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Aviva I Rappaport1, Maureen Rose1, Mary Hendrickson1
1School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC

The prevalence of attention deficit-hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) among Canadian children is approximately 5% and 1 in 66 children, respectively. Feeding challenges are common in children with these two neurodevelopment conditions due to factors such as sensory sensitivity, disordered eating, and drug-nutrient interactions.

To determine facilitators and barriers to sufficient dietary intake among children with ADHD or ASD.

A search strategy was developed and Medline, Embase, and Cochrane were searched. A total of 1502 papers were identified. Titles and abstracts, and full-text papers were screened and eligibility for inclusion was assessed.

A total of 13 and 28 studies that included children with ADHD and ASD respectively were included. Facilitators for dietary intake in ADHD included impulsivity and school-based programs. For children with ASD, feeding accepted foods, positive reinforcement, repeated exposures, food transformation, modelling, and family meals promoted intake. Barriers to intake in children with ADHD included body dissatisfaction, inattention, drug-nutrient interactions, eating disorder behaviours, parental pressure, and picky eating. Children with ASD were more likely to be diagnosed with pica or avoidant restrictive food intake disorder (ARFID), and experienced high levels of food selectivity, gastrointestinal symptoms, and behaviour problems during meals, significantly impacting intake.

Facilitators such as modelling, food transformation, repeated exposures, and positive reinforcement may help children manage feeding difficulties in these two neurodevelopment conditions. However, it must be noted that interventions aimed at facilitating intake in these two populations may take longer to be accepted in comparison to their neurotypical counterparts.

This review provides an overview of factors that facilitate and impede intake in a population of neurodivergent children. The findings can be utilized to improve clinical interventions by dietitians.

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