NUTRITIONAL MANAGEMENT OF CHILDREN WITH ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD) AND AUTISM SPECTRUM DISORDER (ASD): DIETITIANS' PERSPECTIVES, CLINICAL PRACTICES, AND RECOMMENDATIONS

Abstract

This study examined dietitians’ perspectives, clinical practices, and recommendations regarding the nutritional management of children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) in Pakistan. A quantitative cross-sectional survey was conducted with 412 registered dietitians across public hospitals, private clinics, community health centres, and academic institutions. Data were collected using a structured questionnaire assessing nutritional knowledge, assessment practices, dietary interventions, supplementation, barriers, caregiver engagement, and attitudes toward emerging approaches. Findings showed moderate knowledge of ADHD and ASD nutritional management, with a stronger understanding of micronutrient deficiencies than gut–brain axis and supplementation practices. Higher qualifications and longer professional experience were significantly associated with better knowledge scores. Common interventions included reducing refined sugar, structured meal schedules, eliminating artificial additives, food texture modification, and gluten-free/casein-free diets. Major barriers were insufficient training, limited consultation time, lack of local guidelines, and poor caregiver adherence. The study highlights the need for specialized training, standardized protocols, and multidisciplinary care.