Targeted Nutritional and Behavioral Feeding Intervention for a Child with Autism Spectrum Disorder

Food Difficulties in Infancy and ASD: A Literature Review

PURPOSE

The aim of this literature review is to investigate the potential association between specific food difficulties and autism spectrum disorder (ASD) during the first two years of life.

MATERIALS

The search was conducted in PubMed, Google Scholar, Embase and PsycInfo databases.

RESULTS

Twenty-one studies were synthesized (3763 infants and children). Difficulties during breastfeeding, breast milk refusal and avoidance of taking solids have been linked to ASD. Infants with ASD have been referred to as picky eaters. Problematic mealtime behaviour during infancy has also been associated with ASD.

CONCLUSIONS

The present review highlights the association between food difficulties, including problematic mealtime behaviours, food selectivity, breastfeeding difficulties and food refusal during infancy and ASD early during life, including the first months.

Gastrointestinal disorders in children with autism: Could artificial intelligence help?

Autism is one of the pervasive neurodevelopmental disorders usually associated with many medical comorbidities. Gastrointestinal (GI) disorders are pervasive in children, with a 46%-84% prevalence rate. Children with Autism have an increased frequency of diarrhea, nausea and/or vomiting, gastroesophageal reflux and/or disease, abdominal pain, chronic flatulence due to various factors as food allergies, gastrointestinal dysmotility, irritable bowel syndrome (IBS), and inflammatory bowel diseases (IBD). These GI disorders have a significant negative impact on both the child and his/her family. Artificial intelligence (AI) could help diagnose and manage Autism by improving children's communication, social, and emotional skills for a long time. AI is an effective method to enhance early detection of GI disorders, including GI bleeding, gastroesophageal reflux disease, Coeliac disease, food allergies, IBS, IBD, and rectal polyps. AI can also help personalize the diet for children with Autism by microbiome modification. It can help to provide modified gluten without initiating an immune response. However, AI has many obstacles in treating digestive diseases, especially in children with Autism. We need to do more studies and adopt specific algorithms for children with Autism. In this article, we will highlight the role of AI in helping children with gastrointestinal disorders, with particular emphasis on children with Autism.

Gluten-Free Casein-Free Diet for Autism Spectrum Disorders: Can It Be Effective in Solving Behavioural and Gastrointestinal Problems?

Autism spectrum disorder [ASD] is characterized by deficits in communication and social interactions combined with repetitive and restricted patterns of behaviors. Bidirectional changes in brain-gut microbiota are known to be responsible for the pathophysiology of many brain-related disorders, such as autism, as well as well-known gastrointestinal diseases, including gut disorders. Imbalance in the composition of gut microbiota is frequently observed in individuals with ASD. It is therefore believed that this imbalance is significant in the frequent occurrence of gastrointestinal symptoms. The integrity of the intestinal barrier and the blood-brain barrier [BBB] in individuals with ASD is affected. Incompletely digested peptides, toxins, and proinflammatory cytokines cross the BBB by entering the bloodstream and reach the central nervous system. As a result of the accumulation of these elements, brain function is adversely affected. It is hypothesized that incompletely digested peptides acting as opioid agonists reduce pain sensitivity and increase the severity of autism-specific behaviors. However, it is not known exactly how opioid peptides trigger ASD symptoms after they reach the brain. Diet therapies, especially elimination diets, are considered to be an alternative treatment to prevent this condition. Gluten-free casein-free [GFCF] diet is an elimination diet that involves the removal of certain proteins from the normal diet, such as gluten and casein. However, studies that demonstrate the beneficial effects of the GFCF diet on ASD patients and explain its mechanism is limited, which supports the opioid theory. This review aims to investigate the gastrointestinal and behavioral problems that are frequently observed in ASD, the possible action mechanisms of GFCF diets, and the efficacy of these elimination diets.

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

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.