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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
  'Lots of good information packed into an hour'   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
  'Lots of good info I didn't know!'   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
  'The instructor was very knowledgeable and the materials presented were informative, concise and thorough for the time allotted'   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
  'The organized presentation with examples and resources available for use in practice next da!'   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.

Sensory Skills: Helping Parents to Support Sensory Development in their Children for Pediatric Feeding Success
Presented by Karen Dilfer, MS, OTR/L, Stephanie Cohen, MA, CCC-SLP, CLC


Karen Dilfer, MS, OTR/LStephanie Cohen, MA, CCC-SLP, CLC
Course: #4973Level: Intermediate1 Hour
  'Giving us different video examples to show us what is being learnt'   Read Reviews
Many children who experience feeding difficulties struggle to develop the sensory comfort necessary to eat and enjoy a variety of different foods. This course will explore how to help parents help their children develop sensory comfort and prepare them to participate in everyday eating opportunities. The workshop, based on the principles of responsive feeding, will provide a brief overview of a child’s sensory system as it relates to feeding. The instructors will explore how practitioners can help parents to 1.Read their child’s cues, 2. Identify permission, and 3. Engage a child in daily activities to build a child’s sensory comfort and participation. There will be an emphasis on helping therapists use parent coaching techniques so that parents are the ones to support their child’s development in the context of everyday eating routines.

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