Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Autism Res. 2022 Jun;15(6):1142-1155. doi: 10.1002/aur.2707. Epub 2022 Mar 18.
Gastrointestinal (GI) symptoms are one of the prevalent co-occurring issues in autism spectrum disorder (ASD), though the range of symptom frequency estimates varies dramatically across studies, which can limit the further research of GI issues in ASD as well as potential treatment strategies. The wide range of prevalence estimates is partly due to the lack of standardized, validated measures of GI symptoms among people with ASD. The goal of this study was to (1) develop a measure, which included non-verbal and mealtime behaviors, to assess for GI symptoms and (2) evaluate its psychometric characteristics. This was accomplished by drawing on two existing tools, Autism Treatment Network Gastrointestinal Inventory and the Brief Autism Mealtime Behavior Inventory, and deriving new items, to create the "ASD Gastrointestinal and Related Behaviors Inventory" (ASD-GIRBI). The ASD-GIRBI was piloted in an online registry of families with a child with ASD. A psychometric analysis was carried out in a sample of 334 children aged 6-17 years with ASD, resulting in a 36-item tool. The Cronbach's alpha for the overall scale was 0.88. Exploratory factor analysis identified a seven-factor model (1. Bowel movement pain; 2. Aggressive or disruptive during mealtimes; 3. Particular with foods; 4. Abdominal pain and upset stomach; 5. Refusing food; 6. Constipation and encopresis; 7. Motor or other behaviors). Following validation in an independent sample with clinical evaluation of GI symptoms, this tool will be helpful for both research and clinical purposes.
胃肠道 (GI) 症状是自闭症谱系障碍 (ASD) 中常见的共病问题之一，尽管不同研究中症状频率的估计范围差异很大，但这可能会限制对 ASD 中胃肠道问题的进一步研究以及潜在的治疗策略。这种广泛的患病率估计部分是由于缺乏针对 ASD 人群的胃肠道症状的标准化、经过验证的测量方法。本研究的目的是：(1) 开发一种测量方法，包括非言语和用餐行为，以评估胃肠道症状；(2) 评估其心理测量学特征。这是通过借鉴现有的两种工具，自闭症治疗网络胃肠道清单和简要自闭症用餐行为清单，并衍生出新的项目，来创建“自闭症胃肠道和相关行为清单” (ASD-GIRBI) 完成的。ASD-GIRBI 在一个自闭症儿童家庭的在线登记处进行了试点。在一个由 334 名年龄在 6-17 岁的 ASD 儿童组成的样本中进行了心理测量学分析，得出了一个 36 项的工具。整个量表的克朗巴赫α系数为 0.88。探索性因素分析确定了一个七因素模型 (1. 排便疼痛；2. 用餐时具有攻击性或破坏性；3. 对食物特别挑剔；4. 腹痛和胃部不适；5. 拒绝食物；6. 便秘和大便失禁；7. 运动或其他行为)。在对具有胃肠道症状临床评估的独立样本进行验证后，该工具将有助于研究和临床目的。
