Behaviour and Gastrointestinal Symptoms of Children with Autism Spectrum Disorder among Caregivers at Selected Special Schools in Chennai

INTRODUCTION: Autism Spectrum Disorder is a clinically heterogenous neurodevelopmental disorder that manifests as a persistent impairment in social interaction and social communication, with repetitive or stereotyped behaviours that range from mild to severe. Children with Autism Spectrum Disorder presents with unique nutritional challenges and nutritional deficiencies that often lead to poor dietary pattern which lacked the recommended nutrients important for proper growth and development. Along with the poor dietary pattern, they also has problem in eating behavior and gastrointestinal symptoms. STATEMENT OF THE PROBLEM: A study to assess the dietary pattern, eating behaviour and gastro intestinal symptoms of children with Autism Spectrum Disorder among caregivers at selected special schools in Chennai. OBJECTIVES OF THE STUDY 1. To assess the dietary pattern, eating behaviour and gastrointestinal symptoms of children with Autism Spectrum Disorder. 2. To find the correlation between the dietary pattern, eating behaviour and gastrointestinal symptoms of children with Autism Spectrum Disorder. 3. To find the association between the dietary pattern, eating behavior and gastrointestinal symptoms of children with Autism Spectrum Disorder with demographic variables of caregivers and children with Autism Spectrum Disorder. METHODOLOGY: Research approach was exploratory in nature. Descriptive research design was used for this study. The study was conducted among 60 caregivers of children with Autism Spectrum Disorder. The study was conducted in Swabhimaan- Holistic Solutions for Autism, Palavakam, Life Help Projects, Neelankarai and Aikya Foundations, Mount road, Chennai. Non probabaility purposive sampling technique was adopted to select the samples based on inclusion criteria. Self administered questionnaire was used to collect the demographic data of caregivers and children with Autism Spectrum Disorder. Self administered check list was used to collect the data regarding dietary pattern. Interview method was used to collect 24 hours dietary recall. Self administered rating scale was used to collect data regarding eating behavior and gastrointestinal symptoms of children with Autism Spectrum Disorder from the caregivers. RESULTS Twenty (45%) caregivers were in the age group of 25 – 35 years. Majority 59 (98.33%) of the caregivers were females. Majority 54 (90%) of the caregivers were Hindus. Of the total samples, 17 (28.33%) caregivers were graduates and 16 (26.67%) caregivers were postgraduates. Majority 54 (90%) of the caregivers were mothers. Majority 51 (85%) of the caregivers were unemployed. Twenty (35%) caregivers monthly family income was above Rs.30000/- month and 20 (33.33%) of them earned less than Rs.10000/- month. Thirty (50%) caregivers were belonged to nuclear family and 26 (43.3%) of them were living as joint family. Thirty three (55%) caregivers had two children in their family. Majority 59 (98.33%) of the caregivers had one child affected with Autism. Majority 47 (78.33%) of the caregivers were non-vegetarian. Six (10%) caregivers had family history of child with Autism Twenty eight (46.67%) children with Autism Spectrum Disorder were in the age group of 9 – 12 years. Thirty seven (61.67%) children were males. Majority 42 (70%) of the children were first born. Thirty four (56.67%) children were born by cesarean section. Thirty four (56.67%) children were diagnosed at 1 – 2 years. Thirty seven (61.67%) children had hyperactivity and 21 (35%) children had learning disability. Majority 46 (76.67%) of the children were non-vegetarian. Majority 46 (76.67%) of the children used to take meals three times in a day. The assessment of dietary pattern of children with Autism Spectrum Disorder showed that majority 42 (70%) of the children had moderate dietary pattern, 15 (25%) of them had poor dietary pattern. The assessment of eating behavior of children showed that majority 37 (61.67%) of the children had moderate eating behaviour and 5 (8.33%) children had poor eating behaviour. The assessment of gastrointestinal symptoms of children showed that 28 (46.67%) children with Autism Spectrum Disorder had mild gastrointestinal symptoms and only one (1.67%) child had moderate gastrointestinal symptoms. There is a positive, significant correlation between dietary pattern and eating behavior (r= 0.642) at 1% level of significance. There is a negative correlation between dietary pattern and gastrointestinal symptoms (r= -0.464) and also between eating behavior and gastrointestinal symptoms (r=-0.503) of children with Autism Spectrum Disorder at 1% level of significance. There was a statistically significant association between dietary pattern and gender of the child with Autism Spectrum Disorder at 5% level of significance. There was a statistically significant association between eating behaviour and gender of the caregiver at 1% level of significance. There was a statistically significant association between eating behaviour and demographic variables of children with Autism Spectrum Disorder such as birth order of the child, co-morbid conditions and meal time frequency of the child in a day at 5% level of significance. There was a statistically significant association between gastrointestinal symptoms and religion of the caregiver at 1%level of significance. CONCLUSION: The study concluded that the children with Autism Spectrum Disorder had moderate dietary pattern, moderate eating behaviour and mild gastrointestinal symptoms. The study proved a significant positive correlation between dietary pattern and eating behavior of children. There was a statistically significant association between dietary pattern and gender of the child and eating behavior with gender of the caregiver. The study also showed statistically significant association between gastrointestinal symptoms and religion of the caregiver. Nurses play an important role in guiding caregivers and families of children with Autism Spectrum Disorder to improve dietary pattern and eating behavior.