Parents of Tipperary boy with autism and eating disorder to seek treatment in UK

Couple say they cannot access services for their son in Ireland

Caitriona and Rafal Pliszka at home in Cashel, Co Tipperary: They are considering taking Riain to a private facility in Milton Keynes in the UK for an assessment and therapy. Picture: Brendan Gleeson

The parents of a young Tipperary boy with autism and an eating disorder are considering taking him to the UK because they cannot access services for him in Ireland.

Riain Pliszka, 12, from Cashel has been diagnosed with avoidant restrictive food intake disorder (ARFID) and was diagnosed with autism in 2013, at the age of two years old. He also has anxiety.

ARFID is a condition characterised by the person avoiding certain foods or types of food, having restricted intake in terms of the overall amount eaten or both.

He has not been able to access a service which will take a holistic approach to his autism, anxiety and ARFID diagnoses.

His mother Caitriona said Riain had been recently prescribed an antihistamine which tackles his anxiety, sleep issues and helps him to gain weight.

However, she and her husband Rafal are concerned there is no other help for their son.

Caitriona said: “We have seen a slight increase in food intake but to be honest I'm not a fan long-term of this stuff due to long-term side effects. 

“He has not seen any dietician since last August.

Every door is still closed in Ireland and when he comes off this antihistamine, God knows what will happen. Am I back to square one?” 

The family is now considering taking Riain to a private facility in Milton Keynes in the UK for an assessment and therapy. Caitriona is hoping such a step would be covered under the Treatment Abroad Scheme, but she said travel and accommodation would not be covered under the scheme.

She is speaking as Eating Disorder Awareness Week continues until March 5.

Although Riain ate well until he was about 18 months, his diet became more restricted and he started to refuse food from about the age of three.

By the age of six, Riain was in an ASD unit in a mainstream school and had to attend school using a nasogastric tube.

His food intake remains very limited and he has to drink three 125ml portions of compact protein and 200ml of a nutrient-dense drink every day. However, his mother says he is taking less of these recently.

He has been admitted on several occasions to paediatric wards. Over a year ago, Riain’s weight plummeted and a decision was made by his medical team that the NG tube had to stay in permanently, with tube changes when required.

While the HSE says it cannot comment on individual cases, it says South East Community Healthcare is currently working on plans to increase the provision of dietetic services for children’s teams across the region.

A spokeswoman said: “Management of children with ARFID requires a collaborative working between a number of professionals and, depending on a person’s needs and level of complexity, may involve joint working between the acute hospital sector and HSE community healthcare divisions such as primary care, disability and mental health. 

"Such joint working is governed by existing protocols and established hospital group and community healthcare organisation governance structures.” 

She added: “For more complex cases, local services can consult with tertiary specialists and national feeding, eating, drinking and swallowing services — such as those in the Central Remedial Clinic”.

The Psychological Society of Ireland says between 4% and 23% of people with an eating disorder also have an autistic spectrum disorder.

In a statement, the society said: "Feeding and eating disorders among neurodivergent people often emerge during childhood and it is important for clinicians to parse out what exactly is going on for the individual so that an appropriate treatment plan can be put in place.”