Summary: New research identifies a relationship between repetitive behaviors common in autism and gastrointestinal (GI) problems. The study also reports that greater overall autism symptom severity is linked to more severe constipation, stomach pain, and other GI issues, while social and communication challenges showed no clear connection to GI symptoms.
Source: Ohio State University
Researchers report a link between repetitive behaviors in children with autism spectrum disorder and gastrointestinal problems.
A study published in the journal Autism found that children with more pronounced repetitive behaviors—such as rocking, hand flapping, or other stereotyped actions—tended to have more severe gastrointestinal symptoms. The analysis also showed that higher overall autism symptom severity was associated with increased constipation, abdominal pain, and other GI complaints. By contrast, measures of social and communication difficulties were not significantly related to gastrointestinal symptom severity after accounting for other behavioral symptoms.
The research does not identify a biological mechanism that links repetitive autism behaviors and gut problems. However, the findings strengthen evidence for a relationship between GI symptoms and specific autism features, raising the possibility that gastrointestinal distress may intensify repetitive behaviors, or that repetitive behaviors might influence gut symptoms. Understanding that relationship could inform future clinical approaches and interventions for children with autism and co-occurring GI issues, according to Payal Chakraborty, the study’s lead author and a graduate student at The Ohio State University College of Public Health.
Children with autism spectrum disorder are known to experience gastrointestinal abnormalities at higher rates than typically developing peers. These can include chronic diarrhea, constipation, food sensitivities, and abdominal pain. While previous work has linked GI problems to greater irritability and aggressive behaviors, less is known about how gut symptoms relate to core autism features such as repetitive behaviors, social communication, and restricted interests. This study specifically examined those core and associated behavioral domains in young children.
“In the general population there is growing evidence of connections between mood or mental health conditions and gastrointestinal difficulties. For children on the autism spectrum, the question is whether GI problems are an integral part of the condition or whether they arise as a response to other behavioral or sensory features of autism,” Chakraborty said.
Chakraborty began this research during her time at Duke University’s Center for Autism and Brain Development. She analyzed detailed clinical assessments and parent-reported data from 176 children, ages 2 to 7, who had participated in a study exploring umbilical cord blood transplants as a potential autism treatment. In this sample, 93% of participants had at least one reported gastrointestinal symptom and 88% had more than one.
The study controlled for commonly associated behavioral symptoms—irritability, aggression, and specific fears—when testing relationships between autism core features and GI symptom severity. Even after accounting for these associated behaviors, repetitive and stereotyped behaviors remained positively associated with worse GI symptoms. This finding replicates and extends prior work linking irritability and aggression to gastrointestinal problems and highlights repetitive behaviors as an additional autism-related feature connected to GI severity.
Although causal direction cannot be determined from this observational data, one plausible interpretation is that repetitive behaviors may serve as coping mechanisms for children experiencing gastrointestinal discomfort. Many young children with autism develop symptoms at ages when they have limited ability to describe internal sensations such as abdominal pain or nausea. Repetitive actions or self-soothing movements could therefore reflect attempts to manage distress related to GI symptoms.
“Gastrointestinal problems are a major concern for many children with autism and we still have a lot to learn about the complicated gut/brain axis,” Chakraborty said.
The study team included researchers from Duke University—Kimberly Carpenter, Samantha Major, Saritha Vermeer, Brianna Herold, Lauren Franz, Jill Howard, and Geraldine Dawson—and Megan Deaver from Eastern Virginia Medical School. The investigators emphasize the need for further research to explore mechanisms, longitudinal patterns, and potential clinical implications for treating GI symptoms alongside behavioral and developmental supports for children with autism.
About this autism research news
Source: Ohio State University
Contact: Payal Chakraborty – Ohio State University
Image: The image is in the public domain
Original Research: Closed access.
“Gastrointestinal problems are associated with increased repetitive behaviors but not social communication difficulties in young children with autism spectrum disorders” by Payal Chakraborty et al. Autism
DOI: 10.1177/1362361320959503
Abstract
Gastrointestinal problems are associated with increased repetitive behaviors but not social communication difficulties in young children with autism spectrum disorders
Individuals with autism spectrum disorder are more likely than typically developing individuals to experience various gastrointestinal abnormalities, such as chronic diarrhea, constipation, food sensitivities, and abdominal pain. While GI symptoms have been associated with increased irritability and aggressive behavior, their relationship to core autism features is less well understood. In a sample of 176 children with autism spectrum disorder (140 males and 36 females) ages 2–7 years, most participants had at least one reported GI symptom (93.2%) and the majority had multiple symptoms (88.1%). After controlling for associated behavioral symptom domains—irritability, aggression, and specific fears—repetitive behaviors and stereotypies were positively associated with gastrointestinal symptom severity. Social and communication difficulties were not significantly associated with GI symptom severity once associated behavioral symptoms were taken into account. These results replicate earlier reports linking irritability and aggression to gastrointestinal problems and add evidence that GI symptom severity relates specifically to repetitive behaviors, independent of other behavioral symptoms. This pattern suggests gastrointestinal symptoms may exacerbate repetitive behaviors, or that repetitive behaviors may influence GI problems, highlighting the need for further study of the gut–brain axis in autism.