The COVID-19 pandemic has affected us all.  Research suggests, however, that compared to the general population, the pandemic has had significantly greater impacts on people with psychiatric and mental health disorders.  Children with autism spectrum disorder represent a particularly vulnerable population.

Autism spectrum disorder affects1 in 54 children in the US. 

Autism spectrum disorder affects 1 in 54 children in the US.  Children with autism often feel more comfortable following structured routines with specific preferences, including for specific foods and eating environments.  Children with autism spectrum disorder, for example, typically consume a less varied diet due to sensitivities to taste, texture, smell, and appearance of foods.  These limited diets may have health implications: studies have reported a correlation between the diets of children with autism spectrum disorder and nutritional inadequacies.

While we know that disruptions to the habits of children with autism spectrum disorder may lead to increased stress and anxiety, scant research has been conducted to determine how the sweeping changes to the food system brought on by the COVID-19 pandemic have affected children with autism.

In response, ASN member Anita A. Panjwani et al. conducted a cross-sectional online survey among 200 caregivers of children aged 2 to 17 with autism spectrum disorder.  In addition to investigating the impact of the pandemic on the eating habits of the children, the authors wanted to know whether the impacts differed based on the household’s income and food security status.

The survey was conducted in May and June of 2020 when shelter-in-place or stay-at-home orders were in effect across most of the US.  Survey items included impacts on food purchasing and food preparation methods; child’s food and diet characteristics; and child’s physical activity, food intake, and eating behaviors.  The results of the survey, “COVID-19 and Food-related Outcomes in Children with Autism Spectrum Disorder: Disparities by Income and Food Security Status,” were published in Current Developments in Nutrition, the American Society for Nutrition’s open-access journal.

Caregivers reported substantial COVID-19 impacts on food availability and eating behaviors of children with autism spectrum disorder.

According to the study’s findings, “a large proportion of caregivers reported substantial COVID-19 impacts on food availability and eating behaviors of children with autism spectrum disorder.”  Specifically, 57% of participants reported a moderate-to-large impact of the pandemic and its associated regulations on the overall eating behaviors of the child in their care.  Consumption of meat, seafood, vegetables, and 100% fruit juice, for example, all significantly decreased among the children, while the frequency of sweets consumption significantly increased.  sIn addition to poorer diet quality, 55% of respondents reported that the children were less physically active during the pandemic, increasing their risk for weight gain, obesity, and related health disorders.

The results of the survey also underscored the extra burden the pandemic has placed on low-income, food-insecure households that have children with autism spectrum disorder: “Moderate-to-large impacts on eating behaviors were significantly higher among food insecure households upon the onset of COVID-19; however, this difference was marginal prior to COVID-19.”

Children with autism spectrum disorder were already at risk for inadequate nutritional intake and health outcomes even before the pandemic, due to greater food selectivity, lack of diverse diet, and poor gut health.  The results of this survey “suggest COVID-19 has amplified these challenges, particularly among families with low household income and/or household food insecurity status.”  The authors therefore stress “the importance of monitoring the unique needs of this high-risk population and tailoring public health responses to lower resource autism spectrum disorder families.”

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