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How Does Gastrointestinal Dysfunction Affect Children With Autism?

Samantha Heidenreich, OTD, MOT

May 3, 2021



How does gastrointestinal dysfunction affect children with autism?


Here are some studies and statistics of gastrointestinal dysfunction of children with autism.

  • Incidence rates of GI issues associated with ASD vary among studies; however, there is a common conclusion that a relationship exists.
    • Penzol et al., 2019: one-third of ASD patients in the sample had at least one GI issue
      • GI issues were associated with sleep problems and behavioral problems (Penzol et al., 2019)
    • 2014 study suggests that children with autism are about 5x more likely than neurotypical children to have symptoms such as constipation, diarrhea, or abdominal discomfort (McElhanon et al., 2014)
    • Children with autism are at an increased risk for inflammatory bowel disease (IBD) (Lee et al., 2018)
      • IBD includes: Crohn’s disease and ulcerative colitis
      • Based on 300,000 children in the United States, children with autism are 67 percent more likely than typical children to have a diagnosis of IBD
  • Most common gastrointestinal problems seen in children with ASD include: constipation/distention, gut permeability/leaky gut, and diarrhea

Children on the spectrum are five times more likely to have GI symptoms. They also have an increased risk for different inflammatory bowel diseases like Crohn's and ulcerative colitis. One study on 300,000 children in the United States showed that children on the spectrum are 67% more likely than neurotypical children to have some of these different GI disorders. Most commonly, when we look at children on the spectrum, we see symptoms like constipation, diarrhea, and gut permeability. Something very challenging with the nutritional and GI pieces of intervention is there is limited communication. Even if a child has adequate communication, the ability to understand these symptoms and express them in a way that can be understood by adults and their environment is tough for these children. Many times, these symptoms go diagnosed, or the diagnosis is delayed.

And, specific macro/micronutrients impact neural functioning.

  • Choline (learning and memory)
  • Iron (attention and memory)
  • Zinc (needed for cell death)
  • Folic acid/Folate (cognitive performance)
  • Docosahexaenoic acid (DHA) and essential fatty acids (neurodevelopment and visual acuity)
  • Vitamin B6 (balance of excitatory/inhibitory system function)
  • Vitamin B12 (neurologic function,  fatigue)
  • Magnesium (serotonin and dopamine synthesis)

There is a lot of foundational work to overcome this, depending on the age and severity of dysfunction of the child. Understanding that nutrition has specific and certain roles within the body, specifically within the brain, is a good start. A lack of nutrients will negatively affect things like learning, memory, attention, and the synthesis of serotonin. We have to understand what nutrients are needed, what is missing, and how to bridge that gap.

samantha heidenreich

Samantha Heidenreich, OTD, MOT

Samantha Heidenreich, OTD, MOT, Samantha completed her Doctorate of Occupational Therapy at the University of St Augustine for Health Sciences and completed her Masters in OT at the University of St Augustine for Health Sciences with a Bachelors in Special Education K-12 from Coastal Carolina University. Samantha has been in clinical settings with a focus on pediatric occupational therapy, and an emphasis on feeding intervention. She has completed advanced coursework in multiple areas of pediatric intervention, including sequential oral sequencing approach to feeding, AEIOU, primitive reflexes, and sensory integration, and Hanen SPARK communication. For her OTD program, her capstone project focused on nutritional implications for feeding for children with autism, sparking her interest and professional investment in this topic area.

Related Courses

Feeding and Nutrition Interventions for Children on the Autism Spectrum
Presented by Samantha Heidenreich, OTD, MOT


Samantha Heidenreich, OTD, MOT
Course: #5027Level: Intermediate1 Hour
  'very though with asd'   Read Reviews
This course reviews the feeding behaviors and habits of children with autism, as well as the brain/gut relationship and nutritional implications for feeding. Participants will be instructed on how to create appropriate plans of care and intervention for feeding specifically for the ASD population, with an emphasis on nutrition.

Assessment and Intervention for Tethered Oral Tissues (TOTs) in Feeding Therapy
Presented by Samantha Heidenreich, OTD, MOT


Samantha Heidenreich, OTD, MOT
Course: #5377Level: Intermediate1 Hour
  'Very helpful information!!'   Read Reviews
This course will provide foundational review of information about anatomy and physiology of Tethered Oral Tissues and the functional implications that can impact feeding. Additionally, the course will prepare clinicians to support feeding goals and outcomes by improving their ability to assess and provide intervention for Tethered Oral Tissues.

Foundations of Feeding Therapy for OTs: Anatomy, Physiology, Terms, and Tools
Presented by Samantha Heidenreich, OTD, MOT


Samantha Heidenreich, OTD, MOT
Course: #5382Level: Introductory1 Hour
  'It was a lot of information in a short period of time'   Read Reviews
This course provides a foundational overview of the anatomy and physiology of the orofacial complex related to feeding therapy. The course also teaches commonly used terminology in this field of practice and provides an overview of therapeutic tools and their uses specifically for pediatric feeding therapy.

Understanding Primitive Reflexes: How They Impact Child Development and Intervention Strategies for Integration
Presented by Samantha Heidenreich, OTD, MOT


Samantha Heidenreich, OTD, MOT
Course: #5028Level: Introductory1 Hour
  'Enjoyed the class! Would’ve liked to have videos of a newborn receiving the reflex tests'   Read Reviews
This course looks at entry-level knowledge of primitive reflexes. Participants will identify retained reflexes and utilize strategies to support integration to facilitate child development.

Developmental Care And Feeding Of Infants With Neonatal Abstinence Syndrome
Presented by Tina Davis, OTR/L, BCP


Tina Davis, OTR/L, BCP
Course: #5957Level: Intermediate1 Hour
  'Great information!'   Read Reviews
This course will describe the OT role in early assessment and treatment of the infant born with Neonatal Abstinence Syndrome. We will discuss unique challenges of feeding, developmental, sensory and behavioral difficulties. Case studies will be used to review evidenced based and practical strategies that can be used to foster a strengths-based and family-centered approach to care.

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