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Autism Spectrum DisorderGAIN-ASDNCT07646808

Gut Microbiome Characteristics and Neurodevelopmental Functioning in Children With Autism Spectrum Disorder

An observational study of Autism Spectrum Disorder, run by Saveetha University at 1 site in India.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects communication, behavior, sensory processing, and daily functioning. Recent research suggests that the gut microbiome, the community of microorganisms living in the gastrointestinal tract, may influence brain development and function through… Read more about this study

Who is it for?
Ages 3 to 12 years
Conditions the study is for
Autism Spectrum Disorder
How many people
600 participants
Where
1 siteIndia
Study dates
1 Jul 2026to 31 Dec 2026
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 3 to 12 years
  • All sexes
  • No healthy volunteers
  • Child

Study population: The study population will consist of children aged 3 to 12 years with a confirmed diagnosis of Autism Spectrum Disorder (ASD) who are receiving care at participating pediatric rehabilitation, developmental, neurology, psychiatry, and autism care centers. Eligible participants will undergo stool sample collection for gut microbiome analysis and multidomain neurodevelopmental assessment, including evaluation of autism severity, gross motor function, sensory processing, cognitive functioning, behavioral function, sleep, participation, quality of life, gastrointestinal symptoms, dietary intake, and anthropometric nutritional status. Written informed consent will be obtained from parents or legal guardians prior to participation.

Who may be able to join

  • Children aged 3 to 12 years
  • Clinical diagnosis of Autism Spectrum Disorder (ASD) according to DSM-5/ICD criteria and confirmed from medical records or specialist assessment
  • Stable clinical status at the time of enrollment
  • Parent/legal guardian willing to provide written informed consent
  • Child able to undergo stool sample collection and neurodevelopmental assessments
  • Parent/caregiver able to complete questionnaires and provide dietary and medical history

Who cannot join

  • Use of systemic antibiotics, probiotics, prebiotics, synbiotics, or bowel-cleansing agents within the previous 4-12 weeks before stool collection
  • Presence of acute gastrointestinal infection or acute febrile illness at the time of assessment
  • Known chronic gastrointestinal disorders that may independently alter the gut microbiome, such as inflammatory bowel disease, celiac disease, short bowel syndrome, or chronic intestinal malabsorption
  • Major neurological, genetic, or metabolic disorders other than ASD that may independently affect neurodevelopment
  • Current use of medications known to significantly affect gut microbiota or bowel motility, if clinically relevant to your protocol
  • Inability to provide stool sample or complete the required assessments
  • Refusal of consent by parent/legal guardian

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Jeevarathinam Thirumalai, MPT contact

6384577805 ext. +91

jeevarathinamhope@gmail.com

India1 site
  • Saveetha Medical College and Hospital

    Chennai, Tamil Nadu, 602 105

    Indra Sivakumar, PhD, 9444009042 ext. +91, indras.smc@saveetha.com

Other trials in India

About this study

Official title: Association Between Gut Microbiome Characteristics and Neurodevelopmental Functioning in Children With Autism Spectrum Disorder: A Multidomain Investigation of the Gut-Motor Axis

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects communication, behavior, sensory processing, and daily functioning. Recent research suggests that the gut microbiome, the community of microorganisms living in the gastrointestinal tract, may influence brain development and function through the gut-brain and gut-motor axes. Alterations in gut microbiome characteristics have been reported in children with ASD and may be associated with differences in neurodevelopmental outcomes.

This observational study aims to investigate the association between gut microbiome characteristics and neurodevelopmental functioning in children with ASD. The study will evaluate multiple domains of functioning, including motor performance, sensory processing, behavior, cognition, sleep, and participation in daily activities. Gut microbiome characteristics will be assessed using stool sample analysis, and neurodevelopmental outcomes will be measured using standardized assessments and validated questionnaires.

The findings of this study may improve understanding of the relationship between the gut microbiome and neurodevelopmental functioning in children with ASD and provide insights into the role of the gut-motor axis in shaping functional outcomes. This knowledge may support future research and contribute to the development of more personalized approaches to assessment and rehabilitation in ASD.

Read the detailed description

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by impairments in social communication, restricted and repetitive behaviors, sensory processing differences, and variable functional abilities across developmental domains. Increasing evidence suggests that the gut microbiome may play a role in neurodevelopment through bidirectional communication pathways linking the gastrointestinal system and the central nervous system. These interactions, commonly described as the gut-brain axis, have been implicated in behavioral, cognitive, sensory, and motor processes. More recently, the concept of the gut-motor axis has emerged, highlighting potential relationships between gut microbial composition and motor functioning.

Several studies have reported alterations in gut microbiome composition among children with ASD compared with typically developing peers. However, existing research has largely focused on autism symptom severity, behavioral manifestations, or gastrointestinal symptoms, while the association between gut microbiome characteristics and broader neurodevelopmental functioning remains insufficiently explored. Furthermore, few studies have examined multiple functional domains simultaneously within a rehabilitation framework.

The present study aims to investigate the association between gut microbiome characteristics and neurodevelopmental functioning in children with ASD. A multidomain assessment approach will be employed to evaluate neurodevelopmental outcomes encompassing motor performance, sensory processing, behavioral function, cognitive functioning, sleep, and participation in daily activities. Gut microbiome characteristics will be assessed through stool sample analysis using established microbiological methods. Neurodevelopmental outcomes will be evaluated using standardized assessments and validated caregiver-reported instruments.

By examining the relationship between gut microbiome characteristics and multidimensional functional outcomes, this study seeks to enhance understanding of the gut-motor axis in ASD and identify potential microbiome-related factors associated with neurodevelopmental functioning. The findings may contribute to the growing body of evidence on microbiome-neurodevelopment interactions and inform future translational and rehabilitation research in children with ASD.

Keywords
Autism Spectrum Disorder, Gut Microbiome, Gut-Brain Axis, Gut-Motor Axis, Motor Performance
Medical subject headings
Autism Spectrum Disorder

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT07646808
Study groupRoleWhat they receive
Children With Autism Spectrum DisorderChildren diagnosed with Autism Spectrum Disorder (ASD) who meet the study eligibility criteria. Participants will provide stool samples for gut microbiome analysis and undergo multidomain neurodevelopmental assessment.
Typically Developing ChildrenAge- and sex-matched typically developing children without a diagnosis of Autism Spectrum Disorder or other neurodevelopmental disorders. Participants will provide stool samples for gut microbiome analysis and undergo neurodevelopmental assessment for comparison with the ASD cohort.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Indian Scale for Assessment of Autism

    Autism severity will be assessed using the Indian Scale for Assessment of Autism (ISAA). The ISAA total score ranges from 40 to 200, with higher scores indicating greater autism symptom severity (worse outcomes) and lower scores indicating less severe autism-related impairments (better outcomes). The total score will be used to determine the severity of autism symptoms and examine associations with gut microbiome characteristics.

    Measured: Baseline

  2. Gut Microbiome Diversity and Composition

    Gut microbiome characteristics will be assessed from stool samples using 16S rRNA gene sequencing. Primary microbiome outcomes will include alpha diversity indices (Shannon Diversity Index, Simpson Diversity Index, and Chao1 Richness Index), beta diversity measures, and the relative abundance of bacterial taxa. These measures will be used to characterize gut microbial diversity and composition in children with Autism Spectrum Disorder.

    Measured: Baseline (single stool sample collected at study enrollment)

Secondary outcomes (11)
  1. Gross Motor Function Measure-88 Total Score

    Gross motor function will be assessed using the Gross Motor Function Measure-88 (GMFM-88). The GMFM-88 evaluates gross motor performance across five dimensions: lying and rolling, sitting, crawling and kneeling, standing, and walking, running, and jumping. Scores range from 0 to 100%, with higher scores indicating better gross motor function (better outcomes) and lower scores indicating poorer gross motor function (worse outcomes). Total scores and dimension scores will be used to evaluate motor performance and its association with gut microbiome characteristics.

    Measured: Baseline

  2. Gastrointestinal Symptom Severity Score

    Gastrointestinal symptoms, including constipation, diarrhea, abdominal pain, and bloating, will be assessed using a structured Gastrointestinal Symptom Questionnaire (total score range: 0-100, with higher scores indicating greater gastrointestinal symptom severity). Stool consistency will be assessed using the Bristol Stool Form Scale (BSFS), a 7-point scale ranging from Type 1 (separate hard lumps, indicating severe constipation) to Type 7 (entirely liquid stool, indicating severe diarrhea), with higher scores reflecting looser stool consistency.

    Measured: Baseline

  3. Strengths and Difficulties Questionnaire Total Difficulties Score

    Emotional and behavioral difficulties will be assessed using the Strengths and Difficulties Questionnaire (SDQ) Total Difficulties Score. The total difficulties score ranges from 0 to 40, with higher scores indicating greater emotional and behavioral difficulties (worse outcomes) and lower scores indicating fewer difficulties (better outcomes).

    Measured: Baseline

  4. Patient-Reported Outcomes Measurement Information System Sleep Disturbance Scale Score

    Sleep disturbance will be assessed using the Patient-Reported Outcomes Measurement Information System Sleep Disturbance Scale (PROMIS Sleep Disturbance Scale). The scale evaluates perceived sleep quality, sleep difficulties, sleep satisfaction, and sleep-related concerns. Scores range from 8 to 40, with higher scores indicating greater sleep disturbance (worse sleep outcomes) and lower scores indicating better sleep quality. Associations between sleep disturbance and gut microbiome characteristics will be examined.

    Measured: Baseline

  5. Participation Questionnaire for Preschoolers With Autism Score

    Participation will be assessed using the Participation Questionnaire for Preschoolers with Autism (PPA). The questionnaire evaluates participation in home, preschool, community, play, and social activities. The total score ranges from 0 to 100, with higher scores indicating greater participation in everyday activities (better outcomes) and lower scores indicating reduced participation. Associations between participation outcomes and gut microbiome characteristics will be examined.

    Measured: Baseline

  6. Sensory Experiences Questionnaire Total Score

    Sensory processing will be assessed using the Sensory Experiences Questionnaire Version 2.1 (SEQ-2.1), a caregiver-reported measure designed to evaluate sensory experiences in children with Autism Spectrum Disorder. The questionnaire assesses sensory hyperreactivity, hyporeactivity, and sensory-seeking behaviors across multiple sensory modalities. The total score ranges from 0 to 145, with higher scores indicating greater sensory processing difficulties (worse outcomes) and lower scores indicating fewer sensory processing difficulties. Associations between sensory processing outcomes and gut microbiome characteristics will be examined.

    Measured: Baseline

  7. PROMIS Parent Proxy Cognitive Function Score

    Cognitive functioning will be assessed using the Patient-Reported Outcomes Measurement Information System Parent Proxy Cognitive Function Measure (PROMIS Parent Proxy Cognitive Function Measure). The instrument evaluates caregiver-reported difficulties related to attention, memory, concentration, learning, and thinking abilities in children. Scores are reported as standardized T-scores (mean = 50, standard deviation = 10), with higher scores indicating better perceived cognitive functioning (better outcomes) and lower scores indicating poorer cognitive functioning (worse outcomes). Associations between cognitive function and gut microbiome characteristics will be examined.

    Measured: Baseline

  8. Dietary Intake Score

    Dietary intake will be assessed using parent proxy-reported 24-hour dietary recalls collected on 2-3 non-consecutive days, including at least one weekend day, using the multiple-pass recall method. Information on daily energy intake (kcal/day), macronutrient intake (g/day), dietary fiber intake (g/day), and consumption of key food groups (servings/day) will be recorded. A supplementary Food Frequency Questionnaire (FFQ) will assess the habitual consumption of fruits and vegetables, whole grains, fermented foods, sugar-sweetened beverages, and ultra-processed foods. Composite Healthy Diet Score and Unhealthy Diet Score will be derived to characterize dietary patterns, with higher Healthy Diet Scores indicating healthier dietary patterns and higher Unhealthy Diet Scores indicating less healthy dietary patterns. Dietary intake variables will be used as covariates in analyses examining associations between gut microbiome characteristics and neurodevelopmental functioning in children with

    Measured: Baseline

  9. Pediatric Quality of Life Inventory Total Score

    Quality of life will be assessed using the Pediatric Quality of Life Inventory (PedsQL). The instrument evaluates physical, emotional, social, and school functioning in children. Scores range from 0 to 100, with higher scores indicating better health-related quality of life (better outcomes) and lower scores indicating poorer health-related quality of life (worse outcomes). Associations between quality of life and gut microbiome characteristics will be examined in children with Autism Spectrum Disorder.

    Measured: Baseline

  10. Anthropometric Nutritional Status Score

    Anthropometric nutritional status will be assessed using standardized measurements of height (cm), weight (kg), and body mass index (BMI; kg/m²). Age- and sex-specific z-scores for weight-for-age, height-for-age, BMI-for-age, and weight-for-height (where applicable) will be calculated according to the World Health Organization (WHO) Child Growth Standards and Growth Reference charts. For z-score indicators, a value of 0 represents the WHO reference population median, positive values indicate measurements above the reference median, and negative values indicate measurements below the reference median. Nutritional status categories, including undernutrition, normal nutritional status, overweight, and obesity, will be determined using WHO classification criteria. Associations between anthropometric nutritional status and gut microbiome characteristics will be examined in children with Autism Spectrum Disorder.

    Measured: Baseline

  11. Body Mass Index-for-Age Z-Score

    Body mass index (BMI) will be calculated as weight (kg) divided by height squared (m²). BMI-for-age z-scores will be derived using World Health Organization (WHO) age- and sex-specific growth references. A z-score of 0 represents the WHO reference population median, positive z-scores indicate BMI values above the reference median, and negative z-scores indicate BMI values below the reference median. BMI-for-age z-scores will be used to evaluate nutritional status and examine their association with gut microbiome characteristics and neurodevelopmental functioning.

    Measured: Baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Jun 2026
  2. Study start1 Jul 2026 (estimated)
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
600 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07646808
Sponsor's protocol ID
079/06/2026/ISRB/FSR/SIBMS
Acronym
GAIN-ASD
Status last verified
Jun 2026
First submitted
9 Jun 2026
Last updated
16 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Individual participant data (IPD) may be shared upon reasonable request following publication of the study findings, subject to institutional policies, ethical approval requirements, participant confidentiality protections, and applicable data-sharing agreements. A final decision regarding IPD sharing will be made after completion of the study and in accordance with institutional and regulatory guidelines.

Publications

  • Baranek GT, Watson LR, Boyd BA, Poe MD, David FJ, McGuire L. Hyporesponsiveness to social and nonsocial sensory stimuli in children with autism, children with developmental delays, and typically developing children. Dev Psychopathol. 2013 May;25(2):307-20. doi: 10.1017/S0954579412001071.

    PubMed 23627946
  • Kang DW, Adams JB, Gregory AC, Borody T, Chittick L, Fasano A, Khoruts A, Geis E, Maldonado J, McDonough-Means S, Pollard EL, Roux S, Sadowsky MJ, Lipson KS, Sullivan MB, Caporaso JG, Krajmalnik-Brown R. Microbiota Transfer Therapy alters gut ecosystem and improves gastrointestinal and autism symptoms: an open-label study. Microbiome. 2017 Jan 23;5(1):10. doi: 10.1186/s40168-016-0225-7.

    PubMed 28122648
  • Vuong HE, Hsiao EY. Emerging Roles for the Gut Microbiome in Autism Spectrum Disorder. Biol Psychiatry. 2017 Mar 1;81(5):411-423. doi: 10.1016/j.biopsych.2016.08.024. Epub 2016 Aug 26.

    PubMed 27773355
  • Cryan JF, O'Riordan KJ, Cowan CSM, Sandhu KV, Bastiaanssen TFS, Boehme M, Codagnone MG, Cussotto S, Fulling C, Golubeva AV, Guzzetta KE, Jaggar M, Long-Smith CM, Lyte JM, Martin JA, Molinero-Perez A, Moloney G, Morelli E, Morillas E, O'Connor R, Cruz-Pereira JS, Peterson VL, Rea K, Ritz NL, Sherwin E, Spichak S, Teichman EM, van de Wouw M, Ventura-Silva AP, Wallace-Fitzsimons SE, Hyland N, Clarke G, Dinan TG. The Microbiota-Gut-Brain Axis. Physiol Rev. 2019 Oct 1;99(4):1877-2013. doi: 10.1152/physrev.00018.2018.

    PubMed 31460832

Questions about this trial

What is this clinical trial studying?

An observational study of Autism Spectrum Disorder, run by Saveetha University at 1 site in India.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 16 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in India. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Jeevarathinam Thirumalai, MPT (6384577805 ext. +91, jeevarathinamhope@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Indian Scale for Assessment of Autism (time frame: Baseline). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07646808, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Jun 2026.

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