Management of critical care emergencies in children with autism spectrum disorder

Table 10 Nutritional and dietary protocols for children with autism spectrum disorder in the emergency setting¹

Protocol component	Guidelines
Initial assessment
Medical and dietary history	Obtain a detailed medical history, including any comorbid conditions and current medications
	Review the child’s dietary intake, food preferences, and known allergies or intolerances
Caregiver input	Consult with caregivers to understand the child’s typical eating habits, favorite foods, and any aversions
Anthropometric measurements	Measure and document the child’s weight, height, and BMI to assess nutritional status
Nutritional needs
Caloric requirements	Calculate the child’s caloric needs based on age, weight, and clinical condition
Macronutrient distribution	Ensure a balanced intake of carbohydrates, proteins, and fats according to the child’s needs and preferences
Micronutrient needs	Monitor for any signs of micronutrient deficiencies and address them through diet or supplementation
Special dietary considerations
Food sensitivities and allergies	Avoid known allergens and foods that the child is sensitive to, as reported by caregivers
Texture and consistency	Consider the child’s food texture and consistency preferences, providing options that are easier to consume
Gastrointestinal issues	Address any gastrointestinal issues (e.g., constipation, diarrhea) with appropriate dietary modifications
Meal planning and provision
Regular mealtimes	Maintain regular meal and snack times to provide structure and predictability for the child
Familiar foods	Offer familiar and preferred foods to encourage intake and reduce stress
Nutrient-dense foods	Prioritize nutrient-dense foods to ensure adequate nutrition even with limited intake
Feeding strategies
Positive reinforcement	Use positive reinforcement to encourage the child to try new foods or maintain healthy eating habits
Minimal distractions	Create a calm and distraction-free environment during meals to help the child focus on eating
Adaptive utensils	Provide adaptive utensils and cups if needed to facilitate independent eating
Nutritional monitoring
Regular monitoring	Monitor the child’s nutritional intake, weight, and overall health status regularly
Adjustments as needed	Adjust the dietary plan based on the child’s evolving needs and any changes in their medical condition
Supplementation
Vitamin and mineral supplements	Provide vitamin and mineral supplements to address deficiencies or support overall health
Special formulas	Consider using specialized nutritional formulas if the child has significant dietary restrictions or needs
Caregiver education and support
Dietary guidance	Educate caregivers on the importance of balanced nutrition and how to meet their child’s dietary needs.
Meal preparation	Provide tips and resources for preparing nutritious meals that align with the child’s preferences and needs
Emergency planning	Develop an emergency plan for situations where usual foods are unavailable, including suitable alternatives
Documentation
Detailed records	Document all aspects of the child’s nutritional and dietary assessment, interventions, and outcomes
Care plan updates	Regularly update the child’s care plan to reflect any dietary needs or preferences changes

¹This table format provides a structured approach to nutritional and dietary management for children with autism spectrum disorder in an emergency setting.