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Related Experiment Video

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Testing Sensory and Multisensory Function in Children with Autism Spectrum Disorder
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Incontinence in children with autism spectrum disorder.

A von Gontard1, M Pirrung1, J Niemczyk1

  • 1Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany.

Journal of Pediatric Urology
|June 9, 2015
PubMed
Summary

Children with autism spectrum disorder (ASD) have higher rates of incontinence, including nocturnal enuresis (NE) and daytime urinary incontinence (DUI), and lower urinary tract symptoms (LUTS). These children also experience more psychological symptoms and disorders compared to controls.

Keywords:
Autism spectrum disorderDaytime urinary incontinenceFecal incontinenceLower urinary tract symptomsNocturnal enuresis

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Area of Science:

  • Pediatric Health
  • Neurodevelopmental Disorders
  • Urology

Background:

  • Autism spectrum disorder (ASD) is a neurodevelopmental condition often associated with co-occurring medical and psychological issues.
  • Incontinence, including nocturnal enuresis (NE) and daytime urinary incontinence (DUI), is more prevalent in children with special needs, such as ASD, compared to typically developing children.
  • Existing research on ASD has primarily focused on gastrointestinal symptoms, with less attention paid to urinary issues and lower urinary tract symptoms (LUTS).

Purpose of the Study:

  • To investigate the prevalence of incontinence (NE, DUI, fecal incontinence) and LUTS in children with ASD.
  • To compare the rates of incontinence, LUTS, and psychological symptoms/disorders in children with ASD versus age-matched controls.
  • To assess potential delays in daytime bladder and bowel control among children with ASD.

Main Methods:

  • A cohort of 40 children diagnosed with ASD (various subtypes) and 43 age-matched typically developing children were evaluated.
  • Incontinence and LUTS were assessed using a dedicated questionnaire and the International Consultation on Incontinence Questionnaire-Pediatric LUTS (ICIQ-CLUTS).
  • Child psychopathology was evaluated using the Child Behavior Checklist (CBCL/4-18), and psychiatric diagnoses were confirmed via a structured interview (Kinder-DIPS).

Main Results:

  • Children with ASD exhibited significantly higher rates of NE (30.0% vs. 0%) and DUI (25.0% vs. 4.7%) compared to controls.
  • Delayed daytime bladder control (≥5 years: 20.5% vs. 0%) and bowel control (≥4 years: 42.5% vs. 7.5%) were observed in children with ASD.
  • Children with ASD presented with higher LUTS scores and a greater prevalence of psychological symptoms (externalizing, internalizing, total problems) and comorbid psychiatric diagnoses (47.5% vs. 4.7%).

Conclusions:

  • Children with ASD are at an increased risk for NE, DUI, and LUTS, with delayed continence development.
  • Higher incidences of psychological symptoms and comorbid psychiatric disorders are frequently observed alongside ASD.
  • Routine screening for incontinence and LUTS in children with ASD is recommended, followed by appropriate treatment to manage these associated conditions.