Assessing gastrointestinal symptoms in people with autism: Applying a new measure based on the Rome IV criteria

Abstract

BackgroundPeople with autism spectrum disorder (ASD) often struggle with gastrointestinal symptoms, implicating alterations of the gut-microbiota-brain axis, which has also been linked to sensory reactivity, pain, and gastro-intestinal symptoms in ASD. To better understand the prevalence and impact of gastrointestinal symptoms among individuals with ASD, a measure is needed that adhere to the Rome IV criteria of gastrointestinal symptoms and is applicable to individuals with ASD. The Gastrointestinal Symptom Severity Scale (GSSS) is a new assessment tool designed to match this need. MethodsIn a diverse sample of 265 individuals with ASD (mean age = 9.44, SD = 4.99), we examined the psychometric properties of the GSSS, the prevalence of gastrointestinal symptoms and associations with ASD traits, sensory sensitivity, repetitive behaviors, and pain. ResultsA unidimensional factor structure of the GSSS was confirmed and the measure showed good internal consistency, adequate test-retest reliability and strong convergent validity. Around a third of the participants evidenced clear difficulties with gastrointestinal symptoms and gastrointestinal symptoms were strongly associated with more pronounced ASD traits, sensory reactivity, and repetitive behaviors. ConclusionsThe GSSS shows promise as a useful measure to analyze the prevalence, severity, and impact of gastro-intestinal symptoms in individuals with ASD.