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COVID-19 and Food-Related Outcomes in Children with Autism Spectrum Disorder: Disparities by Income and Food Security
Anita A Panjwani1, Regan L Bailey2, Bridgette L Kelleher1
1Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA.
Insights
The COVID-19 pandemic significantly impacted food availability and eating behaviors in children with autism spectrum disorder (ASD), particularly affecting low-resource families and increasing consumption of sweets.
Area of Science:
- Pediatric Nutrition
- Autism Spectrum Disorder Research
- Public Health and Pandemics
Background:
- Limited research exists on the COVID-19 pandemic's effect on food-related behaviors in children with autism spectrum disorder (ASD).
- Previous studies noted increased behavioral issues like distractibility and hyperactivity in children with ASD due to COVID-19.
Purpose of the Study:
- To characterize the pandemic's impact on preferred food access for children with ASD.
- To analyze changes in eating behaviors among children with ASD during the COVID-19 pandemic.
Main Methods:
- A cross-sectional online survey was administered to 200 caregiver proxies of children aged 2-17 years.
- Logistic regression models assessed the association between changes in eating behaviors/food availability and factors like income and food security.
Main Results:
- 57% of caregivers reported significant changes in their child's eating behaviors, and 65% noted unavailability of preferred foods.
- Food insecurity, lower household income (<$50,000), and shelter regulations were associated with increased negative impacts on eating behaviors.
- The pandemic amplified food unavailability risks, especially for food-insecure households and those with lower incomes. Consumption of meats, seafood, and vegetables decreased, while sweets increased.
Conclusions:
- The COVID-19 pandemic substantially affected food availability and eating behaviors in children with ASD, particularly in low-resource settings.
- The findings underscore how the pandemic exacerbated existing health disparities for children with ASD.
- Interventions are needed to mitigate these pandemic-related challenges and support vulnerable populations.
Background:
Limited research suggests increased adverse behavioral outcomes, such as distractibility and hyperactivity, among children with autism spectrum disorder (ASD) as a result of coronavirus 2019 (COVID-19); however, little is known about how the pandemic has impacted food-related behaviors among children with ASD.
Objective:
This study characterizes the impact of the pandemic on access to preferred foods and eating behaviors among children with ASD.
Methods:
Caregiver proxies (n = 200) participated in a cross-sectional, online survey investigating the impact of COVID-19 on reported food and eating behaviors of children, ages 2-17 y. Logistic regression models were used to assess the magnitude of association of a change in the child's eating behaviors and in food availability, overall and by household income and food security status.
Results:
A majority of respondents reported a moderate-to-large impact on their child's eating behaviors (57%) since the onset of COVID-19, and 65% reported unavailability of their child's preferred foods. Increased risk of a moderate-to-large impact on children's eating behaviors was associated with shelter regulations compared with no regulations (OR: 2.30; 95% CI: 1.12, 4.72), food insecurity compared with security status (OR: 2.60; 95% CI: 1.45, 4.67), and household income of <$50,000 compared with ≥$100,000 (OR: 2.33; 95% CI: 1.02, 5.29). The pandemic also amplified the risk of food unavailability by household food security status (food insecure vs. secure; OR: 4.13; 95% CI: 2.12, 7.69) and across income levels (<$50,000 vs. ≥$100,000; OR: 3.48; 95% CI: 1.42, 8.55; and $50,000 to <$100,000 vs. ≥$100,000; OR: 4.00; 95% CI: 1.71, 9.34). Reported frequencies of consumption of meat, seafood, vegetables, and 100% fruit juice significantly decreased among the children post-onset of COVID-19, while frequency of consumption of sweets increased.
Conclusions:
A large proportion of caregivers reported substantial COVID-19 impacts on food availability and eating behaviors of children with ASD, especially among low-resource dyads. This study highlights the added burden of existing disparities due to the pandemic on children living with ASD.
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