Feeding problems and GI dysfunction in children with asperger syndrome or pervasive developmental disorder not otherwise specified; comparison with their siblings

Vahe Badalyan,Richard H Schwartz

doi:10.4236/ojped.2011.14014

Abstract

Objective: There are few previously published studies of feeding problems and/or gastrointestinal dysfunction among children with Asperger syndrome (AS) or Pervasive Developmental Disorder (PDD-NOS), compared to sibling controls. Study Design: On-line parent autism groups 90% from North America. Statistical analysis: Chi square and binomial logistic regression statistical analysis Results: Completed surveys were received for 64 children with AS, 44 with PDD-NOS, total = 108), and 82 normal sibling matches. Children with high-functioning autism had higher likelihood of frequent (>50% of the time) problematic feeding behaviors and gastrointestinal dysfunction, such as unusual food preferences (OR 23.9, 95% CI 7.3 - 78.7), insistence on unusual food presentation (OR 5.8, 95% CI 1.8 - 18.4), and poor mealtime social behavior (OR 16.1, 95% CI 4.1 - 64.1). These children also had higher odds of frequent constipation (OR 8.3, 95% CI 2.2 - 31.9) and fecal incontinence (OR 5.4, 95% CI 1.1 - 27.3). Nine children in AS/PDD-NOS group (4%) were believed by parent to have celiac disease (3 or 1% had intestinal biopsy), compared to 2 in control group. Conclusion: 57% of the AS/PDD-NOS group had frequent unusual food preferences vs. 5% of controls. Forty-eight percent of children with AS/PDD-NOS had frequent dislikes of new foods, compared to 6% of controls. For symptoms of specific gastrointestinal dysfunction, children with AS/PDD-NOS had higher prevalence of frequent constipation (30% vs. 4%) and fecal incontinence (22% vs. 2%).

Highlights

An estimated 1 in 110 children in the US and Canada are estimated to have a diagnosis of Autism Spectrum disorder and these rates have been increasing in the past decade [1]
Autism spectrum disorder (ASD), is a heterogeneous group of neuro-developmental disorders that the Diagnostic and Statistical Manual IV-R currently subdivides into three subgroups: Asperger syndrome, pervasive developmental disorder-not otherwise specified (PDD-NOS) which is the most common and has the least precise diagnostic criteria [2], and classical autism [3]
Surveys were completed for 64 children with Asperger Syndrome, 44 children with PDD-NOS, and 82 of their typically-developing siblings

Summary

Introduction

An estimated 1 in 110 children in the US and Canada are estimated to have a diagnosis of Autism Spectrum disorder and these rates have been increasing in the past decade [1]. Children with PDD-NOS almost universally have impairments in social reciprocity and communication, without significant repetitive and stereotyped behaviors [4]. The current draft guidelines of the upcoming DSM-V will mandate repetitive and stereotyped behaviors in addition to major defects in language and communication and socialization [4]. Previous publications have documented increased rates of feeding problems and gastrointestinal dysfunction among children with ASD. A majority of published studies on the subject of childhood autism and gastrointestinal problems report higher rates of feeding problems in children with ASD compared to controls [5,6,7,8,9,10,11,12,13]. The BAMBI demonstrated good internal consistency, high test-re-test reliability

Methods

Results

Conclusion