31509
An Investigation of Developmental-Behavioral Profiles in Children with Autism Spectrum Disorder and Comorbid Gastrointestinal Symptoms

Poster Presentation
Thursday, May 2, 2019: 11:30 AM-1:30 PM
Room: 710 (Palais des congres de Montreal)
B. Restrepo1, D. G. Amaral2, S. Rogers2, S. Ozonoff3, B. Heath2, A. L. Hechtman3, M. Solomon4, C. W. Nordahl2 and J. Cabral5, (1)Pediatrics, UC Davis MIND Institute, Sacramento, CA, (2)Department of Psychiatry and Behavioral Sciences, The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, UC Davis School of Medicine, University of California Davis, Sacramento, CA, (3)Psychiatry and Behavioral Sciences, University of California at Davis, MIND Institute, Sacramento, CA, (4)Department of Psychiatry & Behavioral Sciences, The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, CA, (5)Department of Community Health, Tufts University, Boston, MA
Background: Parents often voice concerns about gastrointestinal (GI) symptoms in children with autism spectrum disorder (ASD). The extent to which the underlying biology of ASD is also causal of GI problems and whether amelioration of GI problems may decrease core symptoms of ASD are currently unknown.

Objectives: To determine the frequency and severity of GI symptoms in preschool-aged children with ASD. We also examined whether the presence of GI symptoms is associated with differences in behavioral and developmental profiles.

Methods: 259 children with ASD and 129 age-matched typically developing (TD) controls were recruited as part of the UC Davis MIND Institute Autism Phenome Project (APP) and the Girls with Autism Imaging Neurodevelopment (GAIN) study. Participants enrolled between 2 and 3.5 years of age. The study protocols include four-time points; current analyses utilize the first-time point. GI symptoms, including abdominal pain, bloating, constipation, diarrhea, and sensitivity to foods, were assessed using parent-report. Frequency of symptoms was rated on a 5-point scale. Children with at least one symptom in the ‘frequently’ or ‘always’ range were categorized as having GI symptoms. Children with GI symptoms in each diagnostic group were compared to children without GI symptoms on measures of autism severity (ADOS Calibrated Severity Score [ADOS-CSS]), repetitive behaviors (Repetitive Behavior Scale Revised [RBS-R]), developmental and adaptive functioning (Mullen Scales of Early Learning [MSEL] and Vineland Adaptive Behavior Scales [VABS]), and problem behaviors (Child Behavior Checklist [CBCL]). Diagnosis by GI-group interactions were also investigated.

Results: GI symptoms were reported in 51.7% of children with ASD compared to 21.7% in the TD group (chi-square p < .001). The most commonly reported GI symptoms were sensitivity to food (64%), constipation (52%) and diarrhea (47%). Children with ASD were more likely to experience multiple GI symptoms; 27% reported two or more compared to 5% in the TD group. GI symptoms were reported at similar rates in males and females with ASD. The presence of GI symptoms was associated with increased internalizing (p = .002) and externalizing (p = .0008) CBCL t-scores in both ASD and TD children. Investigation of syndrome scale t-scores revealed significant effects for emotional reactivity, somatic complaints, sleep problems, attention problems, and aggressive behavior (p’s < .02, uncorrected). There was a diagnosis by GI symptom interaction for self-injurious behaviors (p = .04) on the RBS-R; GI symptoms were associated with elevated scores in ASD, but not in TD. The presence of GI symptoms was not associated with differences in MSEL or VABS composite scores in either diagnostic group or with ADOS-CSS scores in the ASD group.

Conclusions: Over half of preschool-aged children with ASD had significant GI problems, as reported by parents, which were associated with increased internalizing and externalizing symptoms and self-injurious behaviors. Our investigation reinforces the importance of assessing for GI symptoms in children with ASD as GI problems may contribute to behavioral issues. Additional planned analyses include longitudinal evaluation of symptoms across early and middle childhood as well as investigations of associations between GI symptoms and maternal and child immune-related conditions.

See more of: Gastrointestinal (GI)
See more of: Gastrointestinal (GI)