Lessons in early identification and treatment from a case of disabling vitamin C deficiency in a child with autism spectrum disorder
Abstract
Background: Autism spectrum disorder is a heterogenous neurodevelopmental condition accompanied by a variety of associated features. Case reports suggest one such associated feature, food selectivity, increases risk for nutritional deficiencies; however, little attention has been given to prevent and treat nutritional deficiencies in youth with autism spectrum disorder. Method: Single case report. Results: This single case report presents a child with autism spectrum disorder and food selectivity difficulties that resulted in severe vitamin C deficiency. Although eventually corrected, the nutritional deficiency was debilitating, required invasive interventions, and resulted in significant social/emotional and economic costs. Conclusions: We review the course of treatment and highlight strategies to prevent and more effectively treat nutritional deficiencies in youth with autism spectrum disorder.
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The literature on children and young people with autism with severe food restriction reports health issues stemming from the lack or absence of certain micronutrients, including jaundice, anaemia, scurvy, rickets, gingivitis, and hypogonadism.
“The literature on children and young people with autism with severe food restriction reports a number of health issues stemming from the lack or absence of certain micronutrients, including jaundice, anaemia, scurvy, rickets, gingivitis, and hypogonadism.40,59,61,64,65,[68][69][70]”
From Avoidant/Restrictive Food Intake Disorder and Severe Food Selectivity in Children and Young People with Autism: A Scoping Review (2022) · cites this paper as [40]
Additional serious health concerns cited in this population include chronic constipation, ulcers, visual impairment as a result of vitamin A and B12 deficiencies, arthritis, laboured breathing, movement difficulties, and liver dysfunction.
“These include chronic constipation, ulcers, visual impairment as a result of vitamin A and B 12 deficiencies, arthritis, laboured breathing, movement difficulties, and liver dysfunction.40,52,56,62,[71][72][73]”
From Avoidant/Restrictive Food Intake Disorder and Severe Food Selectivity in Children and Young People with Autism: A Scoping Review (2022) · cites this paper as [40]
Various studies report on the medical management of children and young people with autism with severe food restriction, including assessment and management of gastroesophageal reflux disease, gut disturbances, underlying nutritional deficiencies, enteral or parenteral nutrition to increase weight, and intravenous or oral nutritional supplementation to treat severe malnutrition.
“Various studies report on the medical management of children and young people with autism with severe food restriction, including assessment and management of gastroesophageal reflux disease, gut disturbances (vomiting, constipation), underlying nutritional deficiencies that drive certain behaviours (e.g.iron deficiency, anaemia, and pica), enteral or parenteral nutrition to increase weight, 59,67”
From Avoidant/Restrictive Food Intake Disorder and Severe Food Selectivity in Children and Young People with Autism: A Scoping Review (2022) · cites this paper as [40]
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- Authors
- Rafee, Y., Burrell, K., & Cederna-Meko, C.
- Affiliations
- Hurley Medical Center (US)
- Corresponding author
- Burrell, Katherine
- ORCID
- Rafee, Yaseen
- Venue
- The International Journal of Psychiatry in Medicine
- Publisher
- SAGE Publications
- Published
- 2018-08-04
- Volume
- 54
- Issue
- 1
- Pages
- 64-73
- ISSN
- 0033-278X (ISSN-L)
- 0091-2174
- 1541-3527
- OpenAlex
- W2885254271
- Cited by
- 15
- References
- 36
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 2
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The International Journal of Psychiatry in Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Keywords
- scurvy, autism spectrum disorder, picky eating, nutritional deficiency, early detection, early treatment, children
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Ascorbic Acid, Ascorbic Acid Deficiency, Diet Therapy, Food Preferences, Humans, Male, Patient Care Management, Vitamins, Risk Assessment, Early Diagnosis, Malnutrition
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