In dietetics practice, diagnostic and screening measures for ASD and ADHD should be implemented to gain a clearer understanding of the patient’s condition. Broad screening tools like the usual diet intake, alongside collateral history from family, can be useful. General blood tests may help identify nutritional deficiencies or other health issues, and additional tests might be considered to identify further potential issues. Building a support network is also key. Rebuilding or establishing a multidisciplinary team, including a general practitioner, psychologist, occupational therapist, support worker, and potentially a speech therapist, can provide comprehensive care. An exercise physiologist may also be involved to help the patient reengage in physical activities and improve overall well-being. Referring to an occupational therapist for a sensory profile and functional capacity assessment can help in managing sensory needs and daily tasks.(1) A thorough review of the patient’s history is essential, including understanding their current treatment status and exploring any recent gaps in support. Evaluating factors such as sleep patterns, screen time, and mental health symptoms, including potential depression, anxiety, or psychosis, physical activity and dietary intake. Medication management needs to be reassessed, addressing any issues with interactions between Pharmacotherapy and nutrients. (2)
The initial consultation should be seen as an opportunity to build rapport and reconnect, especially if the patient has been out of touch with medical services for a while. The focus should be on listening to their current situation and offering support.
Building rapport is crucial, in engaging the patient by showing genuine interest in their hobbies or familiar interests can help ease them into the conversation. For example, referencing common interests can create a connection and make the patient feel more at ease. It is important to keep the patient informed about the process, including any tests or additional reviews. Setting clear goals and addressing specific issues like sleep disturbances with appropriate treatments are also important aspects of this plan. Many individuals with early diagnoses may not fully grasp their conditions or might have received deficit-focused information. An affirming approach can help the patient understand their neurotype, focusing on strengths and areas needing support.
Involving them in decision-making ensures they feel included and respected, even if they are initially withdrawn.(3)
Exploring reasons behind dietary intake and lifestyle choices, addressing any negative experiences or beliefs about foods is crucial. Maintaining communication with the GP and psychiatrist for medication reviews and support with co-occurring issues is essential.
A neuro-affirming and trauma-focused approach should be adopted, adapting therapies to suit the individual’s needs and focusing on treating food intake health issues rather than trying to 'fix' behaviours related to autism or ADHD. Taking into consideration and addressing anxiety, low mood, and the impact of significant life changes, is important for supporting positive relationship with food and support healthy eating patterns.
Connecting the patient with other neurodivergent individuals for social support and validating their experiences is beneficial. Linking them with disability employment services for job seeking and acknowledging the need for ongoing support throughout adulthood is crucial. (4)
In the management of complex conditions such as autism and ADHD, dietetics and nutrition are pivotal to overall well-being. Nutritional deficiencies can adversely affect mental health and cognitive function, underscoring the importance of incorporating dietary interventions. A dietitian provides personalised guidance on nutritional intake, aiding in symptom management and enhancing overall health. For individuals navigating the challenges of ASD and ADHD, dietitians develop balanced meal plans tailored to their specific needs, accommodating sensory sensitivities and preferences. These dietary choices positively impact mental and physical health, supporting cognitive function, mood regulation, and emotional well-being. A balanced diet rich in protein, complex carbohydrates, and healthy fats is essential. Protein sources such as lean meats, eggs, and beans help maintain steady blood sugar levels, supporting better concentration and mood stability. Omega-3 fatty acids, found in fish, flaxseeds, and walnuts, are particularly beneficial for brain health and may reduce ASD and ADHD symptoms. Plus, addressing gastrointestinal issues and food sensitivities is crucial. A gluten-free and casein-free diet may be recommended, as some neurodivergent individuals may have sensitivities to these proteins. Incorporating a variety of fruits, vegetables, and whole grains ensures adequate intake of essential vitamins and minerals. Probiotics and prebiotics can improve gut health, potentially influencing behaviour and mood. Additionally, both populations benefit from minimising processed foods and artificial additives, which can exacerbate symptoms. Personalised meal plans that consider sensory preferences and aversions are vital, promoting a positive relationship with food. Working closely with a dietitian ensures that nutritional strategies are tailored to each individual's needs, supporting cognitive function, emotional regulation, and overall health. (5, 6)
By integrating dietary strategies into the care plan, dietitians help patients manage their symptoms more effectively, improving their quality of life. Addressing food aversions and adapting eating behaviours is essential, and dietitians craft personalised strategies to enhance nutritional intake, promote emotional stability, and achieve overall health.
1. Talbott E, De Los Reyes A, Power TJ, Michel JJ, Racz SJ. A Team-Based Collaborative Care Model for Youth With Attention-Deficit Hyperactivity Disorder in Education and Health Care Settings. Journal of Emotional and Behavioral Disorders. 2020;29(1):24-33.
2. van De Sande MMH, van Buul VJ, Brouns FJPH. Autism and nutrition: the role of the gut–brain axis. Nutrition Research Reviews. 2014;27(2):199-214.
3. Levin AA-OX, Lancelotta RA-O, Sepeda ND, Gukasyan N, Nayak S, Wagener TL, et al. The therapeutic alliance between study participants and intervention facilitators is associated with acute effects and clinical outcomes in a psilocybin-assisted therapy trial for major depressive disorder. (1932-6203 (Electronic)).
4. May T, Birch E, Chaves K, Cranswick N, Culnane E, Delaney J, et al. The Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder. Australian & New Zealand Journal of Psychiatry. 2023;57(8):1101-16.
5. Önal SA-O, Sachadyn-Król MA-O, Kostecka M. A Review of the Nutritional Approach and the Role of Dietary Components in Children with Autism Spectrum Disorders in Light of the Latest Scientific Research. LID - 10.3390/nu15234852 [doi] LID - 4852. (2072-6643 (Electronic)).
6. Lange KW, Lange KM, Nakamura Y, Reissmann A. Nutrition in the Management of ADHD: A Review of Recent Research. (2161-3311 (Electronic)).
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