FEEDING BEHAVIORS IN CHILDREN WITH AUTISM SPECTRUM DISORDER: A CROSS-SECTIONAL STUDY

Öz

This study aimed to examine the behavioral feeding problems in a sample of children with Autism Spectrum Disorder (ASD) and to examine the relationship of feeding problems to child sex and parents feelings about strategies to cope. This was a cross-sectional study of children aged 6-15 years with ASD. The parents or caregivers of the children/adolescents with ASD completed the following: sociodemographic information, questions about nutrition, and the Behavioral Pediatric Feeding Assessment Scale (BPFAS) for assessing the child’s behavioral feeding problems and parents’ feelings. Height and weight were used to calculate body mass index (BMI) percentiles. These percentiles for age and sex were used to define overweight and obesity (≥85th and ≥95th percentiles, respectively). The sample of the study consisted of 70 children with ASD (male: 49, female: 21), of which 45.8% were obese. The frequency of obesity in the males with ASD was higher than that in the females with ASD. BPFAS scores were higher in the females than in the males for all frequencies (total score, total problem score, child total score, child problem, parent total score, and parent problem). BPFAS total score was higher in the underweight children group (especially in the females). This study demonstrated that problematic feeding behaviors in children with ASD may differ according to sex. Behavioral interventions should be developed according to differences in feeding behavior.

Anahtar Kelimeler

• Autism spectrum disorder
• behavioral pediatric feeding assessment scale
• developmental disabilities
• feeding disorder
• sex differences

Proje Numarası

This research was supported by Ankara University Scientific Research Projects Directorate with project number 16H0241001.

Teşekkür

We would like to thank the parents who participated in this research, and all the health workers who helped in the collection of the data.

OTIZM SPEKTRUM BOZUKLUĞU OLAN ÇOCUKLARDA YEME DAVRANIŞLARI: KESITSEL BIR ÇALIŞMA

Öz

Çalışmanın amacı, Otizm Spektrum Bzoukluğu (OSB) olan çocuklardan oluşan bir örneklemde davranışsal beslenme sorunlarını incelemek ve beslenme sorunlarının çocuğun cinsiyeti ve ebeveynlerin başa çıkma stratejileri hakkındaki duygularıyla ilişkisini incelemektir. Bu çalışma, 6-15 yaş arası OSB’li çocuklarla yapılan kesitsel bir çalışmaydı. OSB’li çocuk/adolesanların ebeveynleri sosyodemografik bilgileri, beslenmeyle ilgili soruları ve çocuğun davranışsal beslenme sorunlarını ve ebeveynlerin duygularını değerlendirmek için Davranışsal Pediatrik Besleme Değerlendirme Ölçeği’ni (DPBDÖ) tamamlamıştır. Boy uzunluğu ve vücut ağırlığı, vücut kütle indeksi (BKİ) persentillerini hesaplamak için kullanıldı. Yaş ve cinsiyete ilişkin persentiller hafif şişmanlığı ve obeziteyi tanımlamak için kullanıldı (sırasıyla ≥85. ve ≥95. persentil). Araştırmanın örneklemini %45,8’i obez olan 70 OSB’li çocuk (Erkek: 49, kız: 21) oluşturmuştur. OSB’li erkeklerde obezite sıklığı OSB’li kadınlara göre daha yüksekti. DPBDÖ puanları kızlarda erkeklere göre tüm puanlarda (toplam puan, toplam problem, çocuk toplam puanı, çocuk problem, ebeveyn toplam puanı ve ebeveyn sorunu) daha yüksekti. DPBDÖ toplam puanı zayıf çocuk grubunda (özellikle kızlarda) daha yüksekti. Bu çalışma, OSB’li çocuklarda problemli beslenme davranışlarının cinsiyete göre farklılık gösterebileceğini ortaya koymuştur. Beslenme davranışındaki farklılıklara göre davranışsal müdahaleler geliştirilmelidir.

Anahtar Kelimeler

• Otizm spektrum bozukluğu
• davranışsal pediatrik besleme değerlendirme ölçeği
• gelişimsel yetersizlikler
• yeme bozukluğu
• cinsiyet farklılıkları

Proje Numarası

This research was supported by Ankara University Scientific Research Projects Directorate with project number 16H0241001.

Kaynakça

1. Almandil NB, Alkuroud DN, Abdulazeez S, Alsulaiman A, Elaissari A, Borgio JF. Environmental and genetic factors in autism spectrum disorders: Special emphasis on data from arabian studies. Int J Environ Res Public Health. 2019;16(4). doi:10.3390/ijerph16040658.
2. Maenner MJ, Warren Z, Williams AR, et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. MMWR Surveill Summ. 2023;72(2). Avaliable from: https://www.cdc.gov/ncbddd/autism/pdf/ADDM-Community-Report-SY2020-h.pdf
3. Leader G, Tuohy E, Chen JL, Mannion A, Gilroy SP. Feeding Problems, Gastrointestinal Symptoms, Challenging Behavior and Sensory Issues in Children and Adolescents with Autism Spectrum Disorder. 2020;50:1401-10. doi:10.1007/s10803-019-04357-7.
4. Ledford JR, Gast DL. Feeding Problems in Children With Autism Spectrum Disorders: A Review. Focus Autism Other Dev Disabl. 2006;21(3):153-66. doi:10.1177/10883576060210030401.
5. Råstam M. Eating Disturbances in Autism Spectrum Disorders With Focus On Adolescent And Adult Years. Clin Neuropsychiatry. 2008;5. Avaliable from: https://www.seds.se/wp-content/uploads/2014/06/ED-and-autism-spectrum-disorders-Rastam-2008.pdf
6. Page SD, Souders MC, Kral TVE, Chao AM, Pinto-Martin J. Correlates of Feeding Difficulties Among Children with Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord. 2022;52(1):255-74. doi:10.1007/s10803-021-04947-4.
7. Vissoker RE, Latzer Y, Gal E. Eating and feeding problems and gastrointestinal dysfunction in Autism Spectrum Disorders. Res Autism Spectr Disord. 2015;12:10-21. doi:10.1016/j.rasd.2014.12.010.
8. Asil E, Uçar A, Tunay ÇZ, Ayhan AB. Nutritional problems and body mass index of Turkish children with autism. Nutr Food Sci. 2022;52(6):1029-41. doi:10.1108/NFS-12-2021-0389.

9. Curtin C, Hubbard K, Anderson SE, Mick E, Must A, Bandini LG. Food Selectivity, Mealtime Behavior Problems, Spousal Stress, and Family Food Choices in Children with and without Autism Spectrum Disorder. J Autism Dev Disord. 2015;45(10):3308-315. doi:10.1007/s10803-015-2490-x.
10. Kuschner ES, Morton HE, Maddox BB, de Marchena A, Anthony LG, Reaven J. The BUFFET Program: Development of a Cognitive Behavioral Treatment for Selective Eating in Youth with Autism Spectrum Disorder. Clin Child Fam Psychol Rev. 2017;20(4):403-421. doi:10.1007/s10567-017-0236-3.
11. Hartley SL, Darryn AE, Sikora M. Sex Differences in Autism Spectrum Disorder: An Examination of Developmental Functioning, Autistic Symptoms, and Coexisting Behavior Problems in Toddlers. J Autism Dev Disord. 2009;39:1715-22. doi:10.1007/s10803-009-0810-8.
12. Coffman MC, Anderson LC, Naples AJ, Mcpartland JC. Sex Differences in Social Perception in Children with ASD. J Autism Dev Disord. 2015;45:589-99. doi: 10.1007%2Fs10803-013-2006-5.
13. Lai MC, Lombardo M V., Auyeung B, Chakrabarti B, Baron-Cohen S. Sex/Gender Differences and Autism: Setting the Scene for Future Research. J Am Acad Child Adolesc Psychiatry. 2015;54(1):11-24. doi:10.1016%2Fj.jaac.2014.10.003.
14. Baraskewich J, von Ranson KM, McCrimmon A, McMorris CA. Feeding and eating problems in children and adolescents with autism:A scoping review. Autism. 2021;25(6):1505. doi:10.1177/1362361321995631.
15. Crist W, Napier-Phillips A. Mealtime behaviors of young children: A comparison of normative and clinical data. J Dev Behav Pediatr. 2001;22(5):279-86. doi:10.1097/00004703-200110000-00001.
16. Önal S, Çalık Var E, Uçar A, et al. Davranışsal Pediatrik Besleme Değerlendirmesi Ölçeği (DPBDÖ)’ni Türkçe’ye Uyarlama Çalışması. Nevşehir Bilim ve Teknol Derg Cilt. 2017;6(1):93-101. doi:10.17100/nevbiltek.296685.
17. CDC CFDC. Defining Childhood Weight Status | Overweight & Obesity | CDC. Avaliable from: https://www.cdc.gov/obesity/basics/childhood-defining.html
18. Curtin C, Hubbard K, Anderson SE, Mick E, Must A, Bandini LG. Food Selectivity, Mealtime Behavior Problems, Spousal Stress, and Family Food Choices in Children with and without Autism Spectrum Disorder. Published online 2015. doi:10.1007/s10803-015-2490-x.
19. Bandini LG, Curtin C, Phillips S, Anderson SE, Maslin M, Must A. Changes in Food Selectivity in Children with Autism Spectrum Disorder. J Autism Dev Disord. 2017;47:439-46. doi:10.1007/s10803-016-2963-6.
20. Frazier TW, Georgiades S, Hardan AY. Behavioral and Cognitive Characteristics of Females and Males With Autism in the Simons Simplex Collection. J Am Acad Child Adolesc Psychiatry. 2014;53(3):329-40. doi: 10.1016/j.jaac.2013.12.004.
21. Babinska K, Celusakova H, Belica I, Szapuova Z, Waczulikova I, Nemcsicsova D, et al. Gastrointestinal symptoms and feeding problems and their associations with dietary interventions, food supplement use, and behavioral characteristics in a sample of children and adolescents with autism spectrum disorders. Int J Environ Res Public Health. 2020;17(17):1-18. doi: 10.3390/ijerph17176372
22. Kassee C, Babinski S, Tint A, Lunsky Y, Brown HK, Ameis SH, et al. Physical health of autistic girls and women: a scoping review. Mol Autism. 2020;11(1):1-22. doi:10.1186/s13229-020-00380-z.
23. Gotham K, Brunwasser SM, Lord C. Depressive and anxiety symptom trajectories from school age through young adulthood in samples with autism spectrum disorder and developmental delay. J Am Acad Child Adolesc Psychiatry. 2015;54(5):369-76.e3. doi:10.1016/j.jaac.2015.02.005.
24. Curtin C, Hubbard K, Anderson SE, Mick E, Must A, Bandini LG. Food Selectivity, Mealtime Behavior Problems, Spousal Stress, and Family Food Choices in Children with and without Autism Spectrum Disorder. J Autism Dev Disord. 2015;45(10):3308-15. doi:10.1007/s10803-015-2490-x.
25. Alkazemi D, Rahman A, Alsaad S, Kubow S. Parental perceptions and concerns of weight status in children with autism spectrum disorders in Kuwait. Res Autism Spectr Disord. 2016;22:1-9. doi: 10.1016/j.rasd.2015.11.001.
26. Sharp WG, Berry RC, McCracken C, Nuhu NN, Marvel E, Saulnier CA, et al. Feeding problems and nutrient intake in children with autism spectrum disorders: A meta-analysis and comprehensive review of the literature. J Autism Dev Disord. 2013;43(9):2159-73. doi:10.1007/s10803-013-1771-5.
27. Park HJ, Choi SJ, Kim Y, Cho MS, Kim YR, Oh JE. Mealtime Behaviors and Food Preferences of Students with Autism Spectrum Disorder. Foods. 2021;10(1). doi:10.3390/foods10010049.
28. Castro K, Faccioli LS, Baronio D, Gottfried C, Perry IS, Riesgo R. Feeding behavior and dietary intake of male children and adolescents with autism spectrum disorder: A case-control study. Int J Dev Neurosci. 2016;53(1):68-74. doi:10.1016/j.ijdevneu.2016.07.003.
29. Attlee A, Kassem H, Hashim M, Obaid RS. Physical Status and Feeding Behavior of Children with Autism. Indian J Pediatr. 2015;82(8):682-7. doi: 10.1007/s12098-015-1696-4.
30. Dovey TM, Farrow CV, Martin CI, Isherwood E, Halford JCG. When Does Food Refusal Require Professional Intervention? Curr Nutr Food Sci. 2009;5(3):160-71. doi:10.2174/157340109789007162.
31. Bandini LG, Anderson SE, Curtin C, Cermak S, Evans EW, Scampini R, et al. Food selectivity in children with autism spectrum disorders and typically developing children. J Pediatr. 2010;157(2):259-64. doi: 10.1016/j.jpeds.2010.02.013.
32. Lockner DW, Crowe TK, Skipper BJ. Dietary Intake and Parents’ Perception of Mealtime Behaviors in Preschool-Age Children with Autism Spectrum Disorder and in Typically Developing Children. J Am Diet Assoc. 2008;108(8):1360-3. doi:10.1016/j.jada.2008.05.003.
33. Nadon G, Feldman D, Gisel E, Nadon G, Feldman D, Gisel E. Feeding Issues Associated with the Autism Spectrum Disorders. Recent Adv Autism Spectr Disord - Vol I. Published online March 6, 2013. doi:10.5772/53644.