Screening for autism identifies behavioral disorders in children functional defecation disorders

• Published in: European journal of pediatrics Vol. 175; no. 10; pp. 1371 - 1378
• Main Authors: Kuizenga-Wessel, Sophie, Di Lorenzo, Carlo, Nicholson, Lisa M., Butter, Eric M., Ratliff-Schaub, Karen L., Benninga, Marc A., Williams, Kent C.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2016; Springer Nature B.V
• Subjects: Autism; Autism Spectrum Disorder - diagnosis; Autism Spectrum Disorder - psychology; Behavior disorders; Child; Child, Preschool; Communication; Constipation; Constipation - diagnosis; Constipation - psychology; Defecation; Fecal incontinence; Fecal Incontinence - psychology; Feces; Female; Follow-Up Studies; Gastroenterology; Hospitals; Humans; Male; Medicine; Medicine & Public Health; Mental Disorders - diagnosis; Mental Disorders - psychology; Original; Original Article; Parents; Pediatrics; Prospective Studies; Questionnaires; Surveys and Questionnaires; United States > US; Autism spectrum disorders; Pediatrics; Constipation
• ISSN: 0340-6199; 1432-1076; 1432-1076
• DOI: 10.1007/s00431-016-2775-x

This study prospectively assessed whether positive screening surveys for autism spectrum disorders (ASDs) in children with functional defecation disorders (FDDs) accurately identify ASD. Parents of children (4–12 years) who met Rome III criteria for functional constipation (FC), FC with fecal incontinence (FI) and functional nonretentive FI (FNRFI) completed two ASD screening surveys. Children with positive screens were referred for psychological evaluation, and a year later, follow-up surveys were conducted. Of the 97 study participants, 30.9 % were diagnosed with FC, 62.9 % with FC with FI, and 6.2 % with FNRFI. ASD surveys were positive for 27 children (27.8 %). New DSM diagnoses were made in 10 out of the 15 children that completed further evaluation. Two (2.1 %) met criteria for ASD, and 12 (12.4 %) met criteria for other behavioral disorders. Average SRS and SCQ-L scores were higher in subjects with FC with FI as compared to FC alone and in those who reported no improvement versus those who reported improvement 1 year later. Conclusion : While positive ASD screening surveys did not correctly identify ASD in the majority, it did help to identify other unrecognized behavioral disorders in children with FDD. High screening scores were more common in children with FC with FI and in children with poorer responses to current medical treatments. What is Known: •A prior study found that 29 % of children with FDD scored positive on ASD screening questionnaires. •Whether positive screens correctly identify ASD in children with FDD is unknown. What is New: •This study shows that positive ASD screens do not correctly identify ASD in children with FDD. However, the use of ASD screening questionnaires can identify previously unrecognized and untreated behavioral/developmental disorders in children with FDD. •High screening scores are more common in children with FC with FI and in children with poorer responses to current medical treatments.