Study Shows Children With Autism Experience Interrelated Health Issues

Children who have autism are more likely to also have anxiety, gastrointestinal issues, and sensory problems, all of which can effect their daily lives.

One in 88 children has been diagnosed with an autism spectrum disorder (ASD) in the United States, according to the Centers for Disease Control and Prevention. A new study by a University of Missouri researcher found that many children with ASD also experience anxiety, chronic gastrointestinal (GI) problems and atypical sensory responses, which are heightened reactions to light, sound or particular textures. These problems appear to be highly related and can have significant effects on children's daily lives, including their functioning at home and in school.

Micah Mazurek, an assistant professor of health psychology and a clinical child psychologist, found in her study of 2,973 children and adolescents with ASD that nearly one-fourth also had chronic GI problems, such as constipation, abdominal pain, bloating, diarrhea or nausea. The results also showed that children with chronic GI problems were more likely to experience anxiety and sensory problems.

"These problems can have a very real impact on daily life. Children with anxiety may be distressed or reluctant to engage in new activities, and those with sensory problems may have trouble paying attention or participating in over-stimulating enviornments," Mazurek said. "These children may also suffer uncomfortable GI problems that they may not be able to communicate about to adults."

Clinicians should be aware that anxiety, GI problems and sensory sensitivity often co-occur in individuals with ASD. Effectively managing these concurrent issues may improve children's quality of life and their responses to treatment, Mazurek said.

"Parents need to be aware that these problems may underlie some of their children's difficulties, so if they notice any symptoms, they should talk to their doctors or therapists about treatment options," Mazurek said. "Practitioners who work with children with ASD need to be mindful that there is a pretty high rate of these problems, so if children are treated for one issue, it may helpful to screen for these additional symptoms."

This is the first study to examine the relationships among anxiety, GI problems and sensory over-responsivity in a large, nationally representative sample of children and adolescents with ASD. Participants in the study were enrolled in the Autism Treatment Network, a network of 17 autism centers throughout North America that are focused on best practices for medical treatment of children with ASD.

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Reflux and Sleep Apnea in Children - Its a two way street!

This is a very interesting article. For years we have known that sleep apnea exacerbates reflux. Also, we know the treatment of reflux reduces fragmentation of sleep. This is exciting article showing an improved response  in sleep apnea due to reflux treatment. JR

Original Article

Respiratory response to proton pump inhibitor treatment in children with obstructive sleep apnea syndrome and gastroesophageal reflux disease

• Jolanta Wasilewska^a, , , 
• Janusz Semeniuk^a, 
• Beata Cudowska^a, 
• Mark Klukowski^b, 
• Katarzyna Dębkowska^c, 
• Maciej Kaczmarski^a

• ^a Department of Pediatrics, Gastroenterology and Allergology, Medical University of Bialystok, Waszyngtona Street 17, 15-274 Bialystok, Poland
• ^b Department of Pharmacology, Medical University of Bialystok, Waszyngtona Street 17, 15-274 Bialystok, Poland
• ^c Department of Business Informatics and Logistics, Technical University of Bialystok, Tarasiuka Street 2, 16-001 Kleosin, Poland

• Received 31 December 2011. Revised 8 April 2012. Accepted 25 April 2012. Available online 20 June 2012.

• http://dx.doi.org/10.1016/j.sleep.2012.04.016 , How to Cite or Link Using DOI

• Permissions & Reprints

 Link to abstract

Abstract

Objective

Evaluation of the respiratory response to proton pump inhibitors (PPI) in children with obstructive sleep apnea syndrome (OSAS) and gastroesophageal reflux disease (GERD).

Methods

Of 131 children diagnosed with OSAS (Apnea Hypopnea Index, AHI >1/h), 37 children (6.9 years; 28.24%) with GERD symptoms (>3 times/week) were included. Overnight polysomnography with 24 h pH-metry was performed before and after 4–8 weeks of PPI treatment (omeprazole once a day, 1 mg/kg).

Results

Of 37 children, 21 were diagnosed with acid GERD where pre- and post-treatment reflux indexes were 14.09 ± 1.47 vs. 7.73 ± 1.36; (p < 0.001). The number of obstructive apneas and hypopneas decreased after PPI treatment, resulting in an AHI reduction from 13.08 ± 3.11/h to 8.22 ± 2.52/h; (p < 0.01). Respiratory response to PPI ranged from complete resolution of OSA (three children with mild OSA; AHI < 5/h; 10.31 years; 14.29%) to lack of significant AHI change (six children with severe OSA; AHI > 10/h; 3.62 years; 28.57%). Post-treatment AHI was predicted by pre-treatment reflux index (adjusted R² = 0.487;p < 0.001).

Conclusions

Reduction of obstructive respiratory events following short-term PPI treatment in children with both GERD and OSAS may suggest a causal relationship between apnea and reflux in some children. Questionnaire screening for GERD in children with OSAS may be of benefit.

Keywords

• Obstructive sleep apnea syndrome; 
• Gastroesophageal reflux disease; 
• Omeprazole; 
• Polysomnography; 
• pH metry; 
• Reflux Index