Atypical eating behaviors may be a new diagnostic indicator for autism

These behaviors are present in many 1-year-olds with autism.


Atypical eating behavior may include severely limited food preferences, hypersensitivity to food texture or temperatures, and pocketing food without swallowing. Such action is a symptom of autism in a child, suggests a new study by the Penn State scientists.

Such behaviors are present in many 1-year-olds with autism and could signal to doctors and parents that a child may have autism.

The researchers evaluated the eating behaviors described in parent interviews of more than 2,000 children from two studies. They investigated the difference in the frequency of unusual eating behaviors between typical children and those with autism, attention deficit hyperactivity disorder, and other disorders.

Atypical eating behaviors were significantly more common in autism (70.4%) than in children with other disorders (13.1%) and typical children (4.8%). For children with autism who had atypical eating behaviors, the most common behavior was limited food preferences (88%), followed by hypersensitivity to food textures (46%), other peculiar patterns most often eating only one brand of food (27%), pocketing food without swallowing (19%), and pica (12%).

The study data shows that atypical eating behaviors may help diagnostically distinguish autism from other disorders. In addition to that, the study provided further evidence that these unusual feeding behaviors are the rule and not the exception for children with autism.

Susan Mayes, professor of psychiatry, said, “If a primary care provider hears about these behaviors from parents, they should consider referring the child for an autism screening.”

“the earlier autism is diagnosed, the sooner the child can begin treatment with a behavior analyst. Previous studies have shown applied behavior analysis to be most effective if implemented during the preschool years. Behavior analysts use several interventions, including rewards, to make positive changes in the children’s behavior and teach a range of needed skills.”

Keith Williams, director of the Feeding Program at Penn State Children’s Hospital, said, “Identifying and correcting these behaviors can help ensure children are eating a proper diet.”

“There is a distinct difference between worrisome eating behaviors and the typical picky eating habits of young children. Most children without special needs will slowly add foods to their diets during development, but children with autism spectrum disorders, without intervention, will often remain selective eaters.”

“We see children who continue to eat baby food or who won’t try different textures. We even see children who fail to transition from bottle feeding.”

Mayes explained, “Many children with autism eat a restricted diet consisting primarily of grain products, like pasta and bread, and chicken nuggets. Because children with autism have sensory hypersensitivities and dislike change, they may not want to try new foods and will be sensitive to certain textures. They often eat only foods of a particular brand, color, or shape.”

Williams said, “Most children with autism who had atypical eating behaviors had two or more types — almost a quarter had three or more. None of the children with other developmental disorders who did not have autism had three or more.”

According to Williams, this is a common, clinical phenomenon — and it has prompted him and his colleagues to recommend some children for further evaluation.

The study suggests the need to evaluate autism to facilitate early identification and access to evidence-based treatment.

The study is published in the journal Research in Autism Spectrum Disorders.


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