Associations between sensory issues, mealtime behaviours, and food and nutrient intakes in children with Autism Spectrum Disorder : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Human Nutrition and Dietetics at Massey University, Albany, New Zealand

Abstract

Background: Sensory issues are defined as dysfunction within the integration of the seven senses within the brain. Dysfunction can lead to issues within higher-level integrative functions such as social participation and planning and praxis, and lead to atypical responses to one’s environment. Sensory issues are highly prevalent in children with Autism Spectrum Disorder (ASD) and have been associated with difficult mealtime behaviours. It is not known if sensory issues are associated with food or nutrient intake in ASD children living in New Zealand (NZ). Nutritional deficits during development could have compounding effects on cognition and behaviour in ASD. Methods: Analysis of baseline data from an ongoing randomised-controlled trial was undertaken. Using a cross-sectional observational study design we investigated associations of sensory issue severity with frequency of difficult mealtime behaviour and food and nutrient intakes of children aged 2.5–8 years with ASD in NZ. The Sensory Processing Measure (SPM), Behavioural Paediatric Feeding Assessment Scale, Dietary Intake for Child’s Eating (DICE), and four-day food diaries were used to measure sensory issues, difficult mealtime behaviours, food intake, and nutrient intake, respectively. Results: Of 113 participants, 90.2% of children had sensory issues, and 41.5% of children had clinical difficult mealtime behaviours. An increase in sensory issue severity corresponded to an increase in frequency of difficult mealtime behaviours (r=.265, p=.007). Social participation issue severity was inversely associated with the total DICE score (r=-.305, p=.003). More than 50% of the children did not meet Ministry of Health recommendations for servings of fruit, vegetables, breads and cereals, milk and milk products, or nutrient intakes for calcium. Neither sensory issue severity nor frequency of difficult mealtime behaviours appeared to be associated with food and nutrient intakes. Conclusion: Sensory issues are highly prevalent in ASD children and sensory issue severity is positively associated with frequency of difficult mealtime behaviours. Intervention is required in a number of children with ASD to ensure food and nutrient intake recommendations are met.