目的 探讨孤独症谱系障碍(autism spectrum disorder,ASD)儿童的饮食行为问题,为建立ASD的生活自理能力训练方法提供研究基础。方法 实验组为2013年07月-2014年06月于本科就诊的ASD患儿53例,对照组为正常儿童50例,分别对两组儿童的主要照顾者进行饮食行为问题及一般信息调查。结果 实验组在进食能力、进食行为、食物选择和喂养行为四个维度不良饮食行为的发生率均高于对照组。实验组咀嚼有困难占32例( 60%);不会自己吃饭,需要喂饭的有30例(57%);拒绝一切食物的发生率为8例(15%);而对照组在这三个条目的发生率均为0例(0%)。此外,实验组不能在餐桌进餐、吃饭时间超过30 min、需要特定的餐桌/餐具摆放,或需要特定的餐具、不愿尝试新食物等条目的发生率也明显高于对照组。结论 饮食行为问题在ASD儿童中普遍存在,且种类多,程度重。因此,饮食行为问题是ASD儿童生活自理能力训练的重要项目之一。
Abstract
Objectiv To study the dietary behavior problems of children with autism spectrum disorder (ASD) and to provide a basis for the establishment of autism self-care ability training method. Method Caregiver report of eating problems and general information of 53 ASD children and 50 typically developing children were compared. Result In the experiment group,the incidences of unhealthy dietary behaviors were higher than those of control group in all the four dimensions:eating capacity,mealtime behavior,food selection and feeding behavior.There were 32 cases (60%) children with difficulty chewing,30 cases (57%) need to be fed,refuse all food occurred in 8 cases (15%),while the incidence rate was 0% in the control group.In addition,the incidences of children can not be at a table,eat more than 30 minutes of time,need a particular table / tableware placed,or require specific tableware,do not want to specific new food were also significantly higher than those of the control group. Conclusions Eating behavior problems are prevalent in children with autism than typically developing children,there are many types of problems and the extent of the deep.Eating behavior is one of the most important project of the self-care ability training of children with autism.
关键词
孤独症谱系障碍 /
饮食行为问题 /
食物选择 /
喂养行为 /
生活自理能力
Key words
autism /
eating behavior /
food choices /
feeding behavior /
self-care ability
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参考文献
[1] Emond A,Emmett P,Steer C,et al.Feeding symptoms,dietary patterns,and growth in young children with autism spectrum disorders[J].Pediatrics,2010,126(2):337-342.
[2] Kimberly AS,Keith W,Angela FS.A comparison of eating behaviors between children with and without autism[J].Journal of Autism and Developmental Disorders,2004,34(4):433-438.
[3] Kimberly AS,Keith W.Food preferences and factors influencing food selectivity for children with autism spectrum disorders[J].Research in Developmental Disabilities,2006,27(3):353-363.
[4] Yolanda M,Robyn LY,Danielle CR.Feeding and eating behaviors in children with autism and typically developing children[J].J Autism Dev Disord,2008,38(10):1878-1887.
[5] 周长虹,杨红蕾,匡桂芳,等.ASD儿童的饮食行为问题与血矿物质元素水平分析[J].中国儿童保健杂志,2011,08(19):751-753.
[6] American Psychiatric Association.Desk reference to the diagnostic critecial from DSM5[M].5th ed.Washington DC:American Psychiatric Publishing Inc,2013.
[7] Lynda AA,Peter LR,David LS.The children's eating behavior inventory:reliability and validity results[J].Journal of Pediatric Psychology,1991,16(5):629-642.
[8] Wardle J,Guthrie CA,Sanderson S,et al.Development of the children's eating behaviour questionnaire[J].J Child Psychol Psyc,2001,42(7):963-970.
[9] Berlin KS,Davies WH,Silverman AH,et al.Assessing Children's Mealtime Problems With the Mealtime Behavior Questionnaire[J].Children's Health Care,2010,39(2):142-156.
[10] 徐亮.IMFeD 工具对儿童饮食行为问题的调查研究[J].中国中西医结合儿科学,2012,4(2):185-186.
[11] Provost B,Crowe TK,Osbourn PL,et al.Mealtime behaviors of preschool children:comparison of children with autism spectrum disorder and children with typical development[J].Physical & Occupational Therapy in Pediatrics,2010,30(3):220-223.
[12] Jasmin E,Couture M,McKinley P,et al.Sensori-motor and daily living skills of preschool children with autism spectrum disorders[J].Journal of Autism and Developmental Disorders,2009,39(2):231-241.
[13] Smith RA,Farnworth H,Wright B,et al.Are there more bowel symptoms in children with autism compared to normal children and children with other developmental and neurological disorders:A case control study?[J].Autism,2009,13(4):343-355.
[14] Suarez MA,Atchison BJ,Lagerwey M.Phenomenological examination of the mealtime experience for mothers of children with autism and food selectivity[J].Am J Occup Ther,2014,68(1):102-107.
[15] 寿小婧,张嵘.ASD儿童的饮食问题[J].中国儿童保健杂志,2010,18(10):779-781.
[16] Nadon G,Feldman DE,Dumn W,et al.Mealtime problems in children with autism spectrum disorder and their typically developing siblings:A comparison study[J].Autism,2011,15(1):98-113.
[17] Dudova I,Vodicka J,Havlovicova M,et al.Odor detection threshold,but not odor identification,is impaired in children with autism[J].Eur Child Adolesc Psychiatry,2011,20(7):333-340.
[18] Potts M,Bellows B.Autism and diet[J].J Epid emiol Community Health,2006,60(5):375-379.
[19] Alcock J,Maley CC,Aktipis CA,Is eating behavior manipulated by the gastrointestinal microbiota?Evolutionary pressures and potential mechanisms[J].Bioessays,2014;36(8):940-949.
[20] Finegold SM,Dowd SE,Gontcharova V.Pyrosequencing study of fecal microflora of autistic and control children[J].Anaerobe,2010,16(4):444-453.
[21] Adamson M,Morawska A,Sanders MR.Childhood feeding difficulties:a randomized controlled trial of a group-based parenting intervention[J].J Dev Behav Pediatr,2013,34(5):293-302.
基金
国家自然科学基金(81270665);安徽省教育厅重点项目(KJ2012ZD07)