On January 4, 2010
Pediatrics, the official journal of the American Academy of Pediatrics, published online two articles related to the evaluation, diagnosis and treatment of gastrointestinal disorders in individuals with autism spectrum disorders.
Both articles are currently available in free full-text at the
Pediatrics website,and professionals working with the ASD population may find them of value for their own education and in their roles in serving individuals with ASD.
The first is a consensus report based on the review of current available evidence by an expert panel (composition of the panel, evaluative process and resulting twenty-three statements described in the
full report). Because
evidence-based recommendation was not achievable at this time, this consensus report was produced, with a footnote included that,
"The guidance in this article is not intended to advocate for an exclusive course of treatment or to represent a standard of medical care. Individual circumstances will determine variations that may be appropriate."
Buie T, et al "
Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report"
Pediatrics 2010; 125: S1-S18.
DOI: 10.1542/peds.2009-1878C
http://pediatrics.aappublications.org/cgi/reprint/125/Supplement_1/S1ABSTRACT:
Autism spectrum disorders (ASDs) are common and clinically heterogeneous neurodevelopmental disorders. Gastrointestinal disorders and associated symptoms are commonly reported in individuals with ASDs, but key issues such as the prevalence and best treatment of these conditions are incompletely understood. A central difficulty in recognizing and characterizing gastrointestinal dysfunction with ASDs is the communication difficulties experienced by many affected individuals. A multidisciplinary panel reviewed the medical literature with the aim of generating evidence-based recommendations for diagnostic evaluation and management of gastrointestinal problems in this patient population. The panel concluded that evidence-based recommendations are not yet available. The consensus expert opinion of the panel was that individuals with ASDs deserve the same thoroughness and standard of care in the diagnostic workup and treatment of gastrointestinal concerns as should occur for patients without ASDs. Care providers should be aware that problem behavior in patients with ASDs may be the primary or sole symptom of the underlying medical condition, including some gastrointestinal disorders. For these patients, integration of behavioral and medical care may be most beneficial. Priorities for future research are identified to advance our understanding and management of gastrointestinal disorders in persons with ASDs.Pediatrics 2010;125:S1–S18
The second,
Buie T, et al "
Recommendations for evaluation and treatment of common gastrointestinal problems in children with ASDs"
Pediatrics 2010; 125: S19-S29.
DOI: 10.1542/peds.2009-1878D
http://pediatrics.aappublications.org/cgi/reprint/125/Supplement_1/S19includes differential diagnostic and treatment guidelines which make reference to the
consensus report.
ABSTRACT:
Children with autism spectrum disorders (ASDs) can benefit from adaptation of general pediatric guidelines for the diagnostic evaluation of abdominal pain, chronic constipation, and gastroesophageal reflux disease. These guidelines help health care providers determine when gastrointestinal symptoms are self-limited and when evaluation beyond a thorough medical history and physical examination should be considered. Children with ASDs who have gastrointestinal disorders may present with behavioral manifestations. Diagnostic and treatment recommendations for the general pediatric population are useful to consider until the development of evidence-based guidelines specifically for patients with ASDs. Pediatrics 2010;125:S19–S29
As a sidebar to the newsstories on the
Pediatrics articles, it was noted in
one news report that there is a
current well-designed and controlled study at the University of Rochester that is anticipated to provide useful information on the effects of the gluten-free/casein-free diet on children with ASD, and that
Autism Speaks will be issuing its own recommendations on treatment, including diet, within the year via its
Autism Treatment Network.
FOR FURTHER READING, REFERENCEPediatrics Gastrointestinal Consensus Statement & Recommendations Provide First Step Toward Needed Guidelines for Children with AutismAutism SpeaksNo Proof Yet That Special Diets Ease AutismExperts say that, for now, parents should work with their child's doctors
By E.J. Mundell
HealthDay Reporter, BusinessWeekNIMH study NCT00090428, Diet and Behavior in Young Children With Autism.
Autism Speaks Autism Treatment NetworkPediatrics - Official Journal of the American Academy of Pediatrics
© 2010 Regina G. Claypool-Frey
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