Thursday, January 14, 2010

Consensus Report on Gastrointestinal Disorders in Autism

Last week a consensus report was published in Pediatrics that dealt with the subject of gastrointestinal disorders in individuals with autism. This report was the product of a multidisciplinary panel that met in May of last year. After reading it, I can honestly say that I think this is report is some of the best news that has come down the pike recently concerning GI issues and autism is a long time.

The panel basically said that there might well be something to the idea that GI problems are more common in individuals with autism and that, when present, these problems can exacerbate the symptoms of autism. They also pointed out (numerous times) that children with autism would likely have a hard time communicating that they are experiencing pain and that, left untreated, could lead to problem behaviors. Of course, they also strongly emphasized that no association has been proven, that the available evidence is badly lacking, and that much more research is needed.

Of course, if you read the news and blog coverage of this report, that isn't the story you will see. Mostly I found stories like this one Evidence lacking for autism diets, panel says that focus on the "no evidence for special diets" line or the ones that say that there is "no evidence that digestive problems are more common in children with autism". The first statement is true and I will get to that is a minute, but the second is just plain wrong.

 The paper clearly states that the limited (weak) evidence does suggest that GI disorders are more common in autism, saying "Despite the limitations in type and quality of available evidence, the preponderance of data were consistent with the likelihood of a high prevalence of gastrointestinal symptoms and disorders associated with ASDs." The authors hedge this statement by emphasizing that the available data is flawed and more research is needed but this statement is clearly a far cry from "no evidence".

As for the common statement about no evidence that a special diet can help treat autism, well, that is true, but not for the reasons that most people would assume. The reason that evidence is lacking is not because the question has been examined an no relationship has been found, the reason is that the question has not been examined. There have been only one or two studied that directly looked at the question and none that done properly. So perhaps the better way of phrasing the lack of evidence would have been to talk about the fact that it is an unanswered question, not a lack of evidence.

Regardless of what the media has to say about this report, I think this is an important report that possibly marks a turning point in mainstream attitudes about an association between autism and gastrointestinal disorders. In my next post, I am going to attempt to give a summary of what the report actually says.

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