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Tengilimoglu-Metin MM, Kabasakal-Cetin A. Effect of maternal eating behaviors and attitudes towards the feeding process on feeding problems of pre-school age children. Clin Nutr ESPEN 2024; 61:224-229. [PMID: 38777438 DOI: 10.1016/j.clnesp.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/12/2024] [Accepted: 03/29/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND & AIMS Feeding problems in pre-school children are common and negative maternal feeding practices may even worsen the child's problematic eating behavior. Therefore, investigating the effects of maternal eating behaviors and attitudes towards the feeding process on pre-school children's feeding problems may be helpful for preventing feeding problems. This study sought to investigate the effects of maternal eating behaviors and attitudes towards the feeding process on feeding problems of pre-school children. METHODS Mothers of 373 children aged 3-6 were included in this cross-sectional study and data was collected by an online questionnaire including the scales of three-factor eating questionnaire (TFEQ), mother's attitudes towards the feeding process (MATFPS) and behavioral pediatric feeding assessment (BPFAS), as well as demographics and anthropometric measures (height and weight). Spearman's rho test was used to calculate correlation coefficients between the TFEQ, MATFP and BPFA scales. In order to identify independent predictors of child feeding behaviors, a multiple linear regression model was used. RESULTS Results showed that uncontrolled eating subscale was positively (r = 0.160, p < 0.001) and cognitive restriction subscale negatively (r = -0.126, p < 0.05) correlated with MATFP. MATFP was also positively correlated with BPFA (r = 0.368, p < 0.001). Regression analysis indicated that BPFA was significantly predicted by MATFP which was the most important contributor of child feeding problems (β = 0.24, t = 4.88, p < 0.001). CONCLUSIONS This study indicated that maternal eating behaviors were related to maternal attitudes towards the feeding process and, mothers' attitudes were associated with feeding problems of their pre-school children.
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Affiliation(s)
- M Merve Tengilimoglu-Metin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100, Sihhiye, Anakara, Turkey.
| | - Arzu Kabasakal-Cetin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100, Sihhiye, Anakara, Turkey.
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Wenzell ML, Pulver SL, McMahon MXH, Rubio EK, Gillespie S, Berry RC, Betancourt I, Minter B, Schneider O, Yarasani C, Rogers D, Scahill L, Volkert V, Sharp WG. Clinical Correlates and Prevalence of Food Selectivity in Children with Autism Spectrum Disorder. J Pediatr 2024:114004. [PMID: 38447756 DOI: 10.1016/j.jpeds.2024.114004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/11/2024] [Accepted: 02/27/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE To examine clinical correlates and prevalence of food selectivity (FS) - i.e., self-restricted diet, reluctance to try new foods - in children with autism spectrum disorder (ASD) ascertained from a general outpatient autism clinic. STUDY DESIGN A multidisciplinary team (pediatric nurse practitioner, psychologist and dietitian) assessed medical and psychosocial histories and dietary habits in 103 children with ASD (mean age= 5.8 + 2.2 years; range 2-10). Parents rated child mealtime behavior on Brief Autism Mealtime Behavior Inventory (BAMBI) and disruptive behavior on Aberrant Behavior Checklist (ABC). Height and weight measurements were collected. Children were classified as FS or no FS based on parent reported intake and mealtime behavior. A 24-hour dietary recall was used to record intake percentages < 80%. Logistic regression and multivariable modeling were used to evaluate clinical correlates with FS. RESULTS Of 103 children, 45.6% (n=47) were classified as FS; 54.4% (n=56) no FS. After adjusting for potential confounders, the odds of FS increased by 1.91 (95% CI: 1.38, 2.64, p<.001) for every half-SD increase in BAMBI total score and by 1.35 (95% CI: 1.05, 1.74, p=.020) for every half-SD increase in ABC Hyperactivity/Noncompliance. No group differences in anthropometrics or nutritional intake were identified. CONCLUSIONS FS in children with ASD was strongly associated with greater severity of disruptive mealtime and hyperactivity/noncompliance behaviors. FS was not associated with anthropometrics or nutritional intake.
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Affiliation(s)
- Megan L Wenzell
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033.
| | - Stormi L Pulver
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
| | - Meara X H McMahon
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
| | - Emily Kate Rubio
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
| | - Scott Gillespie
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
| | - Rashelle C Berry
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
| | - Ivanna Betancourt
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
| | - Bonnie Minter
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
| | - Olivia Schneider
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
| | - Chitra Yarasani
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
| | - Destinee Rogers
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
| | - Lawrence Scahill
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
| | - Valerie Volkert
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
| | - William G Sharp
- Emory University School of Medicine, Marcus Autism Center, Children's Healthcare of Atlanta, 1920 Briarcliff Rd. NE, Atlanta, GA 30033
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Gentles SJ, Ng-Cordell EC, Hunsche MC, McVey AJ, Bednar ED, DeGroote MG, Chen YJ, Duku E, Kerns CM, Banfield L, Szatmari P, Georgiades S. Trajectory research in children with an autism diagnosis: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:540-564. [PMID: 37194194 PMCID: PMC10913344 DOI: 10.1177/13623613231170280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
LAY ABSTRACT The types of outcomes studied in children on the autism spectrum include clinical characteristics, such as social functioning, communication, language, or autism symptoms. Research that measures these outcomes at multiple timepoints is useful to improve our understanding of what to expect as children develop. In trajectory studies, researchers assess outcomes at three or more timepoints. This method has advantages over two-timepoint studies because it allows researchers to describe changes in the speed of development, such as accelerations, plateaus, or slowdowns. We identified and reviewed 103 published trajectory studies in children (to age 18 years) with an autism diagnosis. Importantly, we did not include studies of treatments or their effects, nor did we summarize the results of studies. Instead, this review summarizes the characteristics of the available published research, including the methods used, the many different outcomes that have been studied over time and the ages over which they have been studied. This summary may be of interest to autistic people and caregivers (parents) who want to know about the existence of research that provides answers about what to expect during an autistic child's development. We have recommended that future trajectory research efforts try to make up for the lack of studies from low- and middle-income countries; that more attention is given to the following outcomes that are meaningful to caregivers and autistic people; and to try to fill in the age gaps where more outcome-specific data are needed.
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St John BM, Ausderau KK. The characterization of feeding challenges in autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241227518. [PMID: 38305224 DOI: 10.1177/13623613241227518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
LAY ABSTRACT Feeding challenges are common for autistic children. Currently, research and intervention for feeding challenges focuses on single factors (e.g. behavior or sensory). Research is needed to understand the complexity of feeding challenges. This study provides a comprehensive description of feeding challenges. Furthermore, this study identifies what factors predict the severity and type of feeding challenges experienced by autistic children. Using the Survey for Characterization of Feeding Challenges in Autistic Children-United States, 427 caregivers of autistic children provided information about their child's feeding challenges. Children were between the ages of 2 and 12 with an average age of 8.42 years. Children in the study had a wide variety of feeding difficulties including challenges in early childhood, sensory challenges, difficulty with family mealtime, and variable self-help skills. On average children's feeding challenges were present prior to their autism diagnosis. We found that children who had early feeding challenges had more severe feeding challenges in later childhood. Also, specific early feeding challenges predicted the types of feeding challenges children would have later in childhood. For example, children who had difficulty transitioning to table foods and who continued to restrict their diet over time were more likely to have sensory-based feeding challenges. Results from this study show how feeding challenges present in a wide variety of ways for autistic children. The findings also highlight the importance of screening for feeding challenges in early childhood and collaborating with families to understand individualized feeding challenge experiences. These results could be used to inform evaluation and intervention for feeding.
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Gent V, Marshall J, Weir KA, Trembath D. Investigating the impact of autistic children's feeding difficulties on caregivers. Child Care Health Dev 2024; 50:e13218. [PMID: 38265139 DOI: 10.1111/cch.13218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 01/25/2024]
Abstract
AIM The aim of this study was to investigate the influence of children's autism characteristics, sensory profiles and feeding difficulties on caregiver-reported impact at mealtimes. BACKGROUND Caregivers of children (5-12 years) with a diagnosis of Autism Spectrum Disorder completed an online survey examining (a) demographic characteristics, (b) children's autism characteristics (Social Communication Questionnaire), (c) sensory profiles (Sensory Profile 2-short form), (d) feeding difficulties (Behavioural Paediatrics Feeding Assessment Scale, BPFAS) and (c) caregiver-reported impact of feeding difficulties (Feeding-Swallowing Impact Survey, FS-IS). RESULTS Seventy-eight caregivers completed surveys for 80 children. Children with clinically significant feeding difficulties on the BPFAS (n = 55, 68.8%) had higher levels of caregiver-reported impact on daily activities, worry and feeding difficulties compared to children without clinically significant feeding difficulties (FS-IS; U = 257.000, z = -4.471, p < 0.01). Spearman's rank correlation showed a statistically significant, moderate correlation between BPFAS total frequency score and FS-IS Daily activities score, rs (98) = 0.56, p < 0.01, indicating that as the frequency of feeding difficulties increased, the impact of these feeding difficulties on caregivers also increased. Using multiple regression, a model comprising of the three factors was statistically significant (F[1, 78] = 87.75, p < 0.001, adj. R2 = 0.52), with children's frequency of feeding difficulties the strongest predictor of caregiver-reported impact with a moderate effect size (r = 0.49). CONCLUSION Autistic children's feeding difficulties had a greater impact on caregivers than autism or sensory profiles, with the frequency of feeding difficulties and the caregiver impact of these feeding difficulties positively correlated. The findings demonstrate that efforts to understand and address feeding difficulties in autistic children must extend beyond the children to include their families.
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Affiliation(s)
| | - Jeanne Marshall
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Kelly A Weir
- The Royal Children's Hospital Parkville, Melbourne, Australia
- School of Health Sciences, The University of Melbourne, Parkville, Melbourne, Australia
- School of Health Sciences & Social Work, Griffith University, Southport, Australia
| | - David Trembath
- Menzies Health Institute Queensland, Griffith University, Southport, Australia
- CliniKids, Telethon Kids Institute, Subiaco, Australia
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Panerai S, Catania V, Ingoglia S, Ruccella D, Ferri R, Zingale M, Fasciana D, Elia M. Eating and Sensory Features of Children With Autism Spectrum Disorder and Their Typically Developing Peers. Am J Occup Ther 2023; 77:7706205040. [PMID: 38018651 DOI: 10.5014/ajot.2023.050226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Abstract
IMPORTANCE Impaired sensory processing is associated with eating problems. There seem to be no previous studies that compare those who have autism spectrum disorder (ASD) with eating problems (ASD-W) and those with ASD without eating problems (ASD-WO) with typically developing (TD) groups. Comparisons are expected to provide further knowledge to guide the intervention programs. OBJECTIVE To investigate differences among ASD-W, ASD-WO, and TD groups in eating and sensory features; to detect associations between sensory and eating behaviors and any most involved sensory dimensions; and to search for age-related differences in sensory and eating features in ASD. DESIGN Nonrandomized comparison study. SETTING Questionnaires administered as parent interviews. PARTICIPANTS A total of 165 children were recruited: 117 with ASD and 48 TD children. OUTCOMES AND MEASURES Standardized questionnaires: the Brief Autism Mealtime Behaviors Inventory for eating problems; the Short Sensory Profile and the Sensory Experience Questionnaire for sensory problems. RESULTS The ASD-W group showed generalized, impaired eating behaviors and turned out to be the most impaired with regard to sensory responsiveness. No differences in feeding behaviors were found between the ASD-WO and TD groups. All children with ASD showed sensory hyper- or hyporesponsiveness. Four main sensory dimensions were found to be associated with eating behaviors in ASD. No age differences were found in the eating and sensory behaviors of children with ASD. CONCLUSIONS AND RELEVANCE Differing eating and sensory profiles were found between the ASD and TD groups, especially in children with ASD-W. Early eating interventions using sensory stimulations are strongly recommended. What This Article Adds: This study reports novel information derived from the comparisons of children with ASD with eating problems and those with ASD without eating problems with typically developing groups of children.
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Affiliation(s)
- Simonetta Panerai
- Simonetta Panerai, PsyD, is Head Psychologist, Unit of Psychology, Department of Brain Aging, Oasi Research Institute, IRCCS, Troina, Italy;
| | - Valentina Catania
- Valentina Catania, PsyD, is Psychologist, Unit of Psychology, Department of Brain Aging, Oasi Research Institute, IRCCS, Troina, Italy
| | - Sonia Ingoglia
- Sonia Ingoglia, PsyD, is Full Professor, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Daniela Ruccella
- Daniela Ruccella, PsyD, is Psychologist, Psychoeducational Service for Children with Autism and Intellectual Disability, Società Cooperativa Sociale "I Corrieri dell'Oasi," Troina, Italy
| | - Raffaele Ferri
- Raffaele Ferri, MD, is Scientific Director, Oasi Research Institute, IRCCS, Troina, Italy
| | - Marinella Zingale
- Marinella Zingale, PsyD, is Psychologist, Unit of Psychology, Department of Mental Retardation, Oasi Research Institute, IRCCS, Troina, Italy
| | - Daniela Fasciana
- Daniela Fasciana, PsyD, is Coordinator Psychologist, Center for Diagnosis and Early Intensive Treatment of Autism Spectrum Disorder, Local Health Authority, Caltanissetta, Italy
| | - Maurizio Elia
- Maurizio Elia, MD, is Director, Unit of Neurology and Neurophysiology, Oasi Research Institute, IRCCS, Troina, Italy
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Adams D, Dargue N, Paynter J. Longitudinal studies of challenging behaviours in autistic children and adults: A systematic review and meta-analysis. Clin Psychol Rev 2023; 104:102320. [PMID: 37515997 DOI: 10.1016/j.cpr.2023.102320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 02/23/2023] [Accepted: 07/12/2023] [Indexed: 07/31/2023]
Abstract
Autistic children and adults are at increased risk of showing behaviours that may be described as challenging, however, little is known about whether or how these behaviours may change over time. Given the profound impact that challenging behaviour can have on both the autistic individual and their support network, it is critical that the trajectory of challenging behaviours be better understood. This systematic review and meta-analysis identified and synthesised observational longitudinal studies of challenging behaviour in autistic individuals. Fifty-six studies were included in the systematic review, and the effect sizes of 37 independent samples arising from 34 of these reports were examined through meta-analysis. Crucially, across the 37 samples, scores on the measures of challenging behaviour reduced by a small, yet significant, extent over time. Although age of the sample at baseline assessment did not moderate the effect, the time between the baseline assessment and final follow-up and age at final follow-up both moderated the magnitude of the effect, with challenging behaviour scores reducing to a larger extent in (a) studies with longer intervals between baseline and final follow-up and (b) studies with older samples at follow-up. The results from the current systematic review and meta-analysis have both theoretical and practical implications for understanding challenging behaviour over time in autistic individuals. Avenues for future research are also highlighted that may allow better understanding, and therefore support of, challenging behaviour in autistic individuals.
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Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia.
| | - Nicole Dargue
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia
| | - Jessica Paynter
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; School of Applied Psychology and Hopkins Centre, Griffith University, Gold Coast, QLD 4222, Australia
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Assessment of Feeding Behaviors and Parents' Frustrations of Children with Autism Spectrum Disorder in Lebanon: A Case-Control Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010117. [PMID: 36670667 PMCID: PMC9856887 DOI: 10.3390/children10010117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023]
Abstract
Children with autism spectrum disorder (ASD) exhibit restrictive and repetitive behaviors that affect their eating habits. The purpose of this study is to identify the behavioral feeding problems and eating habits among ASD children compared to typically developed (TD) children age/gender-matched controls, along with their parents'/caregivers' strategies for dealing with them. It included 43 ASD children and 43 TD children aged two to eleven years. The analysis was performed based on two valid questionnaires: the Behavior Pediatrics Feeding Assessment Scale (BPFA) and "My Child Eating Habits" (MCEH). The BPFA and MCEH scores conceded three manifestations that fall into food selectivity and problematic mealtime behavior in both groups of children. Compared to TD children, children with ASD exhibited higher BPFA scores, which indicated food-related behavioral and skill-based problems (p = 0.004). Children with ASD were less likely to consume fruits, vegetables, and milk than TD children, which may lead to nutritional deficiencies (p = 0.003, p = 0.003, and p = 0.010, respectively). Parents of ASD children were concerned about their behavioral problems and expressed their intention of an early intervention. These findings highlight the importance of nutritional clinical routines that incorporate the evaluation of the nutritional status and feeding behaviors of ASD children.
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Ahumada D, Guzmán B, Rebolledo S, Opazo K, Marileo L, Parra-Soto S, Viscardi S. Eating Patterns in Children with Autism Spectrum Disorder. Healthcare (Basel) 2022; 10:healthcare10101829. [PMID: 36292276 PMCID: PMC9601475 DOI: 10.3390/healthcare10101829] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 12/04/2022] Open
Abstract
The purpose of this research was to analyze the eating patterns of preschool- and school-aged children with ASD, as provided by their families, in the La Araucanía Region of Chile. It involved a cross-sectional study with 72 families with children diagnosed with ASD aged between 2 and 12 years old. Food selectivity, appetite, body mass index (BMI) and frequency of food consumption were studied. The research determined that 97.67% present food selectivity, corresponding to alterations in the frequency of consumption of specific food groups. Moreover, 93.06%, 90.28%, 80.56% and 62.50% of children in the study do not meet the daily recommendations for fruit, fish, water and vegetable consumption, respectively. Therefore, it is important for these findings to be considered when designing and carrying out educational interventions regarding food in families with children with ASD for greater assertiveness and effectiveness in improving health.
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Affiliation(s)
- Danay Ahumada
- Carrera de Nutrición y Dietética, Departamento de Procesos Diagnóstico y Evaluación, Facultad de Ciencias de la Salud, Campus San Francisco, Universidad Católica de Temuco, Temuco 4813302, Chile
- Programa de Magister en Epidemiología Clínica, Facultad de Medicina, Universidad de la Frontera, Temuco 4813115, Chile
| | - Barbara Guzmán
- Carrera de Nutrición y Dietética, Departamento de Procesos Diagnóstico y Evaluación, Facultad de Ciencias de la Salud, Campus San Francisco, Universidad Católica de Temuco, Temuco 4813302, Chile
| | - Soledad Rebolledo
- Carrera de Nutrición y Dietética, Departamento de Procesos Diagnóstico y Evaluación, Facultad de Ciencias de la Salud, Campus San Francisco, Universidad Católica de Temuco, Temuco 4813302, Chile
| | - Karol Opazo
- Carrera de Nutrición y Dietética, Departamento de Procesos Diagnóstico y Evaluación, Facultad de Ciencias de la Salud, Campus San Francisco, Universidad Católica de Temuco, Temuco 4813302, Chile
| | - Luis Marileo
- Programa de Doctorado en Ciencias Agropecuarias, Facultad de Recursos Naturales, Universidad Católica de Temuco, Temuco 4813302, Chile
- Biotechnology of Functional Foods Laboratory, Camino Sanquilco, Padre Las Casas 4850827, Chile
| | - Solange Parra-Soto
- School of Health & Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
- Departamento de Nutrición y Salud Publica, Universidad del Bio-Bio, Chillan 3780000, Chile
| | - Sharon Viscardi
- Biotechnology of Functional Foods Laboratory, Camino Sanquilco, Padre Las Casas 4850827, Chile
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnóstico y Evaluación, Facultad de Ciencias de la Salud, Campus San Francisco, Universidad Católica de Temuco, Temuco 4813302, Chile
- Núcleo de Investigación en Producción Alimentaria, Universidad Católica de Temuco, Temuco 4813302, Chile
- Correspondence:
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Crippa A, Colombo P, De Cosmi V, Mazzocchi A, Scaglioni S, Spolidoro GCI, Bettocchi S, D’Oria V, Viganò N, Mani E, Molteni M, Agostoni C. Understanding feeding problems in autistic children: Exploring the interplay between internalizing symptoms and sensory features. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:2165-2174. [DOI: 10.1177/13623613221080227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Feeding/behavior problems are highly prevalent in autistic children. This study aimed to explore the interplay between autistic features, sensory processing patterns, emotional/behavioral difficulties, and feeding problems in children with a clinical diagnosis of autism spectrum disorder. Ninety-nine children aged 1.5–5 years were assessed using the Children’s Eating Behavior Inventory (CEBI), the Child Behavior Checklist, the Revised Sensory Profile—Second Edition (SP-2), and the Food Frequency Questionnaire. The sample was divided into two subgroups based on the presence of feeding behavior problems as rated by parents on the CEBI. Children with feeding problems showed more severe internalizing symptoms and were more reactive to sensory stimuli than children without feeding problems. We also found a significant relationship between higher levels of autistic features and greater feeding behavior problems. A mediation analysis model indicated that this relationship was mediated by sensory processing, as reflected by SP-2 quadrants scores. Although preliminary, these findings suggest that children with higher levels of autistic features could be at greater risk of developing feeding behavior problems only if they also have a higher sensory sensitivity to environmental stimuli. Lay abstract This study adds to a growing body of research documenting feeding problems in autistic children. Our results indicate that children aged 1.5–5 years with feeding problems may present with elevated internalizing difficulties and alterations in sensory processing when compared to same-age children without feeding problems. Our study also proposes that sensory processing may be an important, mediating factor in the relationship between autism features and feeding problems. The present work suggests, therefore, that implementers should thoroughly consider the sensory profile of autistic children prior to intervening on feeding behaviors. In particular, based on these preliminary findings, feeding interventions could benefit from environments designed to support children who can find them noisy and overwhelming.
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Affiliation(s)
| | | | | | | | - Silvia Scaglioni
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Italy
| | | | - Silvia Bettocchi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Italy
| | - Veronica D’Oria
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Italy
| | | | | | | | - Carlo Agostoni
- University of Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Italy
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Fujino H, Ikeda Y. Dealing with food selectivity and mealtime behaviour in school-children with autism: a qualitative study of special education teachers in Japan. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 69:860-868. [PMID: 37885840 PMCID: PMC10599203 DOI: 10.1080/20473869.2022.2028419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/10/2022] [Indexed: 10/28/2023]
Abstract
Food selectivity in children with autism spectrum disorder (ASD) is a serious issue in special needs schools, and special education teachers face various difficulties in their management of the problem. The aim of this study is to investigate the difficulties that special education teachers face in managing food selectivity in children with ASD. Data were obtained from 12 special education teachers in 2018 via semi-structured in-depth interviews. Thematic analysis was used to identify key conceptions of the participants' experiences, while qualitative analysis of the interview data revealed three major themes. Their personal and professional thoughts and hopes regarding eating habits in children, feelings of uncertainty about their practice, and their interactions with the children and their parents were the key factors behind the difficulties they experience as special education teachers. The findings improve our understanding of the challenges experienced by teachers managing food selectivity in children with ASD. A different conceptualisation of the problem may lead to difficulties in collaboration among the people who are tasked with solving the problem.
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Affiliation(s)
- Haruo Fujino
- Department of Child Development, United Graduate School of Child Development, Osaka University, Suita, Japan
- Department of Special Needs Education, Oita University, Oita, Japan
| | - Yukiko Ikeda
- Department of Special Needs Education, Oita University, Oita, Japan
- Nagasaki Prefectural Kakunan Special Needs School, Nagasaki, Japan
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12
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Deep learning-based school attendance prediction for autistic students. Sci Rep 2022; 12:1431. [PMID: 35082310 PMCID: PMC8791997 DOI: 10.1038/s41598-022-05258-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/07/2022] [Indexed: 12/31/2022] Open
Abstract
Autism Spectrum Disorder is a neurodevelopmental disorder characterized by deficits in social communication and interaction as well as the presence of repetitive, restricted patterns of behavior, interests, or activities. Many autistic students experience difficulty with daily functioning at school and home. Given these difficulties,
regular school attendance is a primary source for autistic students to receive an appropriate range of needed educational and therapeutic interventions. Moreover, school absenteeism (SA) is associated with negative consequences such as school drop-out. Therefore, early SA prediction would help school districts to intervene properly to ameliorate this issue. Due to its heterogeneity, autistic students show within-group differences concerning their SA. A comprehensive statistical analysis performed by the authors shows that the individual and demographic characteristics of the targeted population are not predictive factors of SA. So, we used the students’ recent previous attendance to predict their future attendance. We introduce a deep learning-based framework for predicting short-and long-term SA of autistic students using the Long Short-Term Memory (LSTM) and Multilayer Perceptron (MLP) algorithms. The adopted algorithms outperform other machine learning algorithms. In detail, LSTM increased the accuracy and recall of short-term SA prediction by 20% and 13%, while the same scores of long-term SA prediction increased by 5% using MLP.
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Nygren G, Linnsand P, Hermansson J, Dinkler L, Johansson M, Gillberg C. Feeding Problems Including Avoidant Restrictive Food Intake Disorder in Young Children With Autism Spectrum Disorder in a Multiethnic Population. Front Pediatr 2021; 9:780680. [PMID: 34966704 PMCID: PMC8710696 DOI: 10.3389/fped.2021.780680] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/19/2021] [Indexed: 11/13/2022] Open
Abstract
We examined feeding problems, including Avoidant Restrictive Food Intake Disorder (ARFID), in preschool children with Autism Spectrum Disorder (ASD). Data were collected from a prospective longitudinal study of 46 children with ASD in a multiethnic, low resource area in Gothenburg, Sweden. Feeding problems were found in 76% of the children with ASD, and in 28%, the criteria for ARFID were met. The study highlights early onset age, the heterogeneity of feeding problems, and the need for multidisciplinary assessments in ASD as well as in feeding problems, and also the need for further elaboration of feeding disorder classifications in children.
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Affiliation(s)
- Gudrun Nygren
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child and Adolescent Specialist Centre, SV Hospital Group, Gothenburg, Sweden
| | - Petra Linnsand
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child and Adolescent Specialist Centre, SV Hospital Group, Gothenburg, Sweden
| | - Jonas Hermansson
- Child and Adolescent Specialist Centre, SV Hospital Group, Gothenburg, Sweden
| | - Lisa Dinkler
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Johansson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child and Adolescent Specialist Centre, SV Hospital Group, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Molina-López J, Leiva-García B, Planells E, Planells P. Food selectivity, nutritional inadequacies, and mealtime behavioral problems in children with autism spectrum disorder compared to neurotypical children. Int J Eat Disord 2021; 54:2155-2166. [PMID: 34704615 DOI: 10.1002/eat.23631] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate body composition, nutritional status through food selectivity and degree of inadequate intake, and mealtime behavior in children with autism spectrum disorder (ASD) compared to neurotypical children. METHOD A cross-sectional case-control study was carried out in 144 children (N = 55 with ASD; N = 91 with neurotypical children) between 6 and 18 years of age. Body composition, nutritional intake, food consumption frequency (FFQ), and mealtime behavior were evaluated. RESULTS Results showed a greater presence of children with a low weight (18.4% ASD vs. 3.20% comparison group) and obesity (16.3% ASD vs. 8.6% comparison group) in the ASD group for body mass index (BMI) categories (p = .003; number needed to take [NNT] = 8.07). The presence of obesity in ASD children compared to the comparison group was even higher when considering the fat component (47.5% ASD vs. 19.4% comparison group, p = .002; NNT = 10.3). ASD children had greater intake inadequacy (50% ASD vs. 22% comparison group, p = .014; NNT = 3.58), high food selectivity by FFQ (60.6% ASD vs. 37.9% comparison group, p < .037; NNT = 4.41), and more eating problems (food rejection, limited variety, disruptive behavior), compared to neurotypical children (p = .001). CONCLUSION Children with ASD showed an unbalanced body composition toward both underweight and obesity, a greater degree of inadequate intake, high food selectivity as indicated by their consumption frequency, and more disturbed eating behavior than children with neurotypical development. We suggest monitoring nutritional inadequacies and implementing nutritional strategies to expand the variety of foods children with ASD consume.
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Affiliation(s)
- Jorge Molina-López
- Faculty of Education, Psychology and Sport Sciences, University of Huelva, Huelva, Spain.,Institute of Nutrition and Food Technology. Biomedical Research Center, Health Sciences Technological Park, University of Granada, Granada, Spain
| | | | - Elena Planells
- Institute of Nutrition and Food Technology. Biomedical Research Center, Health Sciences Technological Park, University of Granada, Granada, Spain.,Department of Physiology, Faculty of Pharmacy, University of Granada, Granada, Spain
| | - Paloma Planells
- Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
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15
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Eating Behaviors of Children with Autism-Pilot Study, Part II. Nutrients 2021; 13:nu13113850. [PMID: 34836104 PMCID: PMC8620859 DOI: 10.3390/nu13113850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 12/24/2022] Open
Abstract
Autism spectrum disorder is characterized by social communication deficit and non-normative behavior. The people with autism often experience troubles with feeding. The purpose of this study was to conduct evaluation of the feeding and eating behaviors among children with autism. Patients and Methods: The study group included 41 high-functioning autistic children. The control group consisted of 34 children without the ASD. The questionnaire was used to assess the nutritional status. Results: The children with ASD fuss during mealtimes more frequently, they require entertaining and diverting their attention, they are fed by parents, and they consume their meals away from the table. The significant difference found in the use of utensils and food selectivity works to the disadvantage of the Study Group. Conclusions: The food selectivity occurs significantly more frequently among children with ASD. The feeding and eating problems should be considered on a wider scale. The cooperation of the multidisciplinary and the parents teams should be proposed in the ASD patients care.
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17
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Baraskewich J, von Ranson KM, McCrimmon A, McMorris CA. Feeding and eating problems in children and adolescents with autism: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1505-1519. [PMID: 33653157 PMCID: PMC8323334 DOI: 10.1177/1362361321995631] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
LAY ABSTRACT Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other, broader difficulties with feeding and eating (eating disorder symptoms such as restricting food intake or preoccupation with body shape or weight and insistence on specific food presentation) are also common in autistic individuals. Here, we describe the nature and extent of feeding and eating problems in youth with autism. We found no common characteristics (such as severity of autism symptoms) that best describe autistic youth who experience problems with feeding or eating. Almost all studies we reviewed focused on problems with feeding (selective or picky eating), and only a few studies focused on eating disorder symptoms (concern with weight, shape, and/or body image). However, some researchers reported that eating disorder symptoms may occur more often in autistic individuals compared to their peers without autism. Many studies used the terms "feeding" and "eating" problems interchangeably, but understanding the difference between these problems is important for researchers to be consistent, as well as for proper identification and treatment. We suggest future researchers use "eating problems" when behaviors involve preoccupation with food, eating, or body image, and "feeding problems" when this preoccupation is absent. We highlight the importance of understanding whether feeding or eating problems are separate from autism traits, and the role of caregivers and other adults in the child's treatment. Considerations for health-care providers to assist with diagnosis and treatment are also provided.
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Affiliation(s)
- Jessica Baraskewich
- University of Calgary, Canada
- Alberta Children's Hospital Research Institute, Canada
| | - Kristin M von Ranson
- University of Calgary, Canada
- Alberta Children's Hospital Research Institute, Canada
| | - Adam McCrimmon
- University of Calgary, Canada
- Alberta Children's Hospital Research Institute, Canada
| | - Carly A McMorris
- University of Calgary, Canada
- Alberta Children's Hospital Research Institute, Canada
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18
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Do Atypical Food Preferences in Children with Autism Differ by Severity? Indian J Pediatr 2021; 88:307. [PMID: 33078285 DOI: 10.1007/s12098-020-03534-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/07/2020] [Indexed: 10/23/2022]
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Chen X, Liu H, Wu Y, Xuan K, Zhao T, Sun Y. Characteristics of sleep architecture in autism spectrum disorders: A meta-analysis based on polysomnographic research. Psychiatry Res 2021; 296:113677. [PMID: 33385781 DOI: 10.1016/j.psychres.2020.113677] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 12/22/2020] [Indexed: 01/11/2023]
Abstract
Eleven parameters recorded by polysomnography were used to evaluate the differences in sleep structure between individuals with autism spectrum disorders (ASDs) and typically developed individuals (TDs). Four databases (PubMed, Web of Science, Cochrane Library, and China National Knowledge Infrastructure (CNKI)) were searched for potentially relevant literature published before July 14, 2019. Data extraction was performed by two independent assessors. The Cohen's d effect sizes and their 95% confidence intervals (CIs) were calculated to assess the effectiveness with the random-effects model. The heterogeneity was estimated by Cochran's Q test. The research yielded 14 case-control studies, 11 of which were included in this meta-analysis. Synthesis of the differences in 11 sleep parameters between individuals with ASDs and TDs demonstrated the pooled effect size of Cohen'd was -0.52 (95% CI: (-0.97, -0.08)) for total sleep time (TST), -0.69 (95% CI: (-1.27, -0.11)) for sleep efficiency (SE%) and 0.93 (95% CI: (0.37, 1.48)) for stage 1 sleep (S1%), respectively. Our findings suggested that compared with TDs, individuals with ASDs tend to have a decreased TST and SE% and an increased S1%. Differences of characteristics of sleep architecture in other sleep parameters between individuals with ASDs and TDs were not found in this study.
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Affiliation(s)
- Xin Chen
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Yile Wu
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Kun Xuan
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Tianming Zhao
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, PR China.
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Waltereit J, Czieschnek C, Albertowski K, Roessner V, Waltereit R. Family and Developmental History of Individuals With Autism Spectrum Disorder: Importance of the Clinical Diagnostic Interview for Diagnosis in Adolescents. An Explorative Study. Front Psychiatry 2021; 12:703023. [PMID: 34764892 PMCID: PMC8575716 DOI: 10.3389/fpsyt.2021.703023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/20/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Diagnosis of autism spectrum disorder (ASD) can be made early in childhood, but also later in adolescence or adulthood. In the latter cases, concerns about an individual's behavior typically lead to consultation of a mental health professional (MHP). As part of the initial clinical examination by the MHP, a clinical diagnostic interview is performed, in order to obtain the patient's history, and may lead to the hypothesis of ASD. We were here interested to study family and developmental history as key parts of the patient's history. The aim of the study was to investigate empirical differences between adolescents with ASD and adolescent control persons in family and developmental history. Method: Clinical diagnostic interview items addressing family and developmental history were adopted from their regular use at several university hospitals and in leading textbooks. Parents of male adolescents with normal intelligence and an ASD diagnosis (n = 67) and parents of male adolescents without psychiatric diagnosis (n = 51) between the age of 12 and 17 years were investigated. Data were operationalized into three categories: 0 = normal behavior, 1 = minor pathological behavior, and 2 = major pathological behavior. Differences were analyzed by multiple t-test of two-way ANOVA. Results: Adolescents with ASD expressed a profile of items significantly differing from control persons. Comparison of significant items with the empirical ASD literature indicated robust accordance. Conclusions: Our findings support the importance and feasibility of the clinical diagnostic interview of family and developmental history for initiation of the diagnostic process of ASD in adolescents.
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Affiliation(s)
- Johanna Waltereit
- Department of Child and Adolescent Psychiatry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - Charlotte Czieschnek
- Department of Child and Adolescent Psychiatry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Katja Albertowski
- Department of Child and Adolescent Psychiatry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Robert Waltereit
- Department of Child and Adolescent Psychiatry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
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Koomar T, Thomas TR, Pottschmidt NR, Lutter M, Michaelson JJ. Estimating the Prevalence and Genetic Risk Mechanisms of ARFID in a Large Autism Cohort. Front Psychiatry 2021; 12:668297. [PMID: 34177659 PMCID: PMC8221394 DOI: 10.3389/fpsyt.2021.668297] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/07/2021] [Indexed: 12/27/2022] Open
Abstract
This study is the first genetically-informed investigation of avoidant/restrictive food intake disorder (ARFID), an eating disorder that profoundly impacts quality of life for those affected. ARFID is highly comorbid with autism, and we provide the first estimate of its prevalence in a large and phenotypically diverse autism cohort (a subsample of the SPARK study, N = 5,157 probands). This estimate, 21% (at a balanced accuracy 80%), is at the upper end of previous estimates from studies based on clinical samples, suggesting under-diagnosis and potentially lack of awareness among caretakers and clinicians. Although some studies suggest a decrease of disordered eating symptoms by age 6, our estimates indicate that up to 17% (at a balanced accuracy 87%) of parents of autistic children are also at heightened risk for ARFID, suggesting a lifelong risk for disordered eating. We were also able to provide the first estimates of narrow-sense heritability (h2) for ARFID risk, at 0.45. Genome-wide association revealed a single hit near ZSWIM6, a gene previously implicated in neurodevelopmental conditions. While, the current sample was not well-powered for GWAS, effect size and heritability estimates allowed us to project the sample sizes necessary to more robustly discover ARFID-linked loci via common variants. Further genetic analysis using polygenic risk scores (PRS) affirmed genetic links to autism as well as neuroticism and metabolic syndrome.
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Affiliation(s)
- Tanner Koomar
- Department of Psychiatry, The University of Iowa, Iowa City, IA, United States
| | - Taylor R Thomas
- Department of Psychiatry, The University of Iowa, Iowa City, IA, United States
| | - Natalie R Pottschmidt
- Department of Psychology, Pennsylvania State University, State College, PA, United States
| | - Michael Lutter
- Eating Recovery Center of San Antonio, San Antonio, TX, United States
| | - Jacob J Michaelson
- Department of Psychiatry, The University of Iowa, Iowa City, IA, United States
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Margari L, Marzulli L, Gabellone A, de Giambattista C. Eating and Mealtime Behaviors in Patients with Autism Spectrum Disorder: Current Perspectives. Neuropsychiatr Dis Treat 2020; 16:2083-2102. [PMID: 32982247 PMCID: PMC7504729 DOI: 10.2147/ndt.s224779] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social and communication skills and repetitive and restrictive behaviors. Children and adolescents with ASD are more likely to present feeding problems than their typically developing peers are. The present narrative review of literature aims to highlight the most recent evidence about epidemiology and presentations of eating and mealtime behavioral abnormalities in ASD from infancy to adolescence. Abnormalities in breastfeeding and acceptance of complementary foods have been described by most of the studies evaluating ASD early feeding history. Among the various eating and mealtime behaviors identified in ASD children and adolescents, the most common was food selectivity. The present review also provides brief overviews of the various aspects of food that may influence food acceptance by ASD patients and of the correlation between eating problems and ASD core symptoms, as well as with cognitive level, language skills, and family environment. However, studies evaluating eating problems in ASD children and adolescents are very heterogeneous and they show methodological differences. Moreover, the absence of unique definitions of eating and mealtime behaviors in ASD further limits the comparability of studies.
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Affiliation(s)
- Lucia Margari
- Child Neuropsychiatric Unit, University of Bari Aldo Moro, Bari, Italy
| | - Lucia Marzulli
- Child Neuropsychiatric Unit, University of Bari Aldo Moro, Bari, Italy
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Douglas PS. Pre-emptive Intervention for Autism Spectrum Disorder: Theoretical Foundations and Clinical Translation. Front Integr Neurosci 2019; 13:66. [PMID: 31798425 PMCID: PMC6877903 DOI: 10.3389/fnint.2019.00066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 11/04/2019] [Indexed: 12/28/2022] Open
Abstract
Autism spectrum disorders (ASD) are an emergent public health problem, placing significant burden upon the individual, family and health system. ASD are polygenetic spectrum disorders of neural connectome development, in which one or more feedback loops amplify small genetic, structural, or functional variations in the very early development of motor and sensory-motor pathways. These perturbations trigger a 'butterfly effect' of unpredictable cascades of structural and functional imbalances in the global neuronal workspace, resulting in atypical behaviors, social communication, and cognition long-term. The first 100 days post-term are critically neuroplastic and comprise an injury-sensitive developmental window, characterized by a neural biomarker, the persistence of the cortical subplate, and a behavioral biomarker, the crying diathesis. By the time potential diagnostic signs are identified, from 6 months of age, ASD neuropathy is already entrenched. The International Society for Autism Research Special Interest Group has called for pre-emptive intervention, based upon rigorous theoretical frames, and real world translation and evaluation. This paper responds to that call. It synthesizes heterogenous evidence concerning ASD etiologies from both psychosocial and biological research literatures with complexity science and evolutionary biology, to propose a theoretical framework for pre-emptive intervention. This paper hypothesizes that environmental factors resulting from a mismatch between environment of evolutionary adaptedness and culture initiate or perpetuate early motor and sensory-motor lesions, triggering a butterfly effect of multi-directional cascades of atypical developmental in the complex adaptive system of the parent and ASD-susceptible infant. Chronic sympathetic nervous system/hypothalamic-pituitary-adrenal axis hyperarousal and disrupted parent-infant biobehavioral synchrony are the key biologic and behavioral mechanisms perpetuating these atypical developmental cascades. A clinical translation of this evidence is proposed, for application antenatally and in the first 6 months of life, as pre-emptive intervention for ASD.
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Affiliation(s)
- Pamela S Douglas
- Transforming Maternity Care Collaborative, Griffith University, Brisbane, QLD, Australia.,Discipline of General Practice, The University of Queensland, Brisbane, QLD, Australia
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