Bresciani Giulia, Da Lozzo Prisca, Lega Sara, Bramuzzo Matteo, Di Leo Grazia, Dissegna Andrea, Colonna Vissia, Barbi Egidio, Carrozzi Marco, Devescovi Raffaella
Division of Child Neurology and Psychiatry, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34137 Trieste, Italy.
Department of Medical, Surgical and Health Sciences, University of Trieste, 38122 Trieste, Italy.
Children (Basel). 2023 Jan 30;10(2):253. doi: 10.3390/children10020253.
The aim of this study was to evaluate the interaction between gastrointestinal (GI) disorders, sleep problems, and challenging behaviors in children with a diagnosis of Autism Spectrum Disorder (ASD) and their effect on parental stress. The secondary objective was to assess the frequency and type of GI and feeding disorders in a sample of children with ASD through a multidisciplinary assessment and, finally, to investigate families' perceptions and satisfaction with the proposed multidisciplinary approach. All children underwent a comprehensive gastroenterological and neuropsychiatric evaluation supported by standardized questionnaires. Pediatric gastroenterologists, specifically trained in Applied Behavior Analysis (ABA), provided advice for parent-delivered behavioral intervention for food selectivity. Thirty-six children with an autism diagnosis (29 males, age 4.5 +/-2.2 years, mean +/- SD) were enrolled. A positive correlation between sleep problems and aggressive behavior was found, and this association was stronger in children experiencing more problematic mealtime behaviors (b = 0.788, = 0.014). Sleep difficulties were associated with stereotyped behaviors and parent-perceived stress. Parents interviewed about the gastroenterology visit perceived this multidisciplinary approach as helpful in addressing food selectivity. This study shows that sleep and mealtime issues can have a synergistic negative impact on ASD symptoms. A multidisciplinary approach and an integrated assessment of GI, feeding problems, and sleep disorders could be helpful in diagnosing comorbidities and to provide targeted advice to parents.
本研究的目的是评估患有自闭症谱系障碍（ASD）的儿童胃肠道（GI）疾病、睡眠问题和挑战性行为之间的相互作用及其对父母压力的影响。次要目标是通过多学科评估来评估ASD儿童样本中胃肠道和喂养障碍的频率和类型，最后调查家庭对所提议的多学科方法的看法和满意度。所有儿童均接受了标准化问卷支持的全面胃肠病学和神经精神病学评估。接受过应用行为分析（ABA）专门培训的儿科胃肠病学家为家长提供针对食物选择性的行为干预建议。招募了36名自闭症诊断儿童（29名男性，年龄4.5±2.2岁，均值±标准差）。发现睡眠问题与攻击性行为之间存在正相关，并且这种关联在进餐时间行为问题较多的儿童中更强（b = 0.788，P = 0.014）。睡眠困难与刻板行为和父母感知的压力有关。接受关于胃肠病学就诊访谈的家长认为这种多学科方法有助于解决食物选择性问题。本研究表明，睡眠和进餐时间问题可能对ASD症状产生协同负面影响。多学科方法以及对胃肠道、喂养问题和睡眠障碍的综合评估可能有助于诊断合并症并为家长提供有针对性的建议。
