Autism

Dr. Heba Said

Assistant Professor of Nutrition
 Autism
• Autism is one of five disorders under the category
pervasive developmental disorder (PDD).

• All types of PDD are neurologic disorders that are

usually evident by age 3.
• In general, children who have a type of PDD have
difficulty in talking, playing with other children,
and relating to others, including their families.
 Nutrition Assessment

• Anthropometric Measures.
Height and weight are determined for the child and
adult with autism using the equipment and
growth charts for non affected individuals.

• Biochemical Measures. There is no standard

pattern of tests that should be given other than
the regular blood work for health monitoring.
however, amino acid screening shortly after birth,
thyroid testing, and allergy testing may be
indicated .
Evaluation Dietary Intake
• Evaluations are sometimes difficult to complete
for the child with a very limited intake.

• An effective measure may be provided by having

the parents and caregivers keep a food diary for
several days to determine the macro and micro
nutrient intake.
• Obtaining information related to when food is

presented and the amount eaten is important,

along with fluid consumption.

• Evaluations should include an observation of
the child during meal time.

• The texture of the food presented should be

recorded because sensory integration is
difficult for children with autism, and they
may be very resistant to texture progression
or variety.
• This is reflected in their fixation on one food
(e.g., crackers, dry cereal, or chips). Food jags
and picky eating are common.

• Evaluation should include a description of the

feeding environment, whether there is a high
chair or age-appropriate toddler chair, the
timing of meals, and the location for meals.
 Intervention Strategies
 No one therapy or method will work for all individuals

with autism.

 Many professionals and families use a range of

treatments simultaneously, including behavior

modification, structured educational approaches,

medication, speech therapy, occupational therapy,

and counseling.
• Popular nutrition interventions include
mineral and vitamin therapy and elimination
diets such as a gluten-free , casein-free diet ,
allergy diets , supplementation with essential
fatty acids (EFAs) and megavitamins.
• There are anecdotal reports of success. The
exclusion diets are now used in some
treatment (http://www.autismndi.com).
• Follow-up is an important component of all

therapy. From a nutritional standpoint, routine

measures of height and weight should be

scheduled, and there should be regular

evaluation of eating and feeding behavior related

to increasing ability to self-feed and accept new

and different foods.

Attention-Deficit/Hyperactivity
Disorder

(ADHD)
 ADHD
• neurobehavioral problem seen in children with

increasing frequency.

• It has been associated with learning disorders,

inappropriate degrees of impulsiveness,

hyperactivity, and attention deficit.

Diagnostic criteria were developed by the
American Psychiatric Association and have
designated three types:
1. combined type of hyperactivity and attention
deficit
2. predominately inattentive type
3. predominately ,hyperactive-impulse type.

• ADHD affects the child at home, in school, and

in social situations.
Nutrition Assessment
 Dietary Intake.
• A detailed dietary history would include:
• infant feeding history
• food likes and dislikes
• behavior at mealtimes
• snacking behavior
• presence of food allergies or food intolerances
• If the individual is on medications , the time of
administration in relation to mealtime is
important.
• Feeding evaluations should include observing
the individual

• at mealtime. Generally the problems around

feeding will be behavioral and will not include
oral-motor or positioning peculiarities.

• Evaluating the environment around mealtime

is important because distractions can be
problematic.
Intervention Strategies
• parents have been advised to use the Feingold

diet, which states that foods containing

synthetic food colors and naturally occurring

salicylates be removed from the diet because

of their neurologic effect.

• The outcome of current interest involves the

Food and Drug Administration and committee

discussion related to removing food coloring

from the food supply (Pelsser LM et al, 2011).

Other recommendations have included the

elimination of sugar, the elimination of

caffeine, or the addition of large doses of

vitamins (megavitamin therapy).

• the Dietary Guidelines or MyPlate . The food
should be served at regular times, with small
servings followed by refills.

• This is an important concept because of the

tendency of the child or individual to eat very
small amounts and leave the table, planning
to return or graze throughout the day.
A recent study in Germany of 810 children ages
5-12 provided a food supplement containing
ω-3 and ω-6 fatty acids plus zinc and
magnesium resulting in considerable
reduction in ADHD after 12 weeks of
supplementation (Huss et al., 2010).
Thank you