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Gastrointestinal Symptoms in 2- to 5-Year-Old Children in the Study to Explore Early Development

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Abstract

Gastrointestinal symptoms (GIS) are commonly reported in children with autism spectrum disorder (ASD). This multi-site study evaluated the prevalence of GIS in preschool-aged children with ASD/(n = 672), with other developmental delays (DD)/(n = 938), and children in the general population (POP)/(n = 851). After adjusting for covariates, children in the ASD group were over 3 times more likely to have parent-reported GIS than the POP group, and almost 2 times more likely than the DD group. Children with GIS from all groups had more behavioral and sleep problems. Within the ASD group, children with developmental regression had more GIS than those without; however, there were no differences in autism severity scores between children with and without GIS. These findings have implications for clinical management.

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References

  • Achenbach, T. (1992). Child behavior checklist. . Burlington: Achenbach System of Empirically based Assessment.

    Google Scholar 

  • Alam, R., Abdolmaleky, H. M., & Zhou, J. R. (2017). Microbiome, inflammation, epigenetic alterations, and mental diseases. American Journal of the Medical Genetics Part B Neuropsychiatric Genetics. https://doi.org/10.1002/ajmg.b.32567

    Article  Google Scholar 

  • Aldinger, K. A., Lane, C. J., Veenstra-VanderWeele, J., & Levitt, P. (2015). Patterns of risk for multiple co-occurring medical conditions replicate across distinct cohorts of children with autism spectrum disorder. Autism Res, 8(6), 771–781. https://doi.org/10.1002/aur.1492

    Article  PubMed  PubMed Central  Google Scholar 

  • Bresnahan, M., Hornig, M., Schultz, A. F., Gunnes, N., Hirtz, D., Lie, K. K., … Lipkin, W. I. (2015). Association of maternal report of infant and toddler gastrointestinal symptoms with autism: evidence from a prospective birth cohort. JAMA Psychiatry, 72(5), 466–474. doi:https://doi.org/10.1001/jamapsychiatry.2014.3034

  • Buie, T., Campbell, D. B., Fuchs, G. J., 3rd, Furuta, G. T., Levy, J., Vandewater, J., … Winter, H. (2010). Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics, 125(Suppl 1), S1-18. doi:https://doi.org/10.1542/peds.2009-1878C

  • Campbell, D. B., Buie, T. M., Winter, H., Bauman, M., Sutcliffe, J. S., Perrin, J. M., & Levitt, P. (2009). Distinct genetic risk based on association of MET in families with co-occurring autism and gastrointestinal conditions. Pediatrics, 123(3), 1018–1024. https://doi.org/10.1542/peds.2008-0819

    Article  PubMed  Google Scholar 

  • Chaidez, V., Hansen, R. L., & Hertz-Picciotto, I. (2014). Gastrointestinal problems in children with autism, developmental delays or typical development. Journal of Autism and Developmental Disorders, 44(5), 1117–1127. https://doi.org/10.1007/s10803-013-1973-x

    Article  PubMed  PubMed Central  Google Scholar 

  • Doshi-Velez, F., Ge, Y., & Kohane, I. (2014). Comorbidity clusters in autism spectrum disorders: An electronic health record time-series analysis. Pediatrics, 133(1), e54-63. https://doi.org/10.1542/peds.2013-0819

    Article  PubMed  PubMed Central  Google Scholar 

  • Ferguson, B. J., Marler, S., Altstein, L. L., Lee, E. B., Akers, J., Sohl, K., … Beversdorf, D. Q. (2017). Psychophysiological Associations with Gastrointestinal Symptomatology in Autism Spectrum Disorder. Autism Res, 10(2), 276-288. doi:https://doi.org/10.1002/aur.1646

  • Fung, T. C., Olson, C. A., & Hsiao, E. Y. (2017). Interactions between the microbiota, immune and nervous systems in health and disease. Nature Neuroscience, 20(2), 145–155. https://doi.org/10.1038/nn.4476

    Article  PubMed  PubMed Central  Google Scholar 

  • Gorrindo, P., Williams, K. C., Lee, E. B., Walker, L. S., McGrew, S. G., & Levitt, P. (2012). Gastrointestinal dysfunction in autism: Parental report, clinical evaluation, and associated factors. Autism Res, 5(2), 101–108. https://doi.org/10.1002/aur.237

    Article  PubMed  PubMed Central  Google Scholar 

  • Hyman, S. L., Stewart, P. A., Schmidt, B., Cain, U., Lemcke, N., Foley, J. T., … Ng, P. K. (2012). Nutrient intake from food in children with autism. Pediatrics, 130(Suppl 2), S145–153. doi:https://doi.org/10.1542/peds.2012-0900L

  • Kushak, R. I., Buie, T. M., Murray, K. F., Newburg, D. S., Chen, C., Nestoridi, E., & Winter, H. S. (2016). Evaluation of intestinal function in children with autism and gastrointestinal symptoms. Journal of Pediatric Gastroenterology and Nutrition, 62(5), 687–691. https://doi.org/10.1097/MPG.0000000000001174

    Article  PubMed  Google Scholar 

  • Lewis, S. J., & Heaton, K. W. (1997). Stool form scale as a useful guide to intestinal transit time. Scandinavian Journal of Gastroenterology, 32(9), 920–924. https://doi.org/10.3109/00365529709011203

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685.

    Article  Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P., & Risi, S. (1999). Autism diagnostic observation schedule. Los Angeles: Western Psychological Services.

  • Mazurek, M. O., Vasa, R. A., Kalb, L. G., Kanne, S. M., Rosenberg, D., Keefer, A., … Lowery, L. A. (2013). Anxiety, sensory over-responsivity, and gastrointestinal problems in children with autism spectrum disorders. J Abnorm Child Psychol, 41(1), 165-176. doi:https://doi.org/10.1007/s10802-012-9668-x

  • McElhanon, B. O., McCracken, C., Karpen, S., & Sharp, W. G. (2014). Gastrointestinal symptoms in autism spectrum disorder: A meta-analysis. Pediatrics, 133(5), 872–883. https://doi.org/10.1542/peds.2013-3995

    Article  PubMed  Google Scholar 

  • Mullen, E. (1995). Mullen scales of early learning. San Antonio: Pearson.

    Google Scholar 

  • Owens, J. A., Maxim, R., Nobile, C., McGuinn, M., & Msall, M. (2000). Parental and self-report of sleep in children with attention-deficit/hyperactivity disorder. Archives of Pediatrics and Adolescent Medicine, 154(6), 549–555.

    Article  Google Scholar 

  • Owens, J. A., Spirito, A., & McGuinn, M. (2000). The children’s sleep habits questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children. Sleep, 23(8), 1043–1051.

    Article  Google Scholar 

  • Reynolds, A. M., Soke, G. N., Sabourin, K. R., Hepburn, S., Katz, T., Wiggins, L. D., … Levy, S. E. (2019). Sleep problems in 2- to 5-year-olds with autism spectrum disorder and other developmental delays. Pediatrics, 143(3). doi:https://doi.org/10.1542/peds.2018-0492

  • Russo, M., Martinelli, M., Sciorio, E., Botta, C., Miele, E., Vallone, G., & Staiano, A. (2013). Stool consistency, but not frequency, correlates with total gastrointestinal transit time in children. Journal of Pediatrics, 162(6), 1188–1192. https://doi.org/10.1016/j.jpeds.2012.11.082

    Article  Google Scholar 

  • Rutter, M., Bailey, A., & Lord, C. (2003). SCQ: Social communication questionnaire. Los Angeles: Western Psychological Services.

  • Schendel, D. E., Diguiseppi, C., Croen, L. A., Fallin, M. D., Reed, P. L., Schieve, L. A., … Yeargin-Allsopp, M. (2012). The Study to Explore Early Development (SEED): A multisite epidemiologic study of autism by the Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) network. J Autism Dev Disord, 42(10), 2121-2140. doi:https://doi.org/10.1007/s10803-012-1461-8

  • Shumway, S., Farmer, C., Thurm, A., Joseph, L., Black, D., & Golden, C. (2012). The ADOS calibrated severity score: Relationship to phenotypic variables and stability over time. Autism Res, 5(4), 267–276. https://doi.org/10.1002/aur.1238

    Article  PubMed  PubMed Central  Google Scholar 

  • Teng, A., Bartle, A., Sadeh, A., & Mindell, J. (2012). Infant and toddler sleep in Australia and New Zealand. Journal of Paediatrics and Child Health, 48(3), 268–273. https://doi.org/10.1111/j.1440-1754.2011.02251.x

    Article  PubMed  Google Scholar 

  • Valicenti-McDermott, M. D., McVicar, K., Cohen, H. J., Wershil, B. K., & Shinnar, S. (2008). Gastrointestinal symptoms in children with an autism spectrum disorder and language regression. Pediatric Neurology, 39(6), 392–398. https://doi.org/10.1016/j.pediatrneurol.2008.07.019

    Article  PubMed  Google Scholar 

  • Wang, L. W., Tancredi, D. J., & Thomas, D. W. (2011). The prevalence of gastrointestinal problems in children across the United States with autism spectrum disorders from families with multiple affected members. Journal of Developmental and Behavioral Pediatrics, 32(5), 351–360. https://doi.org/10.1097/DBP.0b013e31821bd06a

    Article  PubMed  Google Scholar 

  • Wiggins, L. D., Reynolds, A., Rice, C. E., Moody, E. J., Bernal, P., Blaskey, L., … Levy, S. E. (2015). Using standardized diagnostic instruments to classify children with autism in the study to explore early development. J Autism Dev Disord, 45(5), 1271-1280. doi:https://doi.org/10.1007/s10803-014-2287-3

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Acknowledgments

Special thanks to SEED family participants, investigators, and staff at the SEED sites. We thank the SEED Data Coordinating Center team at the Clinical and Translational Sciences Institute of Michigan State University for their support throughout this study. This project was supported by Centers for Disease Control and Prevention (CDC) Cooperative Agreements announced under the following RFA’s: Grant Nos. 01086, 02199, DD11-002, DD06-003, DD04-001, and DD09-002 (https://www.cdc.gov/ncbddd/autism/seed.html). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. This work was also supported by NIH/NCATS Colorado CTSA Grant No. UL1 TR001082. Contents are the authors’ sole responsibility and do not necessarily represent official NIH views.

Funding

The authors have no financial relationships relevant to this article to disclose.

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Author notes

  1. Craig J. Newschaffer

    Present address: The Pennsylvania State University, College of Health and Human Development, 325 Health and Human Development Building, University Park, PA, 16802, USA

  2. Gnakub N. Soke

    Present address: Polio Eradication Branch at the Centers for Disease Control and Prevention, Center for Global Health, Global Immunization Division, 1600 Clifton Rd, Atlanta, NE, 30333, USA

Authors and Affiliations

  1. University of Colorado, School of Medicine, 13123 East 16th Ave, B-140, Aurora, CO, 80045, USA

    Ann M. Reynolds & Katherine R. Sabourin

  2. National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway, Chamblee, GA, S106-330341, USA

    Gnakub N. Soke, Laura A. Schieve & Lisa Wiggins

  3. Kaiser Permanent, 3600 Broadway, Oakland, CA, 94611, USA

    Lisa A. Croen

  4. University of North Carolina at Chapel Hill, Campus Box 7435, Chapel Hill, NC, 27599, USA

    Julie L. Daniels

  5. Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, HH85021205, USA

    M. Daniele Fallin, Li- Ching Lee & Craig J. Newschaffer

  6. University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA, 19104, USA

    Tanja V. E. Kral & Jennifer A. Pinto-Martin

  7. Michigan State University, 909 Wilson Road, East Lansing, MI, B50048824, USA

    Amy Sims

  8. The Children’s Hospital of Philadelphia, 2716 South Street, Philadelphia, PA, 19146, USA

    Susan E. Levy

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All authors gave final approval of the article and agree to be accountable for all aspects of the work, ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data. All authors drafted the work or revised it critically for important intellectual content.

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Correspondence to Ann M. Reynolds.

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Conflict of Interest

The authors have no conflicts of interest relevant to this article to disclose. Dr. Reynolds is participating in clinical trials with Roche and is providing consultation to Ovid Therapeutics regarding evaluation of sleep severity and improvement in clinical trials.

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Reynolds, A.M., Soke, G.N., Sabourin, K.R. et al. Gastrointestinal Symptoms in 2- to 5-Year-Old Children in the Study to Explore Early Development. J Autism Dev Disord 51, 3806–3817 (2021). https://doi.org/10.1007/s10803-020-04786-9

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