Assessment & Research

Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature.

Sharp et al. (2013) · Journal of autism and developmental disorders 2013
★ The Verdict

Kids with autism face five times more feeding problems and eat far less calcium and protein.

✓ Read this if BCBAs doing intake assessments or parent training with children with ASD.
✗ Skip if Clinicians serving only verbal adults with no feeding concerns.

01Research in Context

01

What this study did

Miltenberger et al. (2013) pooled 17 earlier studies.

They asked: do kids with autism eat worse than peers?

They looked at feeding problems and actual nutrient intake.

02

What they found

Kids with autism were five times more likely to have feeding problems.

They also took in much less calcium and protein.

The pattern was strong across all 17 studies.

03

How this fits with other research

Sánchez-Gómez et al. (2023) later found the same gaps in Spanish children, even those with mild traits.

Marí-Bauset et al. (2015) and Barak-Levy et al. (2015) saw the same deficits in smaller single-site studies.

Page et al. (2022) explain why the problem persists: most feeding issues link to sensory sensitivity and rigid routines.

Together the papers show the 2013 numbers still hold true today.

04

Why it matters

If you work with kids with ASD, always ask what they actually eat.

Add a quick diet screen to every assessment.

Spot low calcium or protein early and refer to a dietitian before growth or bone health suffers.

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→ Action — try this Monday

Add one nutrition question to your intake form: List every food the child ate yesterday.

02At a glance

Intervention
not applicable
Design
meta analysis
Population
autism spectrum disorder
Finding
negative
Magnitude
large

03Original abstract

We conducted a comprehensive review and meta-analysis of research regarding feeding problems and nutrient status among children with autism spectrum disorders (ASD). The systematic search yielded 17 prospective studies involving a comparison group. Using rigorous meta-analysis techniques, we calculated the standardized mean difference (SMD) with standard error and corresponding odds ratio (OR) with 95 % confidence intervals (CI). Results indicated children with ASD experienced significantly more feeding problems versus peers, with an overall SMD of 0.89 (0.08) and a corresponding OR of 5.11, 95 % CI 3.74-6.97. Nutrient analyses indicated significantly lower intake of calcium (SMD: -0.65 [0.29]; OR: 0.31, 95 % CI 0.11-0.85) and protein (SMD: -0.58 [0.25]; OR: 0.35, 95 % CI: 0.14-0.56) in ASD. Future research must address critical questions regarding the cause, long-term impact, and remediation of atypical feeding in this population.

Journal of autism and developmental disorders, 2013 · doi:10.1007/s10803-013-1771-5