Evidence Based Practice Articles on Autism and Feeding Problems
Autism spectrum disorder is characterized by different forms of difficulties such as verbal and non-verbal communication, repetitive behaviors, and social interactions (Freedman, 2008 p.4). The condition is a learning disorder, and it depicts a development issue in the brain. Children with autism and autistic spectrum disorder find it hard to interact with other children of their age, and when in school, teachers, and other pupils consider the autistic children as “difficult”. However, autism can be managed very well. Children with autism need nursing care to bring out the best from them. According to a research conducted by Marcus Autism Center, children with autism are at risk of poor feeding and feeding disorder (Woodruff Health Sciences Center , 2013 para.1). It is notable that proper and healthy meals help children to develop mentally by socializing during meals, but autistic children do not experience that. Good nursing practice are needed to ensure that autism does not affect feeding and health of a child.
Children with Autism at Considerable Risk of Nutritional Deficits and Feeding Problems
The Department of Pediatrics at the Emory University School of Medicine and the Marcus Autism Center were the first institutions to conduct a research on the issue (Woodruff Health Sciences Center, 2013). First of all, it is not clear what causes autism. It may be genetic since the condition runs in families. Scientists have conducted several other researches to determine the brain sections that lead to the condition (Woodruff Health Sciences Center, 2013). The investigation carried out involved using all peer reviewed articles written on autism and feeding problems.
A meta-analysis of the peer reviewed articles was conducted by researchers from Emory University and Marcus Autism Center. From the research, they noted that most children diagnosed with the condition have a lower intake of calcium and protein, and also have a high number of other nutritional problems (Woodruff Health Sciences Center , 2013). Some of the feeding problems that children with autism experience include allergies for many food products. Therefore, the nurses should monitor the feeding habits of children, and ensure that the children eat food which is full of nutritional value (Woodruff Health Sciences Center, 2013). Secondly, autistic children also suffer from pica, a condition in which they eat nonfood materials, which is also a feeding and behavioral deficiency that nurses must observe and restrain.
The peer reviewed literature meta-analysis did not indicate that feeding disorders in autistic children resulted from the fact that they had a diet with only a few types of food. However, the Marcus Autism Centre researchers subtly indicated that parents of autistic children complained that few foods make up the diets of their autistic children (Woodruff Health Sciences Center , 2013). As a result of this meta-analysis conducted by researchers from Emory University and Marcus Autism Centre, nurses and caregivers of autistic children now have a chance to make the diets of children right by ensuring that they give supplementary nutrients such as proteins and calcium in the form of tablets or injections. The information is essential in making long-term decisions on the management plan for autistic children and the management of other health issues which they have.
Another significant impact of the Emory University and Marcus Autism Center research is that the nurses dealing with autistic children can develop a guideline on how to cope with the condition of those children who suffer from autism. Elimination diet has traditionally been used by nurses in coping with the adverse reactions which autistic children have to some types of food, but now it is clear that utilizing the elimination diet strategy could have a malnutrition potential for those involved (Brown-Guttovz, 2008 p.29). This is what drives the nursing community helping the autistic people to determine the best way of dealing with the feeding disorders. The Emory and Marcus Autism Center research was unique and it aimed at improving nursing process for the autistic children.
Early Feeding Problems that Indicate Autism
Early diagnosis of any condition is beneficial because it helps in determining the right strategies of coping and managing the impacts of the condition. Researchers at the University of Bristol in England noted that children who have feeding disorders are most likely to be autistic (Neale, 2010 Para. 5). This opens a primary method for early diagnosis of ASD (autistic spectrum disorder) which would help in nursing of such children especially in managing their diet and nutrition.
According to the study conducted by Golding and his colleagues, children with autism are selective on the food they eat and accept solid foods way later as compared to those who do not suffer from the condition. They are also not easy to feed, and nurses or parents have to struggle to feed them (Land, 2001 p.10). They are slow feeders and accept very few varied diets. Diagnosis should not be entirely dedicated to the feeding habits; hence, the discovery that children are pervasive food refusers or slow feeders, and other factors such as their speech, attention and behaviors should also be scrutinized to determine if they could be suffering from autism (Neale, 2010 para.8).
To come to that conclusion, the researchers asked parents to fill questionnaires with information on feeding and dietary habits of their children at different stages in life starting with 6 to 54 weeks, and when the children were at the age of 7, their heights were measured (Neale, 2010 para.8). The information collected from the questionnaires was compared with the information collected on children who have ASD and those who did not have. The patterns of feeding were identified the characteristic of resistance towards change exhibited by autistic children and, hence, found to be very important in early diagnosis of the condition for easy management.
SWEAA – A Self-Report Questionnaire Targeting Eating Disturbances within the Autism Spectrum
Children with ASD are sometimes thought to be fussy eaters. In many cases, caregivers and parents withhold food from fussy eaters so that they can eat when hungry. With children suffering from ASD, this strategy is dangerous (Karlsson, Råstam, & Wentz, 2013 p.2225). Wentz et.al developed a self reliant questionnaire which people filled to determine how their eating habits were affected by autism. This questionnaire is useful for teenagers and young adults who have autistic spectrum. However, the young adults must have an IQ of over 70 or have no potential for diagnosis of intellectual disability (Karlsson, Råstam, & Wentz, 2013 p.2225).
The Swedish Eating Assessment for Autism spectrum disorders (SWEAA) research conducted by Wentz et.al showed that people with ASD prefer food of certain colors and taste. They were also unable to eat because of the inability to eat certain foods and cut at the foods with the utensils provided (Lesinskiene, Pūras, Kajokiene, & Senina, 2002). Thirdly, the traditional setup of the eating place in which there was a sense of sociability was a challenge for people with autism because most of them prefer to do things on their own, but not in a place where there are other people.
This indicated that people with ASD could suffer from different other disorders especially related to allergies and phobias, and the best way to handle such cases is by ensuring that these people are well understood (Pinto-Martin, Souders, Giarelli, & Levy, 2005 p.164). Secondly, the SWEAA questionnaire is very essential because it helps in knowing the types of foods that the autistic individual does not naturally take so that substitutes are made available for the individual, and the nutritional balance in the body is maintained (Spurgeon, 1967 p.1416). It is quite unhealthy to withhold food for an autistic individual because such an individual may get malnutrition.
John 2004 Reflective Model
John’s model of reflection is based on five main questions. The cue questions enable an individual to break an issue into several stages including the process, outcomes and experience. In the determination of nursing issues, John’s reflection model was utilized. The breakdown of its application is shown in the discussion below.
Description of the Experience
At this stage, the knowledge of how autism is manifested in individuals is very important. The investigations conducted all focused on the feeding problems associated with the autistic children and the implications which these children might get from the feeding problems. Children with such conditions also have great potential to lack good social skills, especially those which are acquired during meals. Parents and caregivers of children with this condition understand better how the children behave with food. It was noted that children with ASD usually accepted solid food later in life as compared to their peers. Autistic children are also choosy on the foods they take (Neale, 2010 para.4).
The research conducted by Jean Golding and her colleagues also indicated that some were slow eaters, while others were quite troublesome during feeding (Neale, 2010 para.2). In the Emory University and Marcus Autism Center research, an analysis of case recorded about autism and feeding problems were subjected to meta-analysis to come to a conclusion. In the Jean Golding research, parents and caregivers were asked to fill questionnaires which were used in the determination of the impact of autism on feeding, and the SWEAA study involved young adults and teens with ASD. The teens and young adults were required to fill in the questionnaires on their own (Karlsson, Råstam, & Wentz, 2013 p.2226). The information collected from the three empirical researches was subjected to scrutiny and compared to that of feeding behaviors of people without ASD and the difference noted.
The Goals and Objectives of the Researches
All three researches, the Emory University and Marcus Autism Centre, the Jean Golding headed Bristol University research and SWEAA study, had one main goal and objective which they wanted to achieve. The goal was to determine the extent of feeding problems associated with autism and the consequences they have on health and nutrition of people suffering from the condition, and hence, and secondly, to determine the best nursing strategy which would impacts of autism to the people diagnosed with the condition. It is necessary to keep in mind that they all suffer allergies towards some food, they have a dislike for foods of certain colors, and more importantly, they suffer a low intake of calcium and proteins. These are some of the issues which nurses consider to define the relevant supplements or alternative feeding which can be used.
Age is one of the most important factors influencing the study. If feeding disorders are discovered early, they can be used to diagnose the condition early. Early diagnosis leads to early intervention for children with ASD, including offering substitutes and food supplements in their diet to ensure that the feeding disorders do not affect their health. Secondly, it is notable that early diagnosis of any condition offers the best chance for effective management, and hence, it is beneficial in nursing. Good nursing practice requires the individual to have a guideline for management.
What Could Have Been Improved
The articles selected for these assignments are all articles which deal with feeding disorders among the autistic children. However, although they are empirical and they give detailed information on the consequences of the disorders among the autistic, it is worth noting that they do not have mathematical representation, which could be essential for quantification. This would have been appropriate and quite beneficial for the study.
There are many issues that an individual can learn from the exercise. First of all, children with autism are not difficult to feed simply because they want to be rebellious, but because they have allergies for some foods. ASD affects some functions of the brain which cause autistic people to be choosy at what they eat or to have repetitive behavior. It is, however, not certain why children with autism have some allergic reactions to some foods since there is not direct connection of the brain functions with the diet.
Secondly, it is important to develop a diet which can help in substituting the foods which the autistic children do not like, because it would be even harder to nurse the autistic children if they are in bad health. Lastly, some of the traditional strategies used in managing choosy children cannot be applied to children with autism, and hence, it is important for parents to enlist the help of professional nurses with knowledge and experience in handling such children. If food is denied to force them to eat it when hungry, they may still not take it because they do not refuse to take on their volition, but as a direct response from the brain triggered by color of food, smell or taste as a result of brain function.
The study involves analyzing three empirical researches on a learning disorder in regards to nursing. The condition chosen is autism, which is a learning disorder and quite challenging in nursing. Three studies have been analyzed and a John 2004 model of reflection used on the three studies. The intention is to help in further understanding of autism and its implications in nursing.
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