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Development of a Brief Parent-Report Screen for Common Gastrointestinal Disorders in Autism Spectrum Disorder.

TitleDevelopment of a Brief Parent-Report Screen for Common Gastrointestinal Disorders in Autism Spectrum Disorder.
Publication TypeJournal Article
Year of Publication2019
AuthorsMargolis, KG, Buie, TM, J Turner, B, Silberman, AE, Feldman, JF, Murray, KF, McSwiggan-Hardin, M, Levy, J, Bauman, ML, Veenstra-VanderWeele, J, Whitaker, AH, Winter, HS
JournalJ Autism Dev Disord
Date Published2019 Jan
KeywordsAutism Spectrum Disorder, Child, Female, Gastrointestinal Diseases, Health Surveys, Humans, Male, Parents

Gastrointestinal dysfunction in children with autism spectrum disorder (ASD) is common and associated with problem behaviors. This study describes the development of a brief, parent-report screen that relies minimally upon the child's ability to report or localize pain for identifying children with ASD at risk for one of three common gastrointestinal disorders (functional constipation, functional diarrhea, and gastroesophageal reflux disease). In a clinical sample of children with ASD, this 17-item screen identified children having one or more of these disorders with a sensitivity of 84%, specificity of 43%, and a positive predictive value of 67%. If found to be valid in an independent sample of children with ASD, the screen will be useful in both clinical practice and research.


Aims and Objectives:
The goal of this study was to develop a brief, caretaker-reported screening survey for digestive issues in children with ASD. This way, the tool would not rely on a child reporting their pain or discomfort. This is particularly important for children with ASD, many of whom are nonverbal and/or have issues with pain sensory localization. This survey could help identify children with ASD at risk for common digestive problems.

131 participants were recruited for this study. The study took place in two phases. First, parents completed a 35-item questionnaire, the Gastrointestinal Symptom Inventory (GISSI). Once the questionnaire was completed, participants received a free visit with a pediatric gastroenterologist who was blinded to the results of the GISSI. Diagnoses from the pediatric gastroenterologists were then compared to the responses provided on the GISSI to determine which questions best correlated with a true gastrointestinal diagnosis.

The authors found that different digestive problems lined up with specific 17 questions asked on the survey. In the survey, there are a few different scales. Scales are sets of survey questions used to measure specific aspects of digestive problems. Specifically, constipation is strongly related with the Retentive scale and is weakly related to the Motoric and Gassy scales. Gastroesophageal reflux disease is strongly related to the Motoric scale and is less strongly related to the Gassy and Expulsive scales. Diarrhea is highly related to the Expulsive scale only.

The authors of this study created a 17-item questionnaire that could identify children, with challenges in verbal ability and/or pain perception, with the most common digestive issues found in kids with ASD (diarrhea, constipation and gastroesophageal reflux disease).

Alternate JournalJ Autism Dev Disord
PubMed ID30350113
Grant ListK08 DK093786-01A1 / / National Institute of Diabetes and Digestive and Kidney Diseases /
4RO1NS015547 / / National Institute of Health /
PR160365 / / Department of Defense /
UA3 MC11054 / / Autism Speaks and cooperative agreement /
UA3 MC11054 / / Autism Speaks / United States
R01 NS015547 / NS / NINDS NIH HHS / United States
K08 DK093786 / DK / NIDDK NIH HHS / United States