Author:

Keywords:

autism, ASD, defecation disorder, Science & Technology, Life Sciences & Biomedicine, Pediatrics, GASTROINTESTINAL SYMPTOMS, CHILDHOOD CONSTIPATION, EPIDEMIOLOGY, PREVALENCE, ADHD, Attention deficit-hyperactivity disorder, Autism spectrum disorder, FC, FI, FNRFI, Fecal incontinence, Functional constipation, Functional non-retentive fecal incontinence, GP, General practitioner, SCQ, SCQ-L, SRS, Social Communication Questionnaire, Social Communication Questionnaire-Lifetime, Social Responsiveness Scale, Child, Child Development Disorders, Pervasive, Child, Preschool, Cohort Studies, Constipation, Fecal Incontinence, Female, Humans, Male, Prevalence, Prospective Studies, Surveys and Questionnaires, 1106 Human Movement and Sports Sciences, 1114 Paediatrics and Reproductive Medicine, 3213 Paediatrics

Abstract:

OBJECTIVE: To prospectively assess the prevalence of autism spectrum disorder (ASD) symptoms in children presenting with functional defecation disorders. STUDY DESIGN: Children (age 4-12 years) with functional constipation or functional non-retentive fecal incontinence according to the Rome III criteria referred to a specialized outpatient clinic were included. Parents completed 2 validated ASD screening questionnaires about their child; the Social Responsiveness Scale (SRS) and the Social Communication Questionnaire-Lifetime (SCQ-L). A total SRS score of ≥ 51 is a strong indicator for the presence of ASD. On the SCQ-L, a score of ≥ 15 is suggestive for ASD. RESULTS: In total, 242 patients (130 males, median age 7.9 years) were included. Of these, 91% were diagnosed with functional constipation and 9% with functional non-retentive fecal incontinence. Thirteen children (5.4%) had previously been diagnosed with ASD. Twenty-six children (11%) had both SRS and SCQ-L scores at or above cutoff points, strongly suggestive for the presence of ASD. Solely high SRS were present in 42 children (17%), whereas two children (1%) only had high SCQ-L scores. Altogether, 29% had ASD symptoms, indicated by SRS and/or SCQ-L scores at or above the cutoff values. These children were older than children without ASD symptoms and presented with a longer duration of symptoms. CONCLUSIONS: A substantial number of children (29%) presenting with a functional defecation disorder at a tertiary hospital has concomitant ASD symptoms. Clinicians should be aware of ASD symptoms in children with functional defecation disorders.