1. DASLNE Conference 23rd May 2012
Development of the BEFG-ASD - Supporting professionals and parents of children with ASD
Noor Safiza Mohamad Nor
PhD student /Paediatric Dietitian
Institute of Health and Society
Newcastle University
DASLNE Conference 23rd May 2012
Institute for Public Health, National Institutes of Health
Ministry of Health Malaysia

2. Why identify feeding problems and GI symptoms ?
Problems may be similar to typically developing children but more frequent, persistent and longstanding in children with ASD
Contribute to psychosocial and financial impact for children and families
Management of these problems likely to be challenging
Professionals in the community needs to identify and clarify these issues in a systematic way, to engage discussion with parents
No structured questionnaire addressing both problems and the impact –for professionals in the community ( health and education settings)

3. An information pack was developed together with the BEFG-ASD
Aims of research
To develop a Brief structured questionnaire for the Early identification of Feeding problems and Gastrointestinal(GI) symptoms in children with Autism Spectrum Disorders, and the impact of these problems (BEFG-ASD)
Interview based questionnaire for use by a range of professionals in the community
An information pack was developed together with the BEFG-ASD

4. Methods FIELD TESTING OF BEFG-ASD Involvement of experts:
Professionals
Parents
PHASE I
DEVELOPMENT OF
BEFG-ASD
Health professionals
Teachers/Teaching assistants
Community workers
Parents
PHASE II
FIELD TESTING OF BEFG-ASD
PHASE III
Reliability and validity analyses
Telephone interview with professionals
EVALUATION OF BEFG-ASD

5. RESULTS SECTIONS AND QUESTIONS OF THE BEFG-ASD
GI SYMPTOMS
Abdominal pain (not associated with constipation)
Diarrhoea
Chronic constipation
Toileting problems
Frequent vomiting
Weight issues
(9 Questions)
use of Bristol Stool Chart A
FEEDING PROBLEMS
Food selectivity
Food sensitivity (physical food characteristics)
Food sensitivity (child’s food environment)
Problematic mealtime behaviours
Food neophobia
Signs of pica
Parental dietary practices
( 25 Questions) C
IMPACT
Impact of feeding problems
Impact of GI symptoms
(parent’s life, stress, financial, family life)
(8 questions)
- details of impact

6. Feeding Problems (N=73) Types Questions % ‘food neophobia’ 82%
child reluctant to eat new food
82%
‘food selectivity’
child refused to eat family food
child insisted similar food at most meals
child required specific food preparation
>50%
‘food sensitivity’
(based on child’s food environment)
child insists food served in particular way
child has problems with cutlery control
50%
(based on physical characteristics)
insisted food on particular textures, flavours and smells
>30%
‘signs of pica’
eat, lick or chew non-food items (stationaries, bus stops, baby wipes, papers, play dough, hair, furniture and tyres)
‘regular problematic mealtime behaviours’
(at least once a week).
disruptive behaviours (shouting, spitting and throwing foods)
aggressive behaviours (kicking siblings, throwing cutleries to family members and scratching tables)
62 % parents did not receive professional advice on feeding problems or child’s diet

7. Discussion and conclusion
Questionnaire development : mixed qualitative and quantitative approach
Commitment from professionals and parents was impressive
Professionals : 48
Parents :74
BEFG-ASD can be used by a range of professionals in the community to support children with ASD and their families
Multidisciplinary team approach in managing feeding problems

8. THANK YOU FOR YOUR SUPPORT!!!