Improving support for families of children with overweight and obesity and neurodevelopmental disorders in England

About the Project

Children with neurodevelopmental conditions like autism and ADHD are more likely to struggle with overweight or obesity, but families often lack support to manage this. This research will explore why these children are at higher risk and what help is currently available. It will also work with families to understand their needs and identify what kinds of support would be most useful, especially for younger children. The goal is to inform the improvement of services and develop better ways to help children and families lead healthier lives, with a focus on early intervention and inclusive support.

Background:

Children with neurodevelopmental disorders, such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) and intellectual (learning) disabilities are more likely to develop overweight or obesity than children in the general population (1-5). Children with neurodevelopmental disorders are greatly overrepresented in childhood severe obesity clinics with around one quarter of children in NHS Complications of Excess Weight clinics recorded to have ASD and 23% recorded to have a learning disability (6, 7). The true prevalence is likely to be even higher when including children with suspected diagnoses awaiting assessment (7). In comparison, the prevalence of ASD in children in the general population is estimated to be 1% (8, 9).

Mechanisms/reasons for the higher prevalence of obesity in children with neurodevelopmental disorders are not well documented but are reported to include sensory issues and impulsive and disorganised behaviour impacting on food preference and patterns, dysregulated hunger and satiety recognition, use of anti-psychotic medication, and barriers to taking part in physical activity (5-7, 10, 11).

Preliminary public engagement work with parents of children with neurodevelopmental disorders highlights a lack of support for parents in how to support/manage challenging eating issues and overweight/obesity in their children and an overwhelming need for more support in this area. This was particularly pronounced in engagement work with parents from minoritised ethnic backgrounds. Engagement work also highlights the importance of intervening early in childhood, i.e. primary school age before behaviours are entrenched. The potential role of schools and VCSE organisations in providing support in this area was highlighted.

Additionally, the recently updated NICE obesity guidance highlights the importance of further research around 1) effective approaches for obesity management for children and young people with special educational needs and disabilities, and 2) encouraging families and carers to engage with interventions (12).

Research questions:

The key research questions this project will address are: 1) What intervention(s) have been developed to support families of children with neurodevelopmental disorders and overweight/obesity within and outside the UK? and 2) What interventions do these children and families need?

Specific objectives:

1. Review and summarise existing knowledge on the mechanisms for the higher prevalence of overweight/obesity in children with neurodevelopmental disorders
2. Scope and describe existing interventions for overweight/obesity in children with neurodevelopmental disorders and/or their families across socio-demographic groups
3. Investigate and understand the key challenges and support needs for families around overweight/obesity in primary school aged children with neurodevelopmental disorders and how these differ for different socio-demographic groups
4. Identify interventions needed to improve support for primary aged children with overweight/obesity and neurodevelopmental disorders and families for different socio-demographic groups

The student will have the opportunity to focus their project on understanding the needs of particular communities or ethnic groups.