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Aug 2018 DOI 10.14302/issn.2640-690X.jfm-18-2252
Cherif LeilaCorresponding author
Hedi Chaker Hospital, Child and adolescent psychiatry Department, Avenue Majida Boulila, 3029 Sfax, Tunisie.
Background: Feeding problems are common in autism. Parents are frequently worried about the health status of their children, which may be threatened by some consequent nutritional deficiencies. Despite this, feeding behaviours remain little explored by clinicians working with children with autism spectrum disorders and researches are lacking especially in Tunisia. Aims: To evaluate the frequency and the types of feeding problems in children with autism spectrum disorders. Settings and Design: A comparison was made between 57 children with autism spectrum disorders and 57 control groups regarding the feeding problems. Parents completed the children’s eating behavior inventory (CEBI). Autism severity is evaluated using the Childhood Autism Rating Scale. The SPSS statistical package, version 20.0 was used. Results: According to the CEBI, children with autism spectrum disorders showed more feeding problems than the control group (82.4% versus 56.1%, p=0.002). In fact, the parents of these children observed more pica habits on their children compared to the control group (p=0.000). They also observed more selectivity for starchy foods compared to the control group (p=0.000). The more the autistic symptoms were severe, the more children exhibited feeding problems (p=0.02). Conclusions: Our findings suggest that feeding problems are more common in children with autism. Clinical implications trigger the need for clinicians to provide the necessary assessment and treatment.
Aug 2017 DOI 10.14302/issn.2379-7835.ijn-17-1710
Çöpür MazlumCorresponding author
Associate Professor in Child and Adolescence Psychiatry. Arel University Faculty of Science and Letters Department of Psychology
Background: High number of patients suffering from autism spectrum disorders utilize dietary intervention methods, especially gluten-free/casein-free diet. In contrast with its’ extensive usage no sufficient and consistent data exist to support its’ efficiency and safety. Objective: The main aim of this systematic review is to provide a general look to the efficiency and safety of gluten-free/casein-free diet treatment for autism spectrum disorders. Method: Studies used in this systematic review are gathered from 3 online databases (PubMed, Embase and the Cochrane Library). Inclusion criteria are established for study selection. Articles published in a peer-reviewed article between 1990 and 2016 in English about our topic of interest and conducted with patients under the age of eighteen (18) are selected and further analyzed (“Level of Evidence” and “Grade of Recommendation” criteria are utilized). Results: Even though some studies with high values of “Level of Evidence” claim that gluten-free/casein-free diet is beneficial for patients suffering from autism spectrum disorders, studies with lower risk of bias demonstrate otherwise. Since studies such as case reports and cohort studies may contain bias associated with small sample size, absence of clear assessment methods, lack of randomization and short treatment period we suggest that there is no sufficient data to support gluten-free/casein-free diet treatment. Conclusion: Due to controversial outcomes from studies that have different “Level of Evidence” we speculate that efficiency of gluten-free/casein-free diet might be related to individual genetic differences. Therefore, studies conducted with large study groups could not provide statistically significant data to support this treatment option. Further studies should be conducted, especially in the field of genetics, in order to test our hypothesis.
Sep 2019 DOI 10.14302/issn.2574-4518.jsdr-19-2950
I Williams TimCorresponding author
Institute of Education, University of Reading and Priors Court Foundation
Background Children with autism spectrum disorders (ASD) often have difficulties settling to sleep and maintaining asleep through the night. Sleep difficulties are linked to challenging behaviour so understanding the causes of these difficulties is vital. Possible explanations are: (1) that irregular innate cycles lead to difficulties maintaining/initiating sleep at the appropriate times; (2) that children with ASD fail to learn from the contingencies that teach neurotypical children to initiate and maintain sleep. If the cycles are innate then small externally imposed changes in routine will not affect the sleep cycle. Methods The sleep records of 46 children with autism and moderate to profound intellectual impairments attending a residential school were examined to identify the effects of spring time change and weekend leave on 1) the times children went to sleep, 2) the length of their sleep and 3) the number of sleep disruptions. Manual staff recordings of the children’s sleep were conducted and data for these variables were analysed using repeated measures analysis of variance. Results A later sleep time was found in children regarding their sleep onset on Sunday after the time change (average onset was 9:57 p.m. ((s.e. = 8.49 minutes) versus 10:17 p.m. (s.e. = 8.19 minutes), with analysis of variance of sleep onset time showing a significant effect (F (3,41) = 5.02, p = 0.005). However, only two out of three comparison groups showed statistically significant effects (March 23rd versus March 30th mean difference = 0.39, p = 0.003; March 30th April 13th mean difference = 0.36, p = 0.03). No statistical difference was found between March 30th versus April 6th or other sleep parameters in any groups (i.e., sleep duration or night time awakenings). Similarly, no change in any sleep parameters (i.e., sleep onset or awakenings) were found when Sundays sleep parameters were compared to Mondays and/or Tuesdays. Conclusions In this small pilot study, small changes of day/night cycles appear to have few effects on the sleep patterns of children with ASD attending a residential school. While no significant sleep pattern change was found in this population due to change of clock times or weekend visits, larger epidemiological studies addressing other unexamined variables to better delineate changes in ASD are needed.