Core Deficits and Eating Behaviors in Children with Autism: The Role of Executive Function.
Repetitive behaviors in autistic kids forecast both food chasing and food refusal, with executive dysfunction acting as the shared engine.
01Research in Context
What this study did
Liu and colleagues asked 134 parents of autistic kids to fill out three short surveys.
One survey measured repetitive behaviors and social trouble. Another tracked eating quirks like food seeking and food refusal. The third rated everyday executive-function slips such as trouble shifting tasks or waiting.
The team then ran math tests to see if weak executive skills carried the effect of repetitive behaviors onto eating patterns.
What they found
Kids with more repetitive behaviors showed both higher food seeking and higher food refusal.
Social impairment alone did not predict eating quirks.
When executive dysfunction was added to the model, the link between repetitive behaviors and eating stayed strong, suggesting executive problems are a shared driver, not just a side note.
How this fits with other research
Iversen et al. (2021) already showed, across the participants, that poor executive function and repetitive behaviors travel together. Liu’s team extends that marriage into the feeding world.
Laugeson et al. (2014) followed autistic children over the study period and found food selectivity stayed stable and was tied to sensory over-responsivity, not repetitive behaviors. That looks like a contradiction, but the two studies measured different things: Liu looked at momentary approach/avoidance behaviors, while A tracked long-term selectivity rooted in sensory reactions.
Bennett et al. (2017) found that disruptive mealtime behaviors, not plain food selectivity, stressed parents most. Liu’s focus on executive skills gives practitioners a lever: shore up shifting and inhibition, and you may cool both rigid behaviors and stressful mealtimes.
Why it matters
If repetitive behaviors and eating issues share an executive-function engine, you can double-dip in treatment. Embed quick shifting or waiting games right into meals: use visual timers, first/then boards, or bite-size portions that require a pause. Strengthening executive skills may soften both rigidity and food battles, making dinner easier for the child and the whole family.
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02At a glance
03Original abstract
Background: Children with autism spectrum disorder (ASD) frequently experience eating-related behavioral difficulties; however, the relationships among these difficulties, core ASD deficits, and executive function remain poorly understood. The present study examined how core ASD characteristics—restrictive and repetitive behaviors (RRBs) and social impairments—relate to eating behaviors, including food approach and avoidance tendencies. In addition, the study explored whether executive function serves as a mediating mechanism underlying these associations. Methods: A total of 184 children aged 3–12 years participated in this cross-sectional study. All variables were measured using parent-reported questionnaires, and data were analyzed through path modeling. The Social Responsiveness Scale–Second Edition (SRS-2) and the Repetitive Behavior Scale–Revised (RBS-R) were employed to assess social impairments and RRBs, respectively. Eating behaviors—comprising food approach and food avoidance dimensions—were evaluated with the Children’s Eating Behavior Questionnaire (CEBQ), while executive function was measured using the Child Executive Functioning Inventory (CHEXI). Results: The analysis revealed significant associations between RRBs and both food approach and food avoidance behaviors in children with ASD. Crucially, follow-up regression analyses specifying RRBs subtypes showed that Stereotyped Behavior independently predicted both food approach (β = 0.305, p < 0.001) and avoidance (β = 0.217, p = 0.002), while Compulsive Behavior specifically predicted food avoidance (β = 0.173, p = 0.021). Furthermore, executive function appeared to serve as a potential mediator in these relationships, suggesting that impairments in executive control may partially explain how repetitive behaviors influence eating patterns. Although social impairments showed weaker direct associations with eating behaviors, they indirectly affected both food approach and avoidance behaviors through deficits in executive function, highlighting the complex interplay among behavioral, cognitive, and social domains in ASD. Conclusions: These findings indicate that RRBs—one of the core characteristics of ASD—can predict children’s eating behaviors and are concurrently linked to two seemingly opposite eating patterns. Both social impairments and RRBs appear to influence eating behaviors through executive dysfunction. This study provides new insights into the mechanisms underlying atypical eating behaviors in children with ASD and identifies executive function as a promising target for interventions aimed at improving eating-related outcomes in this population.
Nutrients, 2025 · doi:10.3390/nu17243854