Oral microbiome activity in children with autism spectrum disorder.
Steven D Hicks, Richard Uhlig, Parisa Afshari and 5 others
PMID 30107083WHAT IT FOUND
Saliva microbial activity differed between children with autism and typical or developmentally delayed children.
Some patterns tracked communication and gut problems, not ADHD or daily living. This is an association, not a test of treatment.
Key findings
01Twelve oral taxa differed among the autism, typical development, and developmental delay groups; six differed between autism and typical controls, and three between autism and developmental delay.
02Microbial differences were seen in ASD children with GI disturbance (28 taxa) and across communication levels (five taxa and one phylum), but not in ADHD or Activities of Daily Living groups.
03Taxon ratios correctly identified 73 of 90 children with autism and 33 of 53 typical children in a held-out set, and 82 of 90 children with autism and 21 of 30 children with developmental delay in another held-out set.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was a single saliva sample per child, so it cannot show that microbial changes caused autism, gut problems, or communication difficulties. The groups differed in age, sex, gastrointestinal disturbance, food or medicine allergies, and cesarean birth rates, and those differences could still influence the results. Many comparisons were made, and microbes linked to autism versus controls did not overlap with microbes linked to autism subgroups, so one clear biomarker is unlikely. Saliva microbial measures were associated with time of collection, time since eating, and time since tooth brushing, so sampling conditions could affect results. The study used RNA activity rather than the more common 16S abundance method, so it may not match earlier gut microbiome studies. Autism diagnosis was made by clinicians across sites, and only 138 of 180 autism participants had ADOS-2 scores; the ADOS-2 was not administered by research-reliable administrators, and subdomain scores are not usually used quantitatively. ADHD and gastrointestinal subgroups were based on parent report and chart codes, not standardized behavioral or GI severity scales. The diagnostic accuracy work was internal to this dataset, using split samples, so it is not a validated clinical test. The authors suggest probiotics or antibiotics, but no treatment was given or tested in this study.
Declared interests
The supplied publication types list NIH extramural and non-U.S. government research support. No author conflict-of-interest statement is provided.
The easy way to misread this
Do not read saliva microbial panels as a clinical diagnostic test or as evidence that probiotics or antibiotics will help children with autism. The study was observational, and the treatment suggestions were not tested.