PP-123 Comorbidity of avoidant-restrictive food intake disorder with autism spectrum disorder: identification and management

Aim Proper nutrition is one of the most important factors for the optimal development of the child. For children with autism, food selectivity is typical. Leo Kanner, in his first publications about children with autism, mentioned that they are characterized by a limited diet (Kanner, 1943). It is important to optimize identification and management of ARFID (avoidant-restrictive food intake disorder) in vulnerable children – children with ASD. Material and Method Single-stage non-comparative study. All patients were examined by multidisciplinary medical team (psychiatrist, pediatrician, allergist-immunologist, gastroenterologist, endocrinologist, geneticist, dietician), appropriate laboratory and instrumental tests were done. Results The research included 109 children with ASD (diagnosis verified with ADI-R – Autism Diagnostic Interview, Revised, C.Lord, 1994), 76 males/33 females (69,7%/30,3%). The age ranged from 2 years to 17 years 11 months, (94 (26; 177) months). The diagnostic clusters of ARFID are: 1)selective/restrictive food intake behavioral, 2)negatively affected the physical health, 3)social dysfunction. The guideline for diagnosing ARFID has been developed and piloted in children with ASD. A multidisciplinary team is required for the diagnosis and management of ARFID, also for diagnosing medical conditions that can mimic ARFID (allergies, GERD and others), consultation with a geneticist is necessary to exclude inherited metabolic disorders. In 93 out of 109 children with autism (85,3%), signs of selective/restrictive food intake were revealed, of which 89 children (81,7%) had additional signs - diagnostic criteria (negatively affected the physical health and/or social dysfunction), allowing to diagnose ARFID as a co-occurring disorder. Negative impact on health was manifested in abnormal weight and height indicators (65%), low levels of micronutrients, vitamins (68%), metabolic disorders (24%). Conclusions ARFID is highly prevalent among children with autism. It is necessary to follow the guideline which include multidisciplinary examinations for the timely identification and management of ARFID in children with autism, to prevent negative consequences for their development and health.