dc.description.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 | |