A simple urine test might help identify children who are likely to have autism earlier than the best assessment tools now available, a new study says.
Autistic children appear to have specific gut microbe profiles that can be used to distinguish them from neurotypical (or typically developing) children, researchers reported May 26 in the journal Molecular Psychiatry.
A urine test based on these profiles correctly identified 90 percent of autistic children and did not misidentify any children without autism, researchers found.
“What’s really striking about the bacteria is that they make metabolites that are basically altered versions of serotonin and dopamine,” said researcher James Adams, a professor of engineering at the Biodesign Center for Health Through Microbiomes at Arizona State University (ASU) in Tempe.
“These are two key neurotransmitters that affect mood, cognition, and memory,” Adams said of serotonin and dopamine. “This could explain many of the symptoms and co-occurring symptoms in children with autism — their social communication, anxiety, depression, and attention.”
Metabolites are chemicals produced by microbes in the gut. For the new study, researchers measured the concentration of metabolites in 52 children diagnosed with autism and a control group of 47 children who were developing typically.
Nearly all autistic children had at least one metabolite level that exceeded the highest observed among the control group, with some levels measuring 100 to 1,000 times higher.
On average, autistic kids had about three elevated metabolites, while typically developing children had none, researchers said.
These included metabolites of tyrosine, tryptophan, and phenylalanine, which are amino acids involved in key neurotransmitter pathways, researchers said. Other compounds were connected to yeast and fungal activity in the gut.
“What we’ve discovered is that 80 to 90 percent of children with autism have extremely high levels of one or more microbially derived metabolites,” said lead researcher Christina Flynn, a recent doctoral graduate of ASU.
Using this information, researchers created a urine test that looks at 17 specific metabolites in children ages 2 to 11.
“Using this test will tell you which young children are at high risk for being diagnosed with autism, and guide treatment in those who have already been diagnosed to help them lead their best lives,” Flynn said in a news release.
Many families wait a long time to learn their child is autistic, given that current tests rely on observations of the child’s behavior. The earlier autism is diagnosed, the more quickly parents can support their child, researchers said.
“We hope there is a reduction in stigma and shame associated with the condition,” said Flynn, who is a parent of an autistic child.
“Sometimes diagnostic hesitancy happens because parents feel like they’re not good enough parents and they’re being judged,” she said. “But that’s not the case because if we can detect it in urine, it’s a biology-based condition. Hopefully, that will prevent any hesitancy on parents’ parts to seek treatment and seek it as early as possible.”
Further testing is needed to make sure the urine test works, researchers noted.
“For many families, one of the biggest challenges is the waiting — the not knowing,” Flynn said.
“If this test shortens that gap, even by a little, that’s meaningful because earlier intervention can really help.”
These results might do more than help identify kids who are autistic, as they show a potential target for treatment, researchers said. Therapies that influence gut microbes – such as fecal transplant — might help support them.
“We think reducing the levels of these metabolites may help these children lead healthier and happier lives, and we encourage children to be screened sooner to receive earlier interventions,” Adams said.
Autism spectrum disorder (ASD) affects children from all racial and ethnic backgrounds, but research suggests that Black children have historically faced delays in diagnosis compared to their white peers. Although awareness of autism has improved in recent years, barriers such as limited access to specialists, socioeconomic factors, and differences in how symptoms are recognized can still contribute to later identification.
Later diagnoses can mean delayed access to evidence-based interventions, school accommodations, and family support services. Because early intervention has been linked to improved developmental outcomes, identifying autism as early as possible remains a priority for pediatric providers.
Autism diagnosis currently relies largely on behavioral assessments, developmental screenings, caregiver observations, and clinical judgment. While these approaches remain essential, they can be influenced by differences in symptom presentation, cultural perceptions of behavior, and access to experienced specialists.
Some experts believe that biological markers could eventually complement traditional screening methods by providing additional objective data. A lab-based test may help reduce some of the variability that exists in the diagnostic process, particularly in communities where access to developmental specialists is limited.
However, experts caution that biomarkers should not replace comprehensive clinical evaluations. Autism is a complex neurodevelopmental condition, and any future diagnostic tool would likely be used alongside — not instead of — existing screening and assessment practices.
While the research is promising, clinicians should emphasize that the urine test remains investigational and is not currently part of standard autism screening or diagnostic guidelines.
Families should be advised to follow recommended developmental screening schedules and discuss any concerns about social, communication, or behavioral development with their child’s healthcare provider. When developmental concerns are identified, early referral for further evaluation and intervention remains the recommended course of action.
Clinicians can also remind families that an ASD diagnosis is not required to begin many supportive services. Early intervention may help children access resources that support their developmental progress while a formal evaluation is underway.
The study’s findings should be interpreted cautiously. The research included a relatively small number of participants, and larger studies will be needed to determine whether the test performs consistently across broader populations.
Future research will need to include children from diverse backgrounds to ensure that any biomarker-based screening tool is accurate and equitable for all patients.
For providers focused on health equity, demonstrating effectiveness across diverse populations will be a critical step before such a test can be considered for widespread clinical use.
While the urine test remains investigational, it underscores a growing effort to develop objective autism screening tools. If future studies confirm its accuracy across diverse populations, such tests could help clinicians identify developmental concerns sooner and potentially narrow longstanding disparities in autism diagnosis and care for Black children.
More information
The Autism Self-Advocacy Network has more on autism.
SOURCE: Arizona State University, news release, May 26, 2026
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