Effectiveness of visceral osteopathic treatment on gastrointestinal indicators and behaviour patterns in autistic children: using questionnaire and biochemical markers to measure outcomes
Introduction. The precise aetiology of autism is unclear, however recent studies link autism with gastrointestinal (GI) dysfunction. Although there is no specific treatment, the potential to ameliorate the behavioural and GI problems of autistic children is of interest. This study aimed to evaluate inflammatory markers in faecal samples taken from autistic children with GI dysfunction before, during and after visceral osteopathic techniques (VOT), and to link these findings with contemporaneous questionnaires. These data assessed whether GI status could be reliably determined from a single sample, whether VOT affected behaviour and clinical signs, and whether there was any association between biochemical markers and the questionnaire. Methods. Faecal samples were analysed for three biochemical markers, calprotectin, M2-pyruvate kinase and lactoferrin. Forty nine children, between 3½ and 8 years old, and independently diagnosed as autistic by specialist professionals were recruited. Questionnaires using a 10 point Likert scale assessed behavioural parameters and clinical signs throughout the 18 week study period, before, during and after VOT. Results. Due to intra-individual biological variability, analysis of single faecal samples over time did not give a consistent readout of marker levels. The questionnaire showed significant improvement in symptoms and behaviour during treatment, specifically, reduction in vomiting (p<0.001), and poor appetite (p<0.05), and an increase in eye contact (p<0.05). Analysis of an inflammatory marker, together with the questionnaire, showed a highly significant association of ‘need for a fixed routine’ (p<0.0001) and ‘constipation’ (p<0.02) parameters with calprotectin, and showing multivariate coefficients of 3.227 and -1.584 respectively. Discussion and Conclusion. VOT ameliorates GI symptoms in these autistic children and a standardised questionnaire could include ‘need for a fixed routine’ and ‘constipation’ as independent predictors of their bowel dysfunction. This study uniquely used biochemical markers to assess symptomatic changes before, during and after VOT.