This is a genuinely interesting research direction and the article covers it fairly. A few things are worth knowing before sharing this with families or factoring it into clinical decisions.

The study enrolled 30 children with no control group — every participant received the active treatment, with no comparison group. This makes it impossible to separate any treatment effect from natural development over 30 weeks, from parents rating their child more positively after investing hope in an experimental procedure, or from the well-established statistical tendency of extreme scores to move toward the average over time (regression to the mean).

These are not minor issues; they are the reason controlled trials exist.

The word 'normal' in the results refers to a score crossing a threshold on a parent-completed questionnaire in an uncontrolled study. It does not indicate that a child's diagnosis changed or that they became neurotypical.

The abstract states the improvement was 'sustained at one year.' No one-year data are presented anywhere in the paper. I have filed a formal concern with the Frontiers Research Integrity team requesting clarification or correction.

The finding that children without GI disorders improved by 45% — likely the most-cited statistic in follow-up coverage — is based on eight children. That is not a finding that can bear the interpretive weight being placed on it.

None of this dismisses the research direction. The gut-brain axis is a legitimate area of inquiry and the signal here is worth investigating in a properly controlled trial. This study tells us that — and no more.

Families deserve to know the difference.

Respectfully,

Dr David Ruttenberg PhD, FRSA, FIoHE, AFHEA, HSRF  
Fulbright Specialist, Awardee 2024-2027
University College London, Honorary Senior Research Fellow