Assessment & Research

Correlates of Feeding Difficulties Among Children with Autism Spectrum Disorder: A Systematic Review.

Page et al. (2022) · Journal of autism and developmental disorders 2022
★ The Verdict

Feeding problems in autism always travel with sensory and rigidity issues, but every study measures them differently, so build your own simple data sheet instead of trusting published numbers.

✓ Read this if BCBAs who write feeding goals or sit in interdisciplinary clinics.
✗ Skip if Practitioners working only on verbal behavior or academic skills.

01Research in Context

01

What this study did

Dickson and colleagues pulled every paper they could find on feeding problems in kids with autism. They looked at how each study defined and measured feeding issues.

The team compared results across studies to see what patterns showed up again and again.

02

What they found

Two links popped up in almost every paper. Kids who were picky eaters almost always had big sensory issues and rigid behaviors.

The bad news: every study used different checklists and definitions, so you cannot compare numbers across studies.

03

How this fits with other research

Miltenberger et al. (2013) counted five times more feeding problems in autism. Dickson agrees feeding issues are common but warns the tools are too messy to trust exact counts.

Wang et al. (2019) showed sensory problems predict mealtime trouble in Chinese preschoolers. Dickson’s wider sweep says that link holds across cultures and ages.

Sánchez-Gómez et al. (2023) found low vitamin D and fiber in kids with ASD. Dickson’s review explains why: the kids keep eating the same few foods because texture, smell, or color feel wrong to them.

04

Why it matters

When a child with autism refuses food, first ask about sensory triggers, not hunger. Swap out the plate color, cut food smaller, or change texture before you push new nutrients. Document what sensory inputs you changed so the next clinician can see what helped.

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Add two check boxes to your session note: ‘Sensory red flag noticed during snack’ and ‘Rigid behavior blocked new food.' Track for one week.

02At a glance

Intervention
not applicable
Design
systematic review
Population
autism spectrum disorder
Finding
not reported

03Original abstract

Feeding difficulties related to selective intake, or eating a limited variety of foods, are very common in children with autism spectrum disorder (ASD). A systematic search of PubMed, Embase, PsycInfo, and CINAHL identified 29 studies that evaluated eight correlates: age, ASD symptoms and severity, cognitive and adaptive skills, sensory processing and perception, challenging behavior, weight status, gastrointestinal symptoms, and parenting stress. Feeding difficulties related to selective intake are consistently correlated with impaired sensory processing and perception and tend to be positively associated with rigidity and challenging behavior. These feeding difficulties tend to persist with advancing age. Other correlates demonstrated inconsistent findings. A significant limitation of research reviewed is variability in terminology, definitions, and measurement of feeding difficulties.

Journal of autism and developmental disorders, 2022 · doi:10.1080/15374416.2020.1738236