Malabsorption and cerebral dysfunction: A multivariate and comparative study of autistic children

Goodwin, Matthew S.; Cowen, Murray A.; Goodwin, T. Campbell

doi:10.1007/bf01537742

Cited by 100 publications

(36 citation statements)

References 10 publications

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“…With regards to medical problems, many authors (Dohan, 1966;Goodwin et al, 1971;Cade et al, 2000;Erickson et al, 2005;Xia et al, 2010;Adams et al, 2011;Wang et al, 2011;and Souza et al, 2012; among others) have observed higher rates of GI disorders in ASD than TD children. On the other hand, Black et al (2002) and Whitehouse et al (2011) did not find these differences and, similarly, Ibrahim et al (2009), after grouping the symptoms that characterize GI disorders (constipation, diarrhea, abdominal distension, gastroesophageal reflux and food selectivity) only found statistically significant differences for constipation and food selectivity, both attributable to the neurobehavioral disorder, ASD, rather than a primary digestive problem.…”

Section: Introductionmentioning

confidence: 99%

Food Selectivity in Autism Spectrum Disorders

et al. 2013

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Autism spectrum disorders (ASDs) are characterized by difficulties with reciprocal social interactions, deficiency in verbal and non-verbal communication, and restricted, repetitive and stereotyped patterns of behavior and interest; one of these characteristic behaviors is food selectivity. The objective of this study was to perform a systematic review of the literature published between 1970 and 2013 concerning this eating behavior. The articles identified were analyzed in terms of: sample size, study design, and criteria for assessment and intervention, as well as the results, level of evidence and grade of recommendation.The main search was conducted in Medline, although other databases were also consulted (Cochrane Library, Scielo, ScienceDirect and Embase). Regarding the methodological quality of the articles retrieved, almost all had limited statistical validity for some of the following reasons: lack of a control group and/or definitions of inclusion criteria, analysis being based on single individuals, heterogeneous groups including different ages, small sample sizes, or failure to consider phenotypic variability between individuals or alternative explanations, as well as multiple meanings being applied to the term "food selectivity". Despite all this, there is empirical evidence and an overall scientific consensus supporting an association between food selectivity and ASDs.

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Section: Introductionmentioning

confidence: 99%

Food Selectivity in Autism Spectrum Disorders

et al. 2013

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“…In this respect, studies by ValenciMcDermott et al (37) and Adams et al (29) have indicated that 70 % of children with ASD report having a history of GI complaints, against 28 % of neurotypical controls, and that GI symptoms are strongly correlated with the severity of autism (r 0·59; P,0·001). The GI abnormalities found in autistic children include malabsorption (38) , maldigestion (39,40) , microbial overgrowth (fungal, bacterial and viral) (31) and abnormal intestinal permeability (28,41) . These events could cause symptoms including diarrhoea, constipation, gas, belching, probing and visibly undigested foods (42) .…”

Section: Gastrointestinal Abnormalitiesmentioning

confidence: 99%

Autism and nutrition: the role of the gut–brain axis

2014

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Autism spectrum disorder (ASD) is characterised by deficits in the ability to socialise, communicate and use imagination, and displays of stereotypical behaviour. It is widely accepted that ASD involves a disorder in brain development. However, the real causes of the neurodevelopmental disorders associated with ASD are not clear. In this respect, it has been found that a majority of children with ASD display gastrointestinal symptoms, and an increased intestinal permeability. Moreover, large differences in microbiotic composition between ASD patients and controls have been reported. Therefore, nutrition-related factors have been hypothesised to play a causal role in the aetiology of ASD and its symptoms. Through a review of the literature, it was found that abnormalities in carbohydrate digestion and absorption could explain some of the gastrointestinal problems observed in a subset of ASD patients, although their role in the neurological and behavioural problems remains uncertain. In addition, the relationship between an improved gut health and a reduction of symptoms in some patients was evaluated. Recent trials involving gluten-free diets, casein-free diets, and pre-and probiotic, and multivitamin supplementation show contradictive but promising results. It can be concluded that nutrition and other environmental influences might trigger an unstable base of genetic predisposition, which may lead to the development of autism, at least in a subset of ASD patients. Clear directions for further research to improve diagnosis and treatment for the different subsets of the disorder are provided.

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“…In particular, lymphoid nodular hyperplasia of the terminal ileum, mild colitis, mild duodenitis, and altered intestinal permeability have been purported to be more prevalent in autistic than nonautistic populations. 4,18,19 Furthermore, malabsorption syndromes and pancreatic insufficiency have been proposed as common entities in autistic children, 20 and have led some investigators to call for focused GI clinical investigation in this population. A possible gut-brain connection that may underlie autism and other neurodevelopmental diseases may still warrant additional investigation.…”

Section: Discussionmentioning

confidence: 99%

Effects of Intravenous Secretin on Language and Behavior of Children With Autism and Gastrointestinal Symptoms: A Single-Blinded, Open-Label Pilot Study

Lightdale

Hayer²,

Duer³

et al. 2001

Pediatrics

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ABSTRACT. Background. Autism is a severe developmental disorder with poorly understood etiology. A recently published case series describes 3 autistic children with gastrointestinal symptoms who underwent endoscopy and intravenous administration of secretin and were subsequently noted by their parents to demonstrate improved language skills over a 5-week period. This report sparked tremendous public interest, and investigators at several sites moved quickly to design controlled trials to test the efficacy of secretin as a therapy for autistic children. However, this is the first effort specifically designed to replicate the initial reported findings in terms of patient age, presenting symptoms, and drug administration.Objective. To rigorously apply the scientific method by assessing the reproducibility of the reported effects of intravenous secretin on the language of young children with autism and gastrointestinal symptoms.Methods. We performed a single-blinded, prospective, open-label trial by conducting formal language testing and blinded behavioral rating both before and repeatedly after a standardized infusion of secretin. We selected autistic children who were similar in age and profile to those described in the published retrospective case review. Inclusion criteria for study participation included age (3-6 years), confirmed diagnosis of autism, and reported gastrointestinal symptoms (16 had chronic diarrhea, 2 had gastroesophageal reflux, and 2 had chronic constipation). Twenty children (18 male) were admitted to the Pediatric Clinical Research Center at the University of California, San Francisco after administration of the Preschool Language Scale-3 (PLS-3). A 3 CU/kg dose of secretin (Secretin-Ferring) was administered intravenously (upper endoscopy was not performed). Behavioral ratings were derived using the Autism Observation Scale applied to a 30-minute time sample of the child's behavior consisting of a videotape of the PLS-3 (structured setting) and a second free play session with a standard set of developmentally appropriate toys. Participants then returned for follow-up evaluations, with readministrations of the PLS-3 at 1, 2, 3, and 5 weeks' postinfusion, and videotaping of each session for later blinded review by 2 independent observers using the Autism Observation Scale, uninformed about week of posttreatment. We also surveyed parents of our study children about their impressions of the effects of secretin using a 5-point Likert scale for parents to rate changes seen in their child.Results. With a total study completion rate across all participants of 96%, repeated measures analyses of variance revealed no significant increases in children's language skills from baseline across all 5 study time periods after a single infusion of secretin. Similarly, neither significant decreases in atypical behaviors nor increases in prosocial behaviors and developmentally appropriate play skills emerged. Furthermore, no relationship was found between parental reports of change and observable improvement in...

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Malabsorption and cerebral dysfunction: A multivariate and comparative study of autistic children

Cited by 100 publications

References 10 publications

Food Selectivity in Autism Spectrum Disorders

Food Selectivity in Autism Spectrum Disorders

Autism and nutrition: the role of the gut–brain axis

Effects of Intravenous Secretin on Language and Behavior of Children With Autism and Gastrointestinal Symptoms: A Single-Blinded, Open-Label Pilot Study

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