Vocal and motor behaviors as a possible expression of gastrointestinal problems in preschoolers with Autism Spectrum Disorder

Abstract

BackgroundGastrointestinal (GI) problems are one of the most frequent comorbidities in Autism Spectrum Disorder (ASD) but can be under-recognized due to the concomitant communication difficulties of this population. Accordingly, some associated behaviors (AB) such as verbal and motor behaviors (VB and MB, respectively) have been identified as a possible expression of an underlying GI problem and evaluated through an ad hoc questionnaire (the Associated Behaviors Questionnaire -ABQ-). The aims of this study were to investigate the presence and the type of AB in an Italian sample of ASD preschoolers, and to determine their correlations with GI problems.MethodsWe included 85 ASD preschoolers (mean age 4.14 years; SD 1.08) splitted into two groups (GI and No-GI) through the GI Severity Index instrument. AB were evaluated through the ABQ that includes VB, MB and Changes in overall state (C) clusters. Specific tools were administered to evaluate the ASD core ad associated symptoms, as well as the intellective and adaptive functioning.ResultsThe GI group (N = 30) showed significantly higher scores in all the three ABQ areas (VB, MB and C) than the No-GI group (N = 55), with a positive correlation between GI symptoms and some specific AB as well as ABQ Total score. By dividing the whole sample in verbal and non-verbal individuals, both specific and shared AB emerged in the two groups.ConclusionsOur results alert clinicians to consider behavioral manifestations as a possible expression of GI problems in ASD subjects. Therefore, the evaluation of AB may be useful to identify the presence of GI problems in the ASD populations, and especially in non-verbal ASD children.

Prevalence and Clinical Features of Celiac Disease in a Cohort of Italian Children with Autism Spectrum Disorders

“…As far as the CD clinical presentation in children with ASD, our results support a frequent asymptomatic form, which could be partially ascribed to the communication difficulties and the atypical sensory processing characteristic of ASD subjects, which in turn prevent the effective communication and/or the proper localization of GI symptoms [ 20 , 54 , 55 , 56 ]. Within this framework, we must be aware that GI symptoms can occur with sudden irritability or aggressive behavior in non-verbal children with ASD [ 20 , 56 , 57 ].…”

“…Regarding ASD, the American Academy of Pediatrics recommends that every ASD child with GI symptoms should be evaluated with specific exams testing the GI tract [ 19 ]. Pediatricians often have difficulty recognizing signs of GI problems [ 20 ] and completing a medical examination that includes an accurate evaluation and follow-up of corporeal and weight - for - height development because of the frequent difficulty in visiting children with ASD and communication barriers typical of these patients. For these reasons, it could be very useful in the ASD population for the first step of screening for CD to be a blood sample analysis.…”

Gastrointestinal Symptoms in Autism Spectrum Disorder: A Systematic Review

“…There is contradictory evidence regarding whether the prevalence of GIS differs according to gender. Several studies have reported no significant differences in gender, for children with and without GIS [ 48 , 49 , 50 ]. However, other studies have reported gender differences in the frequency of GIS.…”

Autism medical comorbidities

“…Motor behaviours associated with the presence of GI disorders include seeking belly pressure, some pointing behaviours, neck or body posture, certain repetitive behaviours, aggressive or self-injurious behaviours. There is a strong correlation between aggressive behaviours and underlying GI disorders[ 42 ].…”