulty swallowing and vomiting.