Effect of Nutrition and Oral Hygiene Education Using Telehealth on Diet Diversity, Nutrition Literacy and Oral Hygiene Practices in Children With Autism: A Mixed-method Study

The goal of this interventional study is to assess the knowledge of caregivers of children with Autism Spectrum Disorder (ASD) regarding oral and nutritional health and the burdens they encounter in dealing and caring for these children. The main aims to answer are:

Educating caregivers on

* Diet diversities
* Improving oral health habits Participants will have to
* Fill questionnaires
* Undergo educational sessions
* Fill post education questionnaires Researchers will compare pre and post educational questionnaires to see if the intervention makes a difference.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder defined by deficits in social communication and the presence of restricted and repetitive behaviors and interests. The disorder incorporates the constraints and typical behaviors in early childhood, which later becomes problematic to function in society. Although the reason of ASD are unexplained yet, however, air pollution, organic toxicants, seasonal factors, psychological stress, migration, birth order and nutrition may have a close relationship with the incidence of ASD. Emphasizing on the fact that it is a lifelong condition and there is no specific cure to it, it can only be managed and assisted by caregivers specially. Every individual with ASD have a unique and different behavioral pattern. These behavioral patterns are managed by experts of behavior management such as speech or occupational therapists.

Poor oral hygiene is widely reported among children with autism, thus can elevate the likelihood of dental cavities and bad breath. Dental health can be further deteriorated if a child with ASD prefers soft, sweet and sticky food preferences as unhealthy diet intake and limited diet diversity. Food selectivity and other feeding problems are endemic in children with autism spectrum disorders (ASD).

In Pakistan, few studies have comprehensively looked at the children with special needs.

As Pakistan is a Low-Middle-Income country (LMIC) with limited sources and ASD is a domain that still needs more research work to be done. There is a majority of population that overlook the topic and then there is a category that strongly believes myths and misconceptions that evolve regarding 'treatment' and management of Autism in individuals. Another setback is a limited number Professionals with sound knowledge of the disorder that can cater to majority individuals and their caregivers, providing assistance in how to manage the most basic things like oral hygiene and nutritional education - that can ultimately encourage the reduction of burden in caregivers.

Eligibility Criteria:
Inclusion Criteria:

1. Caregivers of Children (5-18 years) with Autism enrolled in Autistic or specialized Schools.
2. Caregivers able to communicate in English or Urdu or Sindhi.
3. Caregiver of one child with Autism.
4. Caregivers with smartphone/laptop/IPhone and internet facility.

Exclusion Criteria:

1. Caregiver of child with Autism living with any known food allergies.
2. Caregiver of child with Autism enrolled in any other trial.
3. Caregiver of child with Autism and any other mental disorders.