Managing Feeding Difficulties in Autistic Children

Study aims

To provide a comprehensive view of the current evidence on strategies and interventions to improve feeding difficulties and problematic mealtime behaviours for children with autism.

Background

Feeding difficulties in autistic children have significant implications for the healthcare system, education system, and society as a whole. The burden on healthcare resources and professionals is exacerbated by the lack of accessible and affordable feeding interventions specifically tailored to the South African context. This creates challenges for affected children, their families, and healthcare practitioners who struggle to meet their complex needs. Findings from South Africa, are similar to those internationally regarding the high prevalence of feeding difficulties and problematic behaviours amongst autistic children, and the added stress and burden this placed on their caregivers. Previous research conducted in South Africa has explored feeding challenges prevalent in autistic children, and caregiver experiences feeding and caring for autistic children. Research has indicated an urgent need to develop evidence-based interventions that can be implemented successfully in under resourced settings. Interventions that have been developed internationally are costly for families and often requires access to trained professionals and resources that may be lacking in the South African context. Additionally, the fit of these interventions within community settings is not clear. Moreover, research in South Africa have illuminated the unique ways in which caregivers successfully manage feeding behaviours in the home environment.

Methods

The development of the PI takes an evidence-based and stepwise approach and draws on the expertise of rehabilitation professionals. Steps involved include a review of the evidence on interventions through a systematic review of available evidence. This information will be tabulated and correlated with availability of resources and appropriateness for the context of the proposed study and include classification of strength. Online questionnaires will be developed based on research from the literature review search. Questions will also include the identification of evidence-based feeding practices through the guidance of the healthcare professionals to assist with those that are appropriate, being used (and if adaptations are being made), and outcomes of the strategies. First, interventions identified from high-quality clinical practice guidelines (CPGs) will be discussed and selected based on consensus. Secondly, interventions not identified but considered as relevant will be suggested by the workgroup and added to the latter list if supported by evidence.  Lastly, stakeholders will be asked for their recommendation based on the information and evidence provided.

The review protocol was registered on PROSPERO (https://www.crd.york.ac.uk/PROSPERO/  registration number: CRD42024563446.

Current progress or findings

We have completed the systematic review and we are currently working on data analysis, article write up and expert review. 

Team members

Christopher Kuzagbe
Arshima Khan
Dr Skye Nandi Adams
Dr Edith Talina Luhanga 
Sarah Young