Gastrointestinal symptoms in autistic children during Covid-19 lockdown: A qualitative study of family experience

Abstract

BackgroundAutistic individuals face barriers to healthcare access and premature mortality. There is an increased prevalence of gastrointestinal (GI) disorders in autistic children compared to not-autistic children. There is a complex interplay between these GI symptoms and various aspects of behaviour, sleep, and mental health in autistic children. Lockdowns during the Covid-19 pandemic changed the delivery of healthcare for all patient groups, and it is particularly important to understand the effects of this on vulnerable groups. In this qualitative study we document the family experiences associated with managing persistent GI symptoms in autistic children and access to related healthcare for these children during Covid-19 lockdowns and restrictions. MethodWe conducted semi-structured interviews with 12 parents of autistic children and subjected data from these interviews to qualitative analysis. ResultsTwo themes emerged (i) Covid-19 lockdowns and restrictions changed the children’s reported GI symptoms in a non-uniform manner; and (ii) parents were divided on the appropriateness of telemedicine services for their child. Some parents reported an increase in their child’s anxiety level that was linked to worsening of GI symptoms. Those parents who reported a reduction in their child’s social anxiety during lockdown related this to improved GI symptoms. Parents reported advantages and disadvantages of both in-person and telemedicine consultations, and they were split on their preferences for these appointment types. ConclusionsTelemedicine is preferred by some but not all families of autistic children. Clinicians should consider the interplay between anxiety and GI symptoms in autistic children when assessing and treating GI symptoms.