A Study On Association Between Core Symptoms And Characteristics Of Eating Behaviors In Children With Autism Spectrum Disorders

ObjectiveAutism spectrum disorder(ASD)is a complex neurodevelopmental disorder.Its prevalence has been increasing in recent years,and it has become an important public health problem.Eating behavior problems are common and having important effects on nutritional status,physical development and long-term prognosis of children with ASD.The purpose of this study is to understand the characteristic of eating behavior problems in children with ASD,and to explore the relationship between it and core symptoms of ASD.Providing clues and theoretical basis for effective intervention and improving their overall health status.Methods1.This is a case-control study,which lasted from December 2016 to January 2019.We observed 213 typically developing(TD)children in an ordinary kindergarten and 273 children with ASD who were from 6 special education institutions and the community rehabilitation project for children with autism in Tianjin,all of whom were aged 3-6 years old.2.Eating behavior problems and core symptoms of 136 children with ASD(3-8 years)from a special education school and community rehabilitation program in Tianjin were investigated by MBQ,SSP,SCQ and RBQ-2.A total of 105 children with ASD who participated in the community rehabilitation program were investigated with CARS,and being divided into " non-classical group","mild to moderate group" and "severe group".3.Using Epi Data 3.1 and SPSS 24.0 for data input and statistical analysis respectively.T-test,analysis of variance,Mann-Whitney U test,Kruskal-Wallis H test,chi-square test,partial correlation analysis and linear regression model were used for statistical analysis according to the characteristics of data.The test level α = 0.05.Results1.The incidence of eating behavior problems of children with ASD among 3-6 years old in our study was 69.6%,while that of TD children was 43.2%.Both the incidence of eating behavior problems and total MBQ scores of ASD were higher than those of TD children(P <0.05).After stratified by age and sex,the results were not change.Similarly,children with ASD had higher incidence and scores for eating ability,abnormal mealtime behaviors and food selectivity,and they also had more specific eating behavior problems when compared with TD children(P <0.05).2.There was no difference in the incidence of eating behavior problems and total scores of MBQ among different age and gender groups of children with ASD(P> 0.05).But the scores of 3-year-old group were higher than 5-year-old group for eating ability and 6-year-old group for eating ability and abnormal mealtime behaviors(P <0.05).Boys had higher eating ability scores than girls(P <0.05).The incidence of eating behavior problems and total scores of MBQ in non-classical group were lower than those in the other groups,and for abnormal eating behaviors and food selectivity scores,non-classical group were also lower than severe group(P < 0.05).3.Children with ASD who had eating behavior problems presented higher scores for total SCQ,communication,restricted,repetitive and stereotyped interests and behaviors,total RBQ-2 and all its subdomains,and lower scores for total SSP,tactile sensitivity,taste sensitivity,under-responsive/seeks sensation,auditory filtering and visual/auditory sensitivity than children with no such problems.After adjusting for age and gender,the total scores of MBQ of children with ASD were positively correlated with the total scores of SCQ,RBQ-2 and all their subdomains.Meanwhile,it showed negative correlations with all SSP scores(P<0.05).In multiple linear regression,the total RBQ-2 scores and SSP scores have predictive effects on the total MBQ scores,which can explain 48.1% of the variance in it(P<0.05).Further more,the total RBQ-2 scores were associated with scores for abnormal mealtime behavior and food selectivity(P <0.05),and the total SSP scores also had influence on scores of eating ability,abnormal mealtime behavior,and food selectivity(P <0.05).Conclusion1.The incidence of eating behavior problems of children with ASD among 3-6 years old in our study was at a relatively high level.Children with ASD have more difficulties than TD children,which reflected a serious situation in eating behavior problems of children with ASD.2.Eating behavior problems may be related to age,gender and severity,but more research is needed in the future.3.Repetitive stereotyped behaviors and sensory processing problems are both important predictors of eating behavior problems in children with ASD.Before intervention,multidisciplinary teams should evaluate systematically and formulate comprehensive intervention measures.