Elsevier

Journal of Pediatric Nursing

Volume 31, Issue 6, November–December 2016, Pages 598-607
Journal of Pediatric Nursing

Autism Spectrum Disorder and the Child's Weight–Related Behaviors: A Parents' Perspective1

https://doi.org/10.1016/j.pedn.2016.05.006Get rights and content

Highlights

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    Children with ASD are at higher risk for obesity than typically developing children.

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    Nutrition, physical activity and screen time are weight-related behaviors.

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    Parent interviews indicate both healthy and unhealthy weight-related behaviors.

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    Parents may not be able to follow HCP instructions for healthy weight-related behaviors.

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    ASD specific weight-related behavior strategies are needed.

Purpose

To explore parent perspectives of how the attributes of their child's autism spectrum disorder(ASD) impact nutrition, physical activity, screen time behaviors and risk for obesity. Secondarily, we examined the parent's perception of the healthcare providers (HCP) influence on these weight-related behaviors.

Design and method

We conducted and audio-recorded telephone interviews with parents of children with ASD (n = 8) using a structured question guide. Data were transcribed and thematic analysis was conducted. Issues surrounding weight-related behaviors and parental strategies used were reported.

Results

Two overarching themes with eight subthemes emerged: (1) Challenges related to features of ASD (subthemes included fixation on food, sensory issues/rigidity, developmental factors, impaired social skills, and medication effects) and (2) Challenges related to the care of children with ASD (subthemes included lack of individualized care planning, picking your battles and the impact of ASD on family).

Conclusion

Strategies extracted from the parent narratives promoted both healthy and unhealthy weight-related behaviors. The key finding in this study is that some parents did not follow HCP guidance when they perceived that the HCP did not understand their particular situation.

Practice Implications

Implementation of healthy weight-related behaviors can be optimized when providers consider the child's challenging ASD behaviors, affirm the difficulties encountered by the family and provide guidance that builds on the individual child/family strengths.

Section snippets

Research Design, Sample and Data Collection

Open-ended, semi-structured telephone interviews with parents of children with ASD were used in this qualitative cross-sectional study. Approval was received by the university's institutional review board. Participants were recruited for a concurrent study through the Interactive Autism Network (IAN) Research Database at the Kennedy Krieger Institute, Baltimore. They also provided consent to participate in this qualitative study. The IAN national Web-based registry was clinically validated in

Participant Description

All parents who participated in the study were either married or living together (Table 2). Parents were generally well educated with a wide range of income. The majority of the children with ASD were boys (86.5%) and ages ranged from 6–16 years (M = 12, SD = 3.25). In this sample, no children or parents met the criteria for underweight, but 37.5% of children and 25% of parents were considered having a normal weight. The remaining parents (75%) and children (62.5%) were overweight or obese based on

Discussion

In this study, eight parents offered insight about their experiences with their child's weight-related behaviors, including nutrition, physical activity and screen time and the potential risk for obesity. They also described HCP influence on these weight-related behaviors. These experiences underscore the increased obesity risk in children with ASD. Individual characteristics of ASD, responses by the family and the environment that the child lives in appears to have the ability to impact the

Conclusion

This study highlights weight-related behaviors and strategies used by parents of children with ASD. Although these children have many of the same weight-related behaviors as typically developing children, the situation is exacerbated by the unique and challenging characteristics of ASD. These challenges can lead to parents making choices that may potentially reinforce negative health behaviors. Awareness of these ASD associated challenges and building on the child's strengths can decrease the

Acknowledgments

We would like to extend our sincere gratitude to the families who participated in our study and to the Kennedy Krieger Institute for assistance with recruitment.

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    1

    No authors have any disclosures or conflicts of interest. No funding was obtained for this manuscript.

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