Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Allergy Unit

Student research

Wheat and Milk Intolerance in Children With and Without Autistic Spectrum Disorder as Detected by Diallertest� Patches

Gemma Sampson
Bachelor of Nutrition and Dietetics, University of Wollongong
Supervisors: Velencia Soutter, Robert Loblay, Anne Swain
October 2007

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Background: Parents of children with Autistic Spectrum Disorder (ASD) often report that wheat and milk promotes undesirable symptoms and behaviours characteristic of food intolerance. Elimination-Oral-Food Challenges are the gold-standard diagnostic tool, but are difficult to complete. Diallertest� patches may be an easier alternative to predict delayed-reactivity (T-cell mediated) food intolerance. This study evaluated the usefulness of Diallertest� patches in predicting delayed-reactivity food intolerance in children with and without ASD in a clinical setting. Additional aims were to identify relationships between food intolerance, behaviour and learning difficulties, and to assess value of digital photographs as a method of diagnosing reactions.

Methods: One-hundred-and-twenty-three (51 ASD and 72 non-ASD) children (1-13 years) with suspected food intolerance and negative skin prick tests were recruited. Diallertest� patches (wheat, milk and control) were attached to the upper back and removed after 48h. Digital photographs recording reactions at 48h and 72h were emailed. Parents returned completed questionnaires regarding their child’s behaviour, physical symptoms, dietary modifications and oral food challenges to the Allergy Unit for analysis. Data were analysed by SPSS 15.0 to calculate descriptive statistics and found to be not-normally distributed so non-parametric tests were used. Chi-square test and Fishers Exact test was used for testing specificity and sensitivity of Diallertest� from oral-challenges using a significance level of p<0.05.

Results: Parents had modified diet for 47 (38%) children, 30 (81%) of which were milk-free and 25 (53%) on wheat-free diets. Thirty-one participants (25%) with Diallertest� patches had been oral-food challenged for milk and wheat. Diallertest� was found to have an overall agreement of 52% (14/27) for wheat and 50% (13/26) for milk reactions of all participants.

Conclusion: These results suggest that Diallertest� patches do not strongly predict food intolerance in this population. Digital photographs are useful in identifying reactions, but careful instruction is necessary to ensure clear and accurate records are taken. Further research with controlled oral-food challenges is required focusing on challenge reaction time and dietary effects, to more accurately determine usefulness of the test.