Date of Award

4-2025

Degree Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Advisor

Dr. Susan Wamithi

Second Advisor

Dr. Waceke Kombe

Third Advisor

Prof. Violet Naanyu

Department

Paediatrics and Child Health (East Africa)

Abstract

Introduction: - ASD is a neurodevelopmental disorder characterized by deficits in social interactions and communication along with restrictive and repetitive behaviours affecting 1 in 100 children globally, with a higher prevalence in males. Despite the rising global statistics, there is limited information regarding the prevalence of ASD in Sub-Saharan Africa. Children with ASD often experience feeding challenges, which have been broadly categorized as food selectivity, food refusal, and disruptive mealtime behaviour, which poses challenges for caregivers during mealtime. While medical management of ASD receives considerable attention, less focus has been placed on the impact of ASD on caregivers and their coping strategies.

Objective: - To explore the experiences, attitudes and coping mechanisms employed during mealtimes among caregivers of children with ASD.

Methodology: - The study design was a phenomenological qualitative study conducted at The Aga Khan University Hospital, Nairobi. Twenty participants were purposively sampled from the Developmental Paediatric Clinic and recruited based on the pre-set selection criteria. After obtaining the informed consent, they completed the Brief Autism Mealtime Behaviour Inventory In Children (BAMBI-C) questionnaire, followed by in-depth interviews. Data was analysed thematically using the NVIVO 12 coding program.

Findings:- The study highlights various feeding challenges arising from the home and social environment, with the most common challenges related to the child's sensory profile. Food preferences tended to lean towards crunchy foods, finely blended foods, or white and beige foods. Family outings were often limited due to disruptive behaviours during mealtime and the difficulty in finding food that met the child's preference criteria.

Conclusion:- Mealtime difficulties in children with ASD extend beyond nutrition, influencing family functioning and caregiver well-being. The findings highlight the need for psychosocial support and comprehensive interventions that address the unique feeding challenges of children with ASD. It also underscored the need for extensive interventions that specifically address the anticipated feeding challenges faced by these children. Additionally, the study highlighted various strategies employed by caregivers, which could be integrated into the overall care of the child.

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1

Last Page

81

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