Re-imagining the physicians’ role in the assessment of feeding challenges in children with autism spectrum disorder

Smile, Sharon; Raffaele, C. Teal; Perlin, Rebecca

doi:10.1093/pch/pxaa008

Cited by 10 publications

(23 citation statements)

References 14 publications

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“…It concurs with a study that revealed the most mothers of children with ASD identified this as one of the feeding challenges [40]. Early identification of feeding challenges in ASD is necessary to minimise adverse health outcomes and strained parent-child relationships [41]. Difficulty with food textures due to the sensory problems thus affect food selectivity [42].…”

Section: Theme 3: Challenges In Introducing New Foodsupporting

confidence: 74%

Exploring Eating and Nutritional Challenges for Children with Autism Spectrum Disorder: Parents’ and Special Educators’ Perceptions

et al. 2020

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Autism spectrum disorder (ASD) is a complex neurodevelopmental disability that is frequently associated with food refusal, limited food repertoire and high-frequency single food intake mainly among children with ASD. Provision of nutrition can be very challenging due to the fact of these behavioural problems, either for the parents or special educators. Healthy nutrition is associated with providing and consuming nutritious food with results being in a good state of health. Semi-structured focus group discussions (FGDs) were conducted among 20 participants at a National Autism Centre to explore their understanding towards healthy nutrition. They were parents and special educators who were actively involved with children with ASD. A series of discussions were transcribed verbatim, and four researchers examined each transcript. Inductive analysis linking codes into main thematic categories was conducted using the constant comparison approach across the full data set. The outcome suggested that participants had limited knowledge relating to the proper dietary and nutritional needs of the children. The key messages from the discussion provide a foundation on the development of a nutrition education module which involves primary caretakers of children with ASD.

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Section: Theme 3: Challenges In Introducing New Foodsupporting

confidence: 74%

Exploring Eating and Nutritional Challenges for Children with Autism Spectrum Disorder: Parents’ and Special Educators’ Perceptions

et al. 2020

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“…Children with ASD and eating problems have complex combinations of medical, nutritional, feeding skills and/or psychosocial issues (Smile et al, 2020). Commonly used terms such as "picky eater", "food refusal" and "food selectivity" seem to imply that these are voluntary behaviours when they are very likely to appear because of unidentified medical, psychological and/or sensorimotor problems that make the process of eating challenging or painful (Williams et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…The literature outlines oro-motor difficulties in children with ASD (Nadon et al, 2013) and in children demonstrating oral aversions, avoidance or fear of eating (Goday et al, 2019). Difficulty progressing to challenging food textures, gagging, food loss, poor mouth clearance, swallowing issues or drooling may all be manifestations of poor oro-motor control (Smile et al, 2020;Sharp et al, 2013). In case such difficulties are noticed, assessment of the child's oral motor skills is vital.…”

Section: Oro-motor Abilitiesmentioning

confidence: 99%

Multidisciplinary approach to assessment and intervention of feeding problems in children with autism spectrum disorders: a clinical perspective

Beaudry‐Bellefeuille¹,

Pomoni

Welch³

et al. 2021

IJOT

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Purpose The aim of this paper is to share the details of a multidisciplinary approach, which includes occupational therapy, and to review the factors that should be considered in the evaluation and treatment of children with autism spectrum disorders (ASD) who are excessively selective in their food choices. Issues in this area are complex and often related to several complementary domains (medical, nutritional, psychosocial, sensorimotor, etc.). However, feeding disorders are frequently assessed and treated from a single discipline and important issues are missed or confounded. Design/methodology/approach A team of experienced clinicians in the field of paediatric feeding disorders gathered the knowledge and experience they acquired from working with individuals with ASD as well as with individuals with other neurodevelopmental diagnosis. A review of current literature in paediatric feeding disorders was used to document and explicate the multifactorial nature of feeding disorders in children with ASD and justify the need for a multidisciplinary approach to issues in this area. Findings Feeding disorders in children with ASD are linked to multiple sensory, motor, behavioural, nutritional and gastrointestinal comorbidities. A multidisciplinary approach is needed and increasingly recommended. However, multidisciplinary teams, specialised in the care of children with ASD and feeding issues, continue to be difficult to locate and access for families. The authors sought to highlight the signs of feeding problems in children with ASD from different domains and share a model of a multidisciplinary approach that can lead to more successful interventions. Originality/value The detailed description of the domains linked to feeding issues and the clinical descriptions provided throughout the paper create a roadmap for other clinicians aiming to set up similar teams.

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“…Sensory sensitivity and selective feeding in children with ASD predisposes them to nutritional inadequacy 13,14 . Children with ASD have been shown to have a preference for carbohydrates and aversion to fruits, whole grains, and vegetables 10 . Significant food selectivity (e.g.…”

Section: Dsm‐5 Diagnostic Criteria For Arfid Inclusion Criteria Exclusion Criteriamentioning

confidence: 99%

Avoidant/restrictive food intake disorder and autism spectrum disorder: clinical implications for assessment and management

Farag¹,

Sims²,

Strudwick³

et al. 2021

Develop Med Child Neuro

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Aim We examined clinical and neurodevelopmental presentations of children with avoidant/restrictive food intake disorder (ARFID) to inform clinical assessment and management. Method Five hundred and thirty‐six patients (mean age 6y 10mo, SD 3y 5mo, range 10mo–20y; 401 males, 135 females) seen by the tertiary multidisciplinary feeding service at the Evelina London Children’s Hospital between January 2013 and June 2019 were included in this case–control study. These children experienced significant feeding difficulties impacting nutrition, development, and psychosocial functioning requiring tertiary specialized input. Data on ARFID diagnosis, demographics, comorbidity, and nutrition was extracted from electronic patient records. Results Forty‐nine per cent of children met ARFID criteria. The remaining participants had other difficulties including feeding, medical, and/or neurodevelopmental conditions. ARFID is more prevalent among younger patients (4–9 years) and in children with comorbid autism spectrum disorder (ASD). Younger age, comorbid ASD, and male sex significantly predicted ARFID. Diet range and male sex significantly predicted nutritional inadequacy, while comorbid ASD did not. A trend was seen between younger age and nutritional inadequacy. Interpretation Young children with ARFID should raise suspicion for ASD. Although significant nutritional deficiencies are common in children with comorbid ARFID and ASD, they are correctable with nutritional supplementation. Specialty perspective potentially limits generalizability of findings to community feeding services. We also emphasize the importance of early identification of nutritional deficits and management.

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Re-imagining the physicians’ role in the assessment of feeding challenges in children with autism spectrum disorder

Cited by 10 publications

References 14 publications

Exploring Eating and Nutritional Challenges for Children with Autism Spectrum Disorder: Parents’ and Special Educators’ Perceptions

Exploring Eating and Nutritional Challenges for Children with Autism Spectrum Disorder: Parents’ and Special Educators’ Perceptions

Multidisciplinary approach to assessment and intervention of feeding problems in children with autism spectrum disorders: a clinical perspective

Avoidant/restrictive food intake disorder and autism spectrum disorder: clinical implications for assessment and management

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