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Cited by 110Autism Spectrum Disorder ResearchGastrointestinal motility and disordersChild Nutrition and Feeding Issues

The Relationship Among Gastrointestinal Symptoms, Problem Behaviors, and Internalizing Symptoms in Children and Adolescents with Autism Spectrum Disorder

Open access
Ferguson, Bradley J., Dovgan, Kristen, Takahashi, Nicole, Beversdorf, David Q.·2019·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2019.00194PMC PMC6465634
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Abstract

Background: Many individuals with autism spectrum disorder (ASD) have co-occurring gastrointestinal (GI) symptoms, but the etiology is poorly understood. These GI symptoms often coincide with problem behaviors and internalizing symptoms, which reduces the quality of life for these individuals. Methods: This study examined the relationships among GI problems, problem behaviors, and internalizing symptoms in a sample of 340 children and adolescents with ASD who are patients at the University of Missouri Thompson Center for Autism & Neurodevelopmental Disorders. Results: The majority of patients experienced constipation (65%), about half experienced stomachaches or stomach pain (47.9%), and others experienced nausea (23.2%) or diarrhea (29.7%). Young children with aggressive problem behaviors were 11.2% more likely to have co-occurring nausea; whereas, older children showed more complex relationships between internalizing symptoms and GI symptoms. Older children with greater anxiety symptoms were 11% more likely to experience constipation, but 9% less likely to experience stomachaches. Older children with greater withdrawn behavior were 10.9% more likely to experience stomachaches, but 8.7% less likely to experience constipation. Older children with greater somatic complaints were 11.4% more likely to experience nausea and 11.5% more likely to experience stomachaches. Conclusions: Results suggest that the presentation of externalizing problem behavior and internalizing symptoms associated with GI problems differs between young children and adolescents with ASD. Therefore, behavior may have different relationships with GI symptoms at different ages, which may have implications for the treatment of and clinical approach to GI disturbances in ASD.

AI snapshot

Written from the paper’s full text.

TL;DR

In 340 children and adolescents with ASD seen at a single clinic, constipation was the most common GI symptom (65%), and GI symptoms showed age-different associations with problem behaviors and internalizing symptoms. In younger children only aggression predicted nausea, whereas in older children anxiety, withdrawn behavior, and somatic complaints predicted different GI symptoms.

Key findings

  • The majority experienced constipation (65%), about half experienced stomachaches or stomach pain (47.9%), and others experienced nausea (23.2%) or diarrhea (29.7%); average total GI symptoms were 1.66 (SD = 0.880, range 1–4).
  • In younger children (ages 2–5), aggressive problem behavior significantly predicted nausea: children with more aggression were 11.2% more likely to experience nausea (B = 0.106, SE = 0.052, p < 0.05); no other GI problems were significantly associated with problem behavior/internalizing symptoms in this age group.
  • In older children (ages 6–18), greater anxiety was associated with 11% higher likelihood of constipation (B = 0.094, SE = 0.048, p < 0.05) but 9% lower likelihood of stomachaches (B = −0.099, SE = 0.050, p < 0.01).
  • Also in older children, greater withdrawn behavior was associated with 10.9% higher likelihood of stomachaches (B = 0.086, SE = 0.042, p < 0.05) but 8.7% lower likelihood of constipation (B = −0.131, SE = 0.046, p < 0.01); greater somatic complaints were associated with 11.4% higher likelihood of nausea (B = 0.130, SE = 0.050, p < 0.01) and 11.5% higher likelihood of stomachaches (B = 0.138, SE = 0.049, p < 0.01).

Methods

  • Retrospective clinic-database study of 340 children and adolescents with ASD, ages 2–18 (M = 5.56, SD = 3.67), who were patients at the University of Missouri Thompson Center for Autism & Neurodevelopmental Disorders and had at least one GI symptom reported at the most recent clinic visit; ASD diagnosis was confirmed with the ADOS or ADI-R.
  • Sample was split by CBCL version: younger group (ages 2–5) N = 200, 80% male, M age = 3.03 (SD = 1.07); older group (ages 6–18) N = 140, 77.1% male, M age = 9.19 (SD = 2.94).
  • Caregiver questionnaires provided dietary problems, nutrition problems, and four dichotomous GI symptoms (constipation, diarrhea, nausea/vomiting, stomachaches/pain); CBCL subscales measured internalizing/externalizing symptoms. Bivariate correlations selected covariates, then separate logistic regressions predicted each GI symptom by CBCL subscales within each age group; younger-group controls were GI medications, total medications, dietary problems, and nutrition problems, and older-group controls were gender and dietary problems.

Limitations

  • Stated: the sample was largely male and Caucasian in both age groups, limiting generalization to females and non-Caucasian individuals with ASD; GI symptoms came from caregiver reports and were not further assessed with a gastroenterological evaluation; participants were selected for having at least one GI symptom, so results may not represent the general ASD population; and the sample came from one clinic in the Midwestern United States.
  • Evident: the design is cross-sectional/retrospective from a single clinic database, so the analyses cannot establish temporal or causal direction between GI symptoms and behavioral/internalizing symptoms.
  • Evident: both GI symptoms and CBCL behavior/internalizing measures rely on caregiver report, so shared method variance or caregiver reporting biases may affect associations.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3389/fpsyt.2019.00194

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

9 tests recomputed · 0 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

0 of 29 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In older children with ASD (aged 6-18), greater somatic complaints were associated with an 11.4% increased likelihood of nausea (B = 0.130, SE = 0.050, p < 0.01).

    “older children with greater somatic complaints were 11.4% more likely to experience nausea (B = 0.130, SE = 0.050, p < 0.01)”
    • Also stated in: § Abstract · plain
      “Older children with greater somatic complaints were 11.4% more likely to experience nausea”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Caregiver-reported concerns about GI symptoms accurately reflect the presence of those GI symptoms in children with ASD.
  • Findingown data

    In older children with ASD (aged 6-18), greater withdrawn behavior was associated with a 10.9% increased likelihood of stomachaches (B = 0.086, SE = 0.042, p < 0.05).

    “Older children with greater withdrawn behavior were 10.9% more likely to experience stomachaches (B = 0.086, SE = 0.042, p < 0.05)”
    • Also stated in: § Abstract · plain
      “Older children with greater withdrawn behavior were 10.9% more likely to experience stomachaches”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Caregiver-reported concerns about GI symptoms accurately reflect the presence of those GI symptoms in children with ASD.
  • Findingown data

    23.2% of the sample experienced nausea.

    “others experienced nausea (23.2%)”
    • Also stated in: § Results · plain
      “others experienced nausea (23.2%)”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Caregiver-reported concerns about GI symptoms accurately reflect the presence of those GI symptoms in children with ASD.
  • Findingown data

    In the sample of children and adolescents with ASD, the majority experienced constipation (65%).

    “The majority of patients experienced constipation (65%)”
    • Also stated in: § Results · plain
      “The majority of the sample experienced constipation (65%).”
    • Also stated in: § Discussion · plain
      “constipation accounted for 65% of the GI symptoms in a sample of 340 children and adolescents with ASD.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Caregiver-reported concerns about GI symptoms accurately reflect the presence of those GI symptoms in children with ASD.
  • Findingown data

    In older children with ASD (aged 6-18), greater withdrawn behavior was associated with an 8.7% decreased likelihood of constipation (B = −0.131, SE = 0.046, p < 0.01).

    “but 8.7% less likely to experience constipation (B = −0.131, SE = 0.046, p < 0.01).”
    • Also stated in: § Abstract · plain
      “but 8.7% less likely to experience constipation”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Caregiver-reported concerns about GI symptoms accurately reflect the presence of those GI symptoms in children with ASD.
  • May combine two claims. 11
  • Classified as probably not a substantial claim. 7

  • May combine two claims.

    Findingown data

    In children and adolescents aged 6-18 with ASD, internalizing symptoms but not externalizing problem behaviors were associated with GI symptoms.

    “Children and adolescents aged 6–18 revealed associations between internalizing symptoms but not externalizing problem behaviors, and GI symptoms.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Caregiver-reported concerns about GI symptoms accurately reflect the presence of those GI symptoms in children with ASD.

  • May combine two claims.

    Findingown data

    The average number of total GI symptoms in the sample was 1.66 (SD = 0.880), with a range from 1 to 4.

    “The average number of total GI symptoms was 1.66 (SD = 0.880), with a range from 1 to 4.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Caregiver-reported concerns about GI symptoms accurately reflect the presence of those GI symptoms in children with ASD.

  • May combine two claims.

    Premisecitation

    Co-occurring internalizing symptoms, such as anxiety and depression, are common in ASD and associated with GI symptoms.

    “Consistent with the theory that stress is linked to GI symptoms in ASD, co-occurring internalizing symptoms, such as anxiety and depression, are common in ASD (15) and associated with GI symptoms as well.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [15] Hovarth, 2002, Autism and gastrointestinal symptoms, Curr Gastroenterol Rep source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Heightened stress and anxiety, rigid-compulsive behavior, and sleep problems have been shown to be associated with GI symptoms in ASD, especially constipation.

    “Heightened stress and anxiety, rigid-compulsive behavior, and sleep problems, have been shown to be associated with GI symptoms in ASD, especially constipation (6, 11, 12, 16–19).”
    Quote in the paperSubstantial claim0 of 7 sources checked
    • cites [6] Fulceri, 2016, Gastrointestinal symptoms and behavioral problems in preschoolers with autism spectrum disorder, Digest Liver Dis source

      Not checked in the free run.

    • cites [11] Ferguson, 2017, Psychophysiological associations with gastrointestinal symptomatology in autism spectrum disorder, Autism Res source

      Not checked in the free run.

    • cites [12] Ferguson, 2016, Associations between cytokines, endocrine stress response, and gastrointestinal symptoms in autism spectrum disorder, Brain Behav Immun source

      Not checked in the free run.

    • cites [16] Coury, 2012, Gastrointestinal conditions in children with autism spectrum disorder: developing a research agenda, Pediatrics. source

      Not checked in the free run.

    • cites [17] Bishop-Fitzpatrick, 2015, The relationship between stress and social functioning in adults with autism spectrum disorder and without intellectual disability, Autism Res source

      Not checked in the free run.

    • cites [18] Nikolov, 2009, Gastrointestinal symptoms in a sample of children with pervasive developmental disorders, J Autism Develop Disord source

      Not checked in the free run.

    • cites [19] Peters, 2014, Rigid-compulsive behaviors are associated with mixed bowel symptoms in autism spectrum disorder, J Autism Develop Disord source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Many individuals with ASD suffer from constipation.

    “However, it appears that many individuals with ASD suffer from constipation (2, 3, 11, 12).”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [2] Buie, 2010, Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report, Pediatrics source

      Not checked in the free run.

    • cites [3] McElhanon, 2014, Gastrointestinal 86 symptoms in autism spectrum disorder: a meta-analysis, Pediatrics source

      Not checked in the free run.

    • cites [11] Ferguson, 2017, Psychophysiological associations with gastrointestinal symptomatology in autism spectrum disorder, Autism Res source

      Not checked in the free run.

    • cites [12] Ferguson, 2016, Associations between cytokines, endocrine stress response, and gastrointestinal symptoms in autism spectrum disorder, Brain Behav Immun source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    A variety of GI issues commonly occur in ASD, including lower GI symptoms (constipation, diarrhea) and upper GI symptoms (nausea and vomiting, stomach aches and pains).

    “A variety of gastrointestinal (GI) issues commonly occur in ASD, including lower GI symptoms (i.e., constipation, diarrhea) and upper GI symptoms (i.e., nausea and vomiting, stomach aches and pains) (2–10), but the etiology is poorly understood.”
    Quote in the paperNot a substantial claim0 of 9 sources checked
    • cites [2] Buie, 2010, Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report, Pediatrics source

      Not checked in the free run.

    • cites [3] McElhanon, 2014, Gastrointestinal 86 symptoms in autism spectrum disorder: a meta-analysis, Pediatrics source

      Not checked in the free run.

    • cites [4] Doshi-Velez, 2014, Comorbidity clusters in autism spectrum disorders: an electronic health record time-series analysis, Pediatrics source

      Not checked in the free run.

    • cites [5] Chaidez, 2014, Gastrointestinal problems in children with autism, developmental delays or typical development, J Autism Develop Disord source

      Not checked in the free run.

    • cites [6] Fulceri, 2016, Gastrointestinal symptoms and behavioral problems in preschoolers with autism spectrum disorder, Digest Liver Dis source

      Not checked in the free run.

    • cites [7] Gorrindo, 2012, Gastrointestinal dysfunction in autism: parental report, clinical evaluation, and associated factors, Autism Res source

      Not checked in the free run.

    • cites [8] Bauman, 2010, Medical comorbidities in autism: challenges to diagnosis and treatment, Neurotherapeutics source

      Not checked in the free run.

    • cites [9] Mouridsen, 2010, A longitudinal study of gastrointestinal diseases in individuals diagnosed with infantile autism as children, Child Care Health Develop source

      Not checked in the free run.

    • cites [10] Ibrahim, 2009, Incidence of gastrointestinal symptoms in children with autism: a populationbased study, Pediatrics source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The Child Behavior Checklist (CBCL) has strong psychometric properties, including test-retest reliability, inter-rater agreement, and internal consistency.

    “The CBCL has strong psychometric properties, including test-retest reliability, inter-rater agreement, and internal consistency (23–25).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [23] Achenbach, 2003, DSM-Oriented and empirically based approaches to constructing scales from the same item pools, J Clin Child Adoles Psychol. source

      Not checked in the free run.

    • cites [24] Nakamura, 2009, A psychometric analysis of the child behavior checklist DSM-oriented scales, J. Psychopathol. Behav. Assess. source

      Not checked in the free run.

    • cites [25] Frizzo, 2014, Reliability of child behavior checklist and teacher's report form in a sample of brazilian children, Universitas Psychologica. source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The sample is largely male and Caucasian in both age groups, making it difficult to generalize the findings to females and non-Caucasian individuals with ASD.

    “First, the sample is largely male and Caucasian in both age groups, making it difficult to generalize the findings to females and non-Caucasian individuals with ASD.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Diagnosis of ASD was confirmed using the Autism Diagnostic Observation Schedule or the Autism Diagnostic Interview-Revised.

    “Diagnosis of ASD was confirmed using the Autism Diagnostic Observation Schedule (20) or the Autism Diagnostic Interview—Revised (21).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [20] Lord, 2002

      Not checked in the free run.

    • cites [21] Lord, 1994, Autism diagnostic interview-revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders, J Autism Develop Disord. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    The sample of participants was from one clinic in the Midwestern United States, so data from other clinics in other regions are needed to generalize these findings to the larger ASD population.

    “Furthermore, the sample of participants was from one clinic in the Midwestern United States, and so data from other clinics in other regions are needed in order to generalize these findings to the larger ASD population.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    Participants were selected based on having at least one GI symptom, so the results may not be representative of the general population of those with ASD.

    “Last, participants included in this study were selected based on having at least one GI symptom, so the results may not be representative of the general population of those with ASD.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    GI symptoms were from caregiver reports and were not further assessed with a gastroenterological evaluation.

    “Second, the GI symptoms were from caregiver reports and were not further assessed with a gastroenterological evaluation.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Young children with ASD who are non-verbal may use aggression as a means of communicating somatic complaints, such as internal abdominal pain and GI discomfort.

    “One explanation for this relationship may be that young children with ASD who are non-verbal use aggression as a means of communicating somatic complaints, such as internal abdominal pain and GI discomfort (2).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] Buie, 2010, Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report, Pediatrics source

      Not checked in the free run.

    • Rests on an assumption: Caregiver-reported concerns about GI symptoms accurately reflect the presence of those GI symptoms in children with ASD.

  • May combine two claims.

    Interpretationcitation

    Depression and anxiety may place an individual with ASD at heightened risk for GI disturbance, but in different manners.

    “Previous research has also shown a relationship between upper GI tract symptoms, including stomachaches, and depression in ASD, suggesting that depression and anxiety may place an individual with ASD at heightened risk for GI disturbance, but in different manners.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Caregiver-reported concerns about GI symptoms accurately reflect the presence of those GI symptoms in children with ASD.
14 of 14

  • The paper relies on this without support.

    Caregiver-reported concerns about GI symptoms accurately reflect the presence of those GI symptoms in children with ASD.

    “Caregivers completed a questionnaire about their concerns now or in the past about the following GI symptoms in their child: constipation, diarrhea, nausea or vomiting, and stomachaches or stomach pain.”
    “Second, the GI symptoms were from caregiver reports and were not further assessed with a gastroenterological evaluation.”

  • The paper relies on this without support.

    The two age groups (2–5 and 6–18 years) capture meaningful developmental differences relevant to the relationship between behavior and GI symptoms.

    “The sample was parsed into two age groups based on which version of the Child Behavior Checklist (CBCL) (22) the caregivers had completed for their child: younger (completed the CBCL for ages 2–5) or older (completed the CBCL for ages 6–18).”
    “Therefore, behavior may have different relationships with GI symptoms at different ages, which may have implications for the treatment of and clinical approach to GI disturbances in ASD.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value: χ2(1) = 0.830, p = .242

    Minor

    The paper reports p = .242 here; recomputing from the test statistic and its degrees of freedom gives p = .362. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .242 · recomputed p = .362

  • Inconsistent p-value: χ2(1) = 0.403, p = .308

    Minor

    The paper reports p = .308 here; recomputing from the test statistic and its degrees of freedom gives p = .526. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .308 · recomputed p = .526

  • Inconsistent p-value: χ2 (1) = 0.007, p = .524

    Minor

    The paper reports p = .524 here; recomputing from the test statistic and its degrees of freedom gives p = .933. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .524 · recomputed p = .933

3 of 3

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upχ²(1) = 0.403reported p = .308 · recomputed p = .526

    “χ2(1) = 0.403, p = .308”

  • Doesn’t add upχ²(1) = 0.83reported p = .242 · recomputed p = .362

    “χ2(1) = 0.830, p = .242”

  • Doesn’t add upχ²(1) = 0.007reported p = .524 · recomputed p = .933

    “χ2 (1) = 0.007, p = .524”

  • Consistentt(182) = 0.578reported p = .564 · recomputed p = .564

    “t(182) = 0.578, p = .564”

  • Consistentt(153) = -0.989reported p = .324 · recomputed p = .324

    “t(153) = −0.989, p = .324”

  • Consistentt(168) = 0.869reported p = .386 · recomputed p = .386

    “t(168) = 0.869, p = .386”

  • Consistentχ²(4) = 9.985reported p = .041 · recomputed p = .041

    “χ2(4) = 9.985, p = .041”

  • Consistentt(178.05) = -4.401reported p < .001 · recomputed p < .001

    “t(178.05) = −4.401, p < .001”

  • Consistentt(224) = 3.182reported p = .002 · recomputed p = .002

    “t(224) = 3.182, p = .002”

9 of 9

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Somatic complaints-stomachache increase does not match the odds ratio

    Minor

    The reported odds ratio of 1.148 corresponds to a 14.8% increase in odds, not 11.5%.

  • Anxiety-constipation increase does not match the odds ratio

    Minor

    The reported odds ratio of 1.098 corresponds to a 9.8% increase in odds per unit, not 11%.

  • Somatic complaints-nausea increase does not match the odds ratio

    Minor

    The reported odds ratio of 1.139 corresponds to a 13.9% increase in odds, not 11.4%.

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 6

  1. 2013, Diagnostic and Statistical Manual of Mental Disorders.
  2. Achenbach, 2001, Manual for the ASEBA School-Age Forms & Profiles: An Integrated System of Multi-informant Assessment
  3. Elliot, 2007, Differntial Ability Scales.
  4. Wechsler, 2003, Wechsler Intelligence Scale for Children
  5. Roid, 2013, Leiter International Performance.
  6. Walker, 2006, Rome III Diagnostic Questionnaire for the Pediatric Functional GI Disorders.

Cited by

Sorted by citations

Related

Authors
Ferguson, B. J., Dovgan, K., Takahashi, N., & Beversdorf, D. Q.
Affiliations
  • University of Missouri (US)
  • Marist University (US)
Corresponding author
Ferguson, Bradley J.
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2019-04-09
Volume
10
Pages
194-194
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2019.00194
PMC
PMC6465634
OpenAlex
W2938032876
Semantic Scholar
8f1edb65923603577f800e619b05aecf6698ecbf
Cited by
110
References
32
Citations by year
2026: 11 · 2025: 20 · 2024: 16 · 2023: 16 · 2022: 16 · 2021: 8 · 2020: 21 · 2019: 2
FWCI
6.83
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
University of Missouri
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords
autism spectrum disorder, gastrointestinal symptoms, constipation, stomach pain, nausea, diarrhea, behavioral problems, internalizing problems, anxiety, aggression, withdrawal, somatic symptoms, children and adolescents, age differences

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