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Quiz: Autism, ADHD, and the Gut

Test your understanding of Chapter 13. Choose the best answer, then click Show Answer to check.

Question 1

Which phrase is an example of identity-first language?

  1. "A person with autism"
  2. "A child who suffers from autism"
  3. "An autistic person"
  4. "A person who has recovered from autism"
Show Answer

The correct answer is C. Identity-first language puts the identity first, as in "autistic person," which many autistic people prefer because they see autism as part of who they are. Option A is person-first language, which some people prefer, so the best rule is to use the words a specific person chooses. Options B and D frame autism as a disease, which this chapter avoids.

Concept Tested: Identity-First Language Bloom's Level: Remember

Question 2

In the 2014 meta-analysis of 15 studies, how did the odds of general GI symptoms in autistic children compare with comparison children?

  1. About 4.4 times higher
  2. About the same
  3. About half as high
  4. About 40 times higher
Show Answer

The correct answer is A. The pooled odds ratio for general GI symptoms was 4.42. That is a large, consistent association, but the study could not show why the symptoms were more common. Option D exaggerates the result roughly tenfold, the kind of error that spreads in headlines.

Concept Tested: GI Symptoms in Autism Bloom's Level: Remember

Question 3

What is an open-label trial?

  1. A study in which neither participants nor researchers know who gets the real treatment
  2. A study that tests a treatment only in mice
  3. A study that compares a treatment with a look-alike placebo
  4. A study in which participants and researchers know who is getting the treatment, usually with no placebo group
Show Answer

The correct answer is D. In an open-label trial, everyone knows who is treated, so improvements could come from expectations, attention, or time passing. Option A describes a double-blind design, which is the opposite, and option C describes a placebo-controlled trial.

Concept Tested: Open-Label Trial Bloom's Level: Remember

Question 4

Which statement best describes the idea of neurodiversity?

  1. Autism and ADHD are diseases that should be cured as early as possible.
  2. Natural variation in how brains develop and work, including autism and ADHD, is part of human diversity, so the goal is understanding and support.
  3. Neurodivergent people never need any help or health care.
  4. Only people with ADHD are neurodivergent.
Show Answer

The correct answer is B. Neurodiversity treats differences like autism and ADHD as part of normal human variation, calling for support and accommodation rather than cure. Option C is a common misunderstanding: the neurodiversity view still recognizes real challenges and co-occurring health problems, such as gut pain, that deserve care.

Concept Tested: Neurodiversity Bloom's Level: Understand

Question 5

Why might gut pain in some autistic children go unnoticed for a long time?

  1. Interoceptive and communication differences can make internal pain harder to notice or describe, so it may show up as changes in sleep or behavior.
  2. Autistic children cannot feel pain.
  3. GI problems never happen in autistic children.
  4. Doctors are not allowed to examine autistic children.
Show Answer

The correct answer is A. Many autistic people notice or interpret internal signals differently, and describing body sensations can be hard, so discomfort may appear as night waking, irritability, or pressing on the belly. Option B is false and harmful: the pain signals are real; the difference is in how they're noticed or expressed.

Concept Tested: Interoceptive Differences Bloom's Level: Understand

Question 6

How can selective eating help explain why autistic children's gut microbiomes differ on average from other children's?

  1. Selective eating directly changes a person's genes.
  2. Selective eating is caused by gut bacteria.
  3. A narrower diet feeds a narrower range of gut bacteria, so diet differences can create microbiome differences.
  4. Selective eating has no effect on the gut.
Show Answer

The correct answer is C. Autistic children on average have higher odds of feeding problems, and diet shapes the microbiome, so a less varied diet can mean less diverse gut bacteria. Option B reverses the arrow; the 2021 Yap study supported the chain from autism-related preferences to diet to microbiome, not microbes causing eating patterns.

Concept Tested: Selective Eating Bloom's Level: Understand

Question 7

A company says 10 children took its gut supplement for 6 weeks and their parents rated them as "much calmer." There was no comparison group. What is the biggest problem with this evidence?

  1. Six weeks is too long for any study.
  2. With only 10 children and no placebo group, the change could be due to chance or parents' expectations rather than the supplement.
  3. Parents are never allowed to rate their children.
  4. The supplement must have worked because most children improved.
Show Answer

The correct answer is B. A tiny sample swings easily by chance, and parents who know their child is taking a supplement may see what they expect. A placebo-controlled trial with many more children, where neither parents nor researchers know who got what, would be needed. Option D is the trap the company wants you to fall into.

Concept Tested: Sample Size Bloom's Level: Apply

Question 8

A website promises that its "gut detox program," with antibiotics, a restrictive diet, and homemade fecal transplants, will help children "recover from autism." Which concern from this chapter is MOST important?

  1. The program is probably too expensive, but otherwise fine.
  2. It should be tried first, since there's nothing to lose.
  3. The program is fine if it has many positive reviews.
  4. It's a harmful cure claim: it treats autism as a disease, lacks evidence, and uses risky interventions such as unsupervised fecal transplants and restrictive diets.
Show Answer

The correct answer is D. There's no evidence that any program cures autism, and the components carry real risks; the FDA reported in 2019 that a person died after a drug-resistant infection was passed on through an investigational fecal transplant. Restrictive diets can add to nutrient gaps in children who already eat a narrow range of foods. Option B is wrong because there is a lot to lose: safety, money, time, and a child's sense of being accepted.

Concept Tested: Harmful Cure Claims Bloom's Level: Apply

Question 9

In a study, autistic children have lower microbiome diversity than comparison children. After researchers account for diet variety, the difference nearly disappears; accounting for age changes almost nothing. What is the best interpretation?

  1. Diet variety is a confounder that explains most of the difference, while age is balanced between groups and isn't.
  2. Autism directly lowers microbiome diversity.
  3. Age is the main cause of the difference.
  4. Low microbiome diversity causes autism.
Show Answer

The correct answer is A. A confounder differs between groups and affects the outcome; when it's accounted for, the apparent group difference shrinks. Age affects diversity but is spread evenly across groups, so it can't explain the gap. This mirrors the 2021 Yap study. Option D reverses the direction and ignores the confounder.

Concept Tested: Diet as Confounder Bloom's Level: Analyze

Question 10

In the maternal immune activation (MIA) mouse study, a gut bacterium improved some "autism-like behaviors" in the offspring. Why doesn't this show that probiotics would help autistic people?

  1. Because the mice were too young
  2. Because the bacterium used was not a real bacterium
  3. Because no studies have ever been done in mice
  4. Because a lab-triggered mouse model with "autism-like behaviors" is not human autism, and mouse results often don't carry over to people
Show Answer

The correct answer is D. The MIA model triggers an immune response on purpose in pregnant mice, and the behaviors measured are only loose stand-ins for parts of human experience. Results in mice are reasons to ask questions, not evidence for treating people. Option C is simply false; this was itself a mouse study.

Concept Tested: Maternal Immune Activation Bloom's Level: Analyze