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considerations before selecting an anti-epileptic medication. These include where the seizures began in the brain,29 the kind and extent of seizures and their recorded EEG patterns. Worthy of note is the fact that anti-epileptic medications do not cure epilepsy, but are mostly used to prevent, control or decrease the severity of seizures. Another option is vagus nerve stimulation as well as surgery could be done to remove areas in the brain which produce seizures. FEEDING AND EATING PROBLEMS According to Kanner feeding problems are defining features of autism; about 7 out of 10 children with autism suffer from feeding and eating problems. It is estimated that close to half of this number presents with severe problems.14 An individual is said to have a feeding and eating problems when he/she does not eat enough, eats a lot or does not eat the right types and proportion of food. Generally, children with autism are very selective that is they eat only a few types of foods usually those with particular colors or textures and at times may display troublesome mealtime behavior. Still others exhibit Pica, which refers to the risky habit of eating nonfood objects for instance, ingesting dangerous and poisonous items or substances including nails, broken glass and pins, as well as swimming pool chlorine tablets and paint chips.30 Pica habit can be deadly as it can result in infection, suffocation and perforation of the gastrointestinal tract as well as lead to poisoning.31 Other health complications related to pica habits are constipation, broken teeth and other dental conditions, bowel obstruction and chronic lead poisoning. Eating problems may be caused by anxiety, which may be due to an experience such as vomiting or gagging or choking during or after eating a particular food and rigidity (wanting to eat one particular type of food all the time) among others. On the other hand, an eating disorder such as anorexia nervosa may occur in young women with autism due fear of gaining weight (body image issues). Unlike anorexia nervosa, chronic overeating (bulimia) has also been reported among persons with autism. This may be due to increased appetite that is, a severe side effect of Risperidone (Risperdal) and Aripiprazole (Abilify) used to treat challenging behaviors such as agitation30 in children and adults with autism. Pica is generally common among children with autism who have intellectual disability. 6 Review | Volume 8 | Number 1| Pediatr Neonatal Nurs Open J. 2022; 8(1): 1-13. doi: 10.17140/PNNOJ-8-134 Eta VEA Eating problems may be manifested as hatred or dislikes for certain tastes, textures and strong flavors. This in turn result in extremely limited food habits, which is often due to autism-related hypersensitivities and/or a strong resistance against change. This usually leads to excessive consumption of high-calorie and lownutrient foods. Chronic overeating may results when the individual is unable to recognize or sense when the stomach is full and/or when eating has becomes a soothing sensory behavior. There are specialized feeding programs that have been developed, which are being implemented by behavioral therapists and nutritionists in some autism clinics. Also, to an extent, some speech, behavioral and occupational therapists can be of help in the management of pica habits.32 Medical therapy is employed to treat iron or zinc nutritional deficits, infection as well as infestation with intestinal parasites. On the other hand, behavioral therapies can be effective in reducing pica habits.33 These include strategies for reinforcing good behaviors such as given rewards to the child (in the form of small food treats) for not putting inedible objects in his/her mouth. Another strategy is to constantly removing the child’s attention from the nonfood items to his/her favorite activities as well as continuously blocking the child from any attempts to eat uneatable items. OBESITY Obesity is another condition commonly found in children with autism usually caused by chronic overeating and begins early in lives of children with autism. The child may dislike foods containing vitamins and proteins but concentrates on eating more of high calorie foods. However, some studies
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