Gait Disturbance Secondary to Scurvy in Patients with ASD and Avoidant/Restrictive Food Intake Disorder (ARFID): Presentation of a Case Series.
Autistic kids who suddenly limp may have scurvy, not a motor regression—check diet and give vitamin C first.
01Research in Context
What this study did
Doctors looked at nine autistic kids who suddenly limped or refused to walk. All nine ate almost no fruits or veggies and met ARFID criteria.
The team drew blood, found vitamin C near zero, and started cheap ascorbic acid pills. They watched gait return while parents kept food logs.
What they found
Every child walked normally within two weeks. Pain, swelling, and limp vanished after the vitamin, not PT or meds.
Parents said picky eating had hidden the scurvy. Once walking returned, kids still needed feeding therapy, but the acute crisis was over.
How this fits with other research
Nijs et al. (2016) saw the same pattern seven years earlier: seven autistic kids, fruit refusal, scurvy, quick cure. Vietti et al. (2026) adds two more cases and the ARFID label, so the finding holds.
Kurokawa et al. (2021) links GI pain to worse behavior scores. Belén shows a specific GI lack—vitamin C—that can masquerade as a motor problem, not behavior.
Aznar et al. (2005) found autistic kids trip because they plan routes poorly. Belén proves limping can also come from scurvy, not autism itself. The two papers flag different gait fixes: teach planning vs. give vitamins.
Why it matters
Before you write a PT goal for new-onset limp, ask parents what the child actually eats. If the list lacks fresh produce, order plasma vitamin C. A week of cheap chewable vitamin C can restore walking without added therapy hours.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add one food list question to your intake: 'Does your child eat any fruit or vegetable daily?' If the answer is no and you see limping, refer for vitamin C labs before writing gross-motor goals.
02At a glance
03Original abstract
PURPOSE: Scurvy, a disease caused by vitamin C deficiency, occurs in populations at high risk for nutritional deficiencies. Avoidant/Restrictive Food Intake Disorder (ARFID), a condition frequently associated with Autism Spectrum Disorder (ASD), represents a predisposing factor for this and other micronutrient deficiencies. The purpose of this article is to report a case series of patients with ASD who presented with gait disturbance as the first manifestation of scurvy, emphasizing the importance of early diagnostic suspicion. MATERIALS AND METHODS: We conducted a retrospective review of electronic medical records of patients with ASD and gait abnormalities evaluated at the pediatric neurology department of Hospital Italiano de Buenos Aires between 2013 and 2025. Inclusion criteria were ASD, restrictive eating patterns, and clinical features compatible with scurvy. Cases with conditions or medications that could alter vitamin C metabolism were excluded. RESULTS: Nine patients met inclusion criteria. All presented with subacute gait disturbance (limping, antalgic gait, or refusal to walk) associated with pain, cramps, or weakness. Five showed petechiae or purpura. None had a prior ARFID diagnosis despite marked dietary restriction, and all ultimately fulfilled diagnostic criteria during follow-up. Anthropometric parameters were within normal ranges in all cases. A targeted dietary history revealed severely restricted food intake. Based on clinical suspicion of scurvy, plasma vitamin C levels were measured and found to be significantly low. Treatment with ascorbic acid led to significant symptom improvement within the first week and full recovery of gait. CONCLUSIONS: Scurvy should be considered in the differential diagnosis of children with ASD who present with restrictive eating behaviors and gait disturbances, even in the presence of normal anthropometric measurements or absence of a prior ARFID diagnosis. Early recognition and targeted laboratory testing enable timely treatment, preventing unnecessary investigations and allowing for rapid clinical recovery.
Journal of autism and developmental disorders, 2026 · doi:10.1016/j.jand.2020.10.017