Clinical–Radiological Discordance in the Detection of Chronic Constipation in Children Newly Diagnosed with Autism Spectrum Disorder: A Retrospective Study

Background/Objectives: Chronic constipation in patients with autism spectrum disorder (ASD) may be undetected during routine care and can exacerbate ASD symptoms such as irritability and hyperactivity. This retrospective study evaluated the prevalence of radiographic findings suggestive of chronic constipation in children newly diagnosed with ASD, and it compared these findings with those based on routine clinical history and examination alone.

Methods

A retrospective chart review of pediatric patients diagnosed with ASD at neurology clinics in Jordan between 2022 and 2025 was conducted. Informed consent was required for an abdominal radiographic examination at screening to initiate the standard treatment protocol at participating clinics. A more stringent version of the Leech criteria, equivalent to a total Leech score of ≥10, was applied to the radiographic images to identify patients with findings suggestive of chronic constipation. Data were extracted via retrospective chart review using a standardized data collection form.