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Zaffanello M, Piacentini G, Nosetti L, Zoccante L. Sleep Disordered Breathing in Children with Autism Spectrum Disorder: An In-Depth Review of Correlations and Complexities. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1609. [PMID: 37892271 PMCID: PMC10605434 DOI: 10.3390/children10101609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023]
Abstract
Sleep-disordered breathing is a significant problem affecting the pediatric population. These conditions can affect sleep quality and children's overall health and well-being. Difficulties in social interaction, communication, and repetitive behavioral patterns characterize autism spectrum disorder. Sleep disturbances are common in children with ASD. This literature review aims to gather and analyze available studies on the relationship between SDB and children with autism spectrum disorder. We comprehensively searched the literature using major search engines (PubMed, Scopus, and Web of Science). After removing duplicates, we extracted a total of 96 records. We selected 19 studies for inclusion after a thorough title and abstract screening process. Seven articles were ultimately incorporated into this analysis. The research findings presented herein emphasize the substantial influence of sleep-disordered breathing on pediatric individuals diagnosed with autism spectrum disorder (ASD). These findings reveal a high incidence of SDB in children with ASD, emphasizing the importance of early diagnosis and specialized treatment. Obesity in this population further complicates matters, requiring focused weight management strategies. Surgical interventions, such as adenotonsillectomy, have shown promise in improving behavioral issues in children with ASD affected by OSA, regardless of their obesity status. However, more comprehensive studies are necessary to investigate the benefits of A&T treatment, specifically in children with ASD and OSA. The complex relationship between ASD, SDB, and other factors, such as joint hypermobility and muscle hypotonia, suggests a need for multidisciplinary treatment approaches. Physiotherapy can play a critical role in addressing these intricate health issues. Early sleep assessments and tailored weight management strategies are essential for timely diagnosis and intervention in children with ASD. Policy initiatives should support these efforts to enhance the overall well-being of this population. Further research is crucial to understand the complex causes of sleep disturbances in children with ASD and to develop effective interventions considering the multifaceted nature of these conditions.
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Affiliation(s)
- Marco Zaffanello
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37126 Verona, Italy;
| | - Giorgio Piacentini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37126 Verona, Italy;
| | - Luana Nosetti
- Department of Pediatrics, Pediatric Sleep Disorders Center, “F. Del Ponte” Hospital, Insubria University, 21100 Varese, Italy;
| | - Leonardo Zoccante
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital Verona, 37126 Verona, Italy;
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The Perspectives of Preservice Kinesiology Students Concerning Autism and Physical Activity: Differences by Adapted Physical Activity Exposure. J Phys Act Health 2023; 20:180-192. [PMID: 36706762 DOI: 10.1123/jpah.2022-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/17/2022] [Accepted: 11/21/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND This study investigated the effect of an adapted physical activity (APA) course on knowledge and perceptions of preservice trainees regarding physical activity (PA) and autism spectrum disorder in 3 areas: knowledge/perspectives, importance and ease of improving developmental domains, and importance and ease of improving motor skills. METHODS Four hundred upper-level undergraduate students were recruited to participate in this survey-based study (251 APA students and 149 non-APA students participated). Survey data were analyzed using multivariate analyses of variance. RESULTS Participants estimated that the moderate to vigorous PA recommendations are 39.34 minutes per day, that 46.65% of moderate to vigorous PA occurs during school, and that 61.03% of children have motor difficulties. Participants perceived activities of daily living, sleep habits, and heart health as the easiest domains to improve, and problem behaviors, social skills, and self-esteem as the most difficult domains to improve. Knowledge/perspectives regarding autism spectrum disorder and PA were different by APA exposure (F12,324 = 3.11, P < .001). Differences included self-efficacy in providing PA advice, knowledge of PA guidelines, and willingness to provide motor assessment referrals. Students differed by APA exposure in the importance of developmental domains (F8,381 = 4.37, P < .001) but not ease of improving those domains. CONCLUSION Results suggest that APA education and contact with children with disabilities improves self-efficacy, perspectives, and knowledge of PA and motor concerns in children with autism spectrum disorder.
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McPherson AC, Perez A, Buchholz A, Forhan M, Ball GDC. "It's not a simple answer." A qualitative study to explore how healthcare providers can best support families with a child with autism spectrum disorder and overweight or obesity. Disabil Rehabil 2021; 44:3540-3546. [PMID: 33399017 DOI: 10.1080/09638288.2020.1867909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE This qualitative study aimed to explore the experiences of parents supporting their child with Autism Spectrum Disorder (ASD) and overweight or obesity (OW/OB), including their weight management support needs. METHODS Interview transcripts were analysed using inductive thematic analysis. Nine parents (n = 9 mothers) of ten children with ASD (7 males, 3 females) participated in individual semi-structured interviews. RESULTS The three themes developed were: (1) Our journey to obtain weight management support; (2) I need real-world solutions; and (3) The what, who and how of our weight management needs. Parents reported being proactive in seeking weight management support for their child but were disappointed with the services offered. Resources were not tailored to the child's complex nutrition and behavioural issues or their abilities and functioning. A multidisciplinary approach that integrated both disability and weight management expertise was desired, but not experienced. A range of formal and informal programs were recommended. CONCLUSION This study provides a call to action for supports that ensure children with ASD and OW/OB receive integrated, individualised support to maximise their health and wellness.Implications for rehabilitationChildren with autism spectrum disorder (ASD) are at high risk of developing overweight or obesity.The weight management support needs of parents of children with ASD and overweight or obesity are not being met.Support must be tailored to the child's needs, which are often complex.Health services that integrate expertise in both disability and weight management are needed for children with ASD and their families.
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Affiliation(s)
- Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Dalla Lana School of Public Health and Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Arnaldo Perez
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Annick Buchholz
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Mary Forhan
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Geoff D C Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
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Doreswamy S, Bashir A, Guarecuco JE, Lahori S, Baig A, Narra LR, Patel P, Heindl SE. Effects of Diet, Nutrition, and Exercise in Children With Autism and Autism Spectrum Disorder: A Literature Review. Cureus 2020; 12:e12222. [PMID: 33489626 PMCID: PMC7815266 DOI: 10.7759/cureus.12222] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Diet and nutrition play an important and essential role in everyone's life. It helps build a healthy body and a strong mind. We know that food rich in nutrients can remove toxins from the body, make an excellent immune system, curb hunger, and prevent obesity. Obesity is one of the most concerning, alarming, and fastest-growing pandemics. It affects not only adults but also adolescents and children. The disease's early-onset calls for prompt attention to control the physical, psychological, financial, and social burden it creates. Children with autism and autism spectrum disorders (ASDs) are commonly affected by eating disorders. Their preference for energy-dense food with low nutrition can alter their metabolism, leading to the accumulation of oxidative radicals, causing them to deteriorate mentally and physically. Although dieting and losing weight are now commonly seen in the general population, it has become hard to bring awareness to children with special needs about diet, nutrition, and obesity. Despite efforts, parents of such children usually cannot help control the eating because tantrums and behavioral problems are common. It is now imperative for doctors and parents to work alongside nutritionists and dieticians to help these children eat healthy to be fit and improve the quality of life.
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Affiliation(s)
- Shriya Doreswamy
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.,Otorhinolaryngology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
| | - Anam Bashir
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Jesus E Guarecuco
- Neuroscience and Psychology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Simmy Lahori
- Medicine, Pramukhswami Medical College, Karamsad, Anand, IND.,Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Ayesha Baig
- Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Lakshmi Rekha Narra
- Anesthesiology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Pinal Patel
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Stacey E Heindl
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.,Internal Medicine, Avalon University School of Medicine, Willemstad, CUW
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Developmental-Behavioral Pediatricians' Diagnosis and Coding of Overweight and Obesity in Children with Autism Spectrum Disorder. J Dev Behav Pediatr 2020; 41:258-264. [PMID: 32040046 DOI: 10.1097/dbp.0000000000000783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The prevalence of obesity in autism spectrum disorder (ASD) is high, and managing obesity in children with ASD can be challenging. The study's objective was to examine developmental-behavioral pediatricians' (DBPs) coding practices for overweight/obesity in children with ASD and patient characteristics associated with coding. METHODS We analyzed the clinical data on children with ASD with at least 1 visit at one of 3 developmental-behavioral pediatrics network sites between January 2010 and December 2011. Weight status was calculated using body mass index z-scores. For children meeting the criteria for overweight/obesity, we assessed the frequency of weight-related ICD-9 diagnosis codes at DBP visits, used multivariable logistic regression to determine characteristics associated with the presence of these codes, and examined the prevalence of weight-related codes relative to other diagnosis codes. RESULTS The sample included 4542 children, ages 2 to 19 years. 15.5% of children met the criteria for overweight, 14.7% for obesity, and 6.3% for severe obesity. Of children meeting the criteria for overweight/obesity/severe obesity, 7.5% had a weight-related code documented at their visits. Children with obesity or severe obesity and older children had higher odds of having a weight-related code. Compared with not being on medications, atypical antipsychotics use was significantly associated with increased odds of having a weight-related code. Of 3802 unique ICD-9 diagnosis codes documented at any visit during the study period, only 4% were related to weight. CONCLUSION Few children meeting the criteria for overweight/obesity had documented weight-related codes. Weight-related coding was more likely for children with obesity, who were older, and those taking atypical antipsychotics.
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Curtin C, Hyman SL, Boas DD, Hassink S, Broder-Fingert S, Ptomey LT, Gillette MD, Fleming RK, Must A, Bandini LG. Weight Management in Primary Care for Children With Autism: Expert Recommendations. Pediatrics 2020; 145:S126-S139. [PMID: 32238539 DOI: 10.1542/peds.2019-1895p] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2020] [Indexed: 11/24/2022] Open
Abstract
Research suggests that the prevalence of obesity in children with autism spectrum disorder (ASD) is higher than in typically developing children. The US Preventive Services Task Force and the American Academy of Pediatrics (AAP) have endorsed screening children for overweight and obesity as part of the standard of care for physicians. However, the pediatric provider community has been inadequately prepared to address this issue in children with ASD. The Healthy Weight Research Network, a national research network of pediatric obesity and autism experts funded by the US Health Resources and Service Administration Maternal and Child Health Bureau, developed recommendations for managing overweight and obesity in children with ASD, which include adaptations to the AAP's 2007 guidance. These recommendations were developed from extant scientific evidence in children with ASD, and when evidence was unavailable, consensus was established on the basis of clinical experience. It should be noted that these recommendations do not reflect official AAP policy. Many of the AAP recommendations remain appropriate for primary care practitioners to implement with their patients with ASD; however, the significant challenges experienced by this population in both dietary and physical activity domains, as well as the stress experienced by their families, require adaptations and modifications for both preventive and intervention efforts. These recommendations can assist pediatric providers in providing tailored guidance on weight management to children with ASD and their families.
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Affiliation(s)
- Carol Curtin
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts; .,Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Susan L Hyman
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,University of Rochester Medical Center, Rochester, New York
| | - Diane D Boas
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,The Barbara Bush Children's Hospital, Maine Medical Center, Portland, Maine
| | - Sandra Hassink
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,Institute for Healthy Childhood Weight, American Academy of Pediatrics, Itasca, Illinois
| | - Sarabeth Broder-Fingert
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,Boston Medical Center and School of Medicine, Boston University, Boston, Massachusetts
| | - Lauren T Ptomey
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,University of Kansas Medical Center, Kansas City, Kansas
| | - Meredith Dreyer Gillette
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,Children's Mercy Kansas City and School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri
| | - Richard K Fleming
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,University of Massachusetts Boston, Boston, Massachusetts
| | - Aviva Must
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,School of Medicine, Tufts University, Boston, Massachusetts; and
| | - Linda G Bandini
- Healthy Weight Research Network, University of Massachusetts Medical School, Worcester, Massachusetts.,Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester, Massachusetts.,Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts
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Silva DVD, Santos PNM, Silva DAVD. EXCESS WEIGHT AND GASTROINTESTINAL SYMPTOMS IN A GROUP OF AUTISTIC CHILDREN. ACTA ACUST UNITED AC 2020; 38:e2019080. [PMID: 32215545 PMCID: PMC7089583 DOI: 10.1590/1984-0462/2020/38/2019080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/04/2019] [Indexed: 01/26/2023]
Abstract
Objective: To evaluate the nutritional status and gastrointestinal changes in children
with autism spectrum disorder (ASD). Methods: Cross-sectional, descriptive analysis of 39 children with ASD aged between
three and ten years old, registered in the participating association.
Nutritional status was evaluated by body mass index/age and weight/age,
according to the guidelines from the World Health Organization. In order to
investigate whether gastrointestinal alterations occurred, the interviewees
answered a questionnaire about the presence of these symptoms within the
last 30 days. In order to evaluate food consumption, a 24-hour recall
questionnaire was applied and the food reported were grouped as: gluten
sources, casein and ultra-processed sources. For the statistical analysis,
Epi-Info software version 7.2 was used. Multivariate logistic regression
analysis was performed to evaluate the variables associated with
gastrointestinal alterations. Results: There was a high prevalence of overweight children with autism spectrum
disorder (64.1%). No child was underweight. Thirty-four children (84.2%) had
gastrointestinal symptoms. Consumption of gluten was associated with
gastrointestinal symptoms (β=0.38; 95%CI 0.07-0.75; p=0.02). Conclusions: The high prevalence of being overweight should be considered during the
follow-up visits of children with ASD. The influence of gluten consumption
on the presence of gastrointestinal symptoms was observed in this study, and
the causes involved in these alterations need to be further
investigated.
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