Screening for autism identifies behavioral disorders in children functional defecation disorders

Area of Science:

• Pediatric Gastroenterology
• Developmental Pediatrics
• Child Psychology

Background:

• A previous study indicated 29% of children with functional defecation disorders (FDDs) screened positive for autism spectrum disorders (ASDs).
• The diagnostic accuracy of ASD screening in children with FDDs remains unclear.

Purpose of the Study:

• To prospectively evaluate the accuracy of ASD screening surveys in identifying ASD in children with FDDs.
• To determine if positive ASD screens can identify other behavioral or developmental disorders in this population.

Main Methods:

• Prospective assessment of children aged 4-12 years meeting Rome III criteria for functional constipation (FC), FC with fecal incontinence (FI), or functional nonretentive FI (FNRFI).
• Administration of two ASD screening surveys, followed by psychological evaluation for positive screens.
• One-year follow-up surveys to assess outcomes and treatment response.

Main Results:

• Of 97 participants, 27.8% had positive ASD screens. Two children (2.1%) were diagnosed with ASD, while 12 (12.4%) were diagnosed with other behavioral disorders.
• Higher ASD screening scores (SRS and SCQ-L) were observed in children with FC with FI compared to FC alone.
• Elevated screening scores correlated with poorer treatment response at one-year follow-up.

Conclusions:

• Positive ASD screening surveys in children with FDDs do not reliably diagnose ASD.
• ASD screening tools can be valuable in identifying previously unrecognized behavioral and developmental disorders in children with FDDs.
• High screening scores are associated with more complex presentations (FC with FI) and less favorable treatment outcomes.