Autism spectrum disorder (ASD) is a neurodevelopmental disease that includes deficits in social communication and interplay, associated with the presence of limited, repetitive behaviour that are present from early development and can persevere throughout life. Children with ASD often experience urinary dysfunction symptoms, such as voiding issues, incontinence, and constipation, impacting their daily activities but still no consistent information exist in children with ASD. This study aimed to investigate the prevalence of urinary dysfunction symptoms and their correlations with ASD severity and sensory patterns.

Children aged between 3–9 years, diagnosed with ASD according to DSM-5 were included. Children’s autism severity were reviewed by Childhood Autism Rating Score (CARS) and Rome IV criteria was used for lower urinary tract symptoms using the dysfunctional voiding and incontinence symptoms score, and presence of constipation. Sensory patterns were assessed by Sensory Profile while participation to daily living activities were assessed by WeeFIM. The results were analyzed by SPSS 23. The Mann-Whitney U test was used to compare nonparametric variables. The associations between categorical variables were tested by X2 test with Yates' continuity correction or Fisher's exact test. All values in the text and tables are expressed for facility as mean ± SD.. A two-sided P  < 0.05 was considered significant.

Of 248 children with ASD (study group) and 150 typical developing children (control group) included. According to study group's results: 186 (75%) were boys. The age was 5.6 ± 2.2 years.  ASD was mild to moderate in 148 children and severe in 100 children. Ninety one (37 %) children had constipation, including 22 with mild-to-moderate ASD and 54 with severe ASD. 81 (33 %) children had voiding dysfunction, including 26 who could not be toilet trained, and  of 19 these patients had moderate-to-severe ASD. 37 (15 %) patients had both constipation and voiding dysfunction. The presence of voiding dysfunction and/or constipation correlated with the severity of ASD (p=0.73) and sensory patterns (p=0.68). Children with voiding and/or constipation dysfunction show poor registration or avoids from sensory stimulations. Children with sensory processing disorder and voiding/constipation dysfunction had lower independence in daily living activities.

Children with ASD have a high prevalence of urinary symptoms, and the presence of symptoms have strong correlations with the severity of ASD and sensory patterns which effects independence in daily living activities.

Studies on effects sensory integration therapy on urinary symptoms should be planned on children with ASD. A multi-professional approach for children with ASD  and urinary symptoms is recommended.

Continence 12S (2024) 101546
DOI: 10.1016/j.cont.2024.101546