Investigation of the relationship between voiding dysfunction, fecal continence, and physical fitness level with depression and quality of life in their caregivers in children and adolescents autism spectrum disorder

Purpose: To examine urinary incontinence, fecal continence level, and physical fitness level in children and adolescents with Autism Spectrum Disorder (ASD), as well as their caregivers' depression and quality of life, and to investigate the relationship between these parameters. Method: A total of 68 individuals diagnosed with ASD and their caregivers were included in the study. Autism severity was assessed using the Childhood Autism Rating Scale (CARS), urinary incontinence using the Urinary Incontinence Symptom Score (UISS), fecal incontinence using the Holschneider Continence Score, physical fitness level using the Brockport Physical Fitness Test (BPFT), body mass index (BMI), curl-up test, dominant side grip strength test, sit-and-reach test, and family depression level was assessed using the Beck Depression Inventory and quality of life using the Nottingham Health Profile (NHP). Results: The mean CARS score for individuals was 34.82±3.61 points, with 76.5% having urinary incontinence and 60.3% having fecal incontinence. Moderate depression was found in 36.7% of caregivers, and severe depression in 35.3%. A significant correlation was found between the CARS score and the IBSS (r=0.422), the Holschneider continence score (r=-0.471), the time taken to walk 1 mile (r=0.707), and the Curl up test (r=-0.245) (p<0.05). A relationship was found between the IBSS score and the time taken to walk 1 mile (r=0.596; p<0.001) and the Curl-up test (r=-0.439; p=0.001). A relationship was found between the Holschneider continence score and the time taken to walk 1 mile (r=-0.530; p<0.001) and the Curl up test (r=0.394; p=0.001). A correlation was found between the CARS score and caregivers' Beck Depression score (r=0.383; p=0.001) and NHP Section 1 score (r=0.369; p=0.002). A correlation was found between the IBBS score and caregivers' Beck Depression score (r=0.367; p=0.002); A relationship was determined between the Holschneider continence score and caregivers' Beck Depression score (r=-0.504; p<0.001) and NHP Section 1 score (r=-0.369; p=0.002). Conclusion: As the severity of autism increases in children and adolescents with ASD, urinary incontinence problems increase and fecal continence decreases. The increase in urinary incontinence problems and decrease in fecal continence with increasing autism severity reduces physical functioning skills. As a result of these relationships, caregivers' depression levels increase and their quality of life decreases. We recommend implementing special exercise programs for children and adolescents with ASD and approaches that involve the family. Keywords: Family, child, parent, disabled, physiotherapy