The effectiveness of a newly designed diet programme on dietary intake for children with autism at Kaimes School.

Abstract

Autism Spectrum Disorder (ASD) is a lifelong, complex neuro-developmental disorder, affecting; communication skills, social interests and repetitive behaviours (Yu et al. 2013), at a time when a child is typically developing social skills (Arndt et al. 2005). The term ASD is expanding to cover this vast variance in cognitive, social and communicative functions. It is currently estimated that 1.1% of the UK population is on the autism spectrum (Brugha et al. 2012). There are presently over 200 specialised schools and nurseries in Scotland facilitating for children with ASD (The national Autistic society. 2017), and although it is well established that these children commonly are seen to have extremes in food neophobias (Ledford and Gast 2006), as well as growing evidence which suggests that GI pathologies and intestinal barrier defects, commonly seen in individuals with ASD, contribute to the clinical expression of autism (Buie et al. 2010). There is a distinct lack of guidelines regarding clinical practice, service delivery and public policy surrounding dietary interventions for these children. 2.1 Objective To construct a tailor-made dietary intervention for individuals with ASD, who attend Kaimes Secondary school in Edinburgh and are known to be 'fussy eaters'. This intervention should take into account, current nutritional status, and involve the participant in the preparation of food, thereby increasing sensory exposer, and expanding the variety of foods eaten. 2.2 Method Two pupils took part in this case study, parents of these children were asked to fill in a Food Frequency diary, while a 24-hour food recall was carried out over the phone prior to commencement of the intervention. Eight sessions took place over a 4-week period consisting of three introductory sessions, and five cooking sessions. During the first Introductory session weights and height were measured using standard procedures, allowing for BMI centile and nutritional status to be calculated. Following this the participants were introduced visually, to a range of vegetables through a variety of games, videos and discussion with visual aide, this not only let researchers gauge reactions to the novel foods, but increased exposure to these vegetables. Further sessions involved the participants in a cooking class, making foods it was known the child liked with a vegetable being a key ingredient, then asking the participants to try the foods. Visual analogue scales were used to measure the child's mood in the session along with interaction with the novel food. The volume of food eaten were recorded, and finally, nutritional analysis of these foods were taken to calculate the percentage of Dietary reference intake of these foods, which could be added to baseline DRIs. 2.3 Results Both case studies shown some deficiencies in certain macro and micronutrients, over the intervention periods some increases were seen, including; Iron, Copper, Zinc, Vitamin A, Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, and Vitamin C. Observational evidence suggests that cooking classes were a success in terms of participant's willingness to try novel foods, as part of recipes for preferred foods. 2.4 Conclusion It is possible to increase nutritional status of an individual with ASD through individually tailored cooking sessions, however, eight sessions are not enough time to fully understand the underlying factors forming these aversions or for the children to form any preferences for these foods. This case study could therefore be used as the basis for further research comprising of a longer time period, more thorough investigations into physical and behavioural history surrounding these foods, and a multidisciplinary model of intervention involving education, sensory exposure and family influence. 2.5 Key Words Autism, ASD, Dietary intervention, cooking class, guidelines, novel food