The Relationship Between Avoidant/Restrictive Food Intake Disorder in Children Diagnosed with Autism Spectrum Disorder and Orthorexia Nervosa in Their Mothers.
Mom’s clean-eating worries can worsen ARFID in her autistic child, so screen parents too.
01Research in Context
What this study did
Borte and colleagues looked at kids with autism who also show signs of ARFID. They asked moms to fill out forms about their own eating habits and their child’s food refusal.
The team wanted to know if a mom’s “clean-eating” worries—called orthorexia—add to the child’s feeding problems beyond the child’s own autism traits.
What they found
Both child autism severity and mom’s orthorexia scores predicted worse ARFID symptoms. The two factors worked on their own; together they stacked the risk.
In plain words: the more rigid a mom is about “healthy” food, the more her autistic child may refuse meals.
How this fits with other research
Islamoğlu et al. (2025) also found sky-high ARFID rates in autistic kids, but they pointed to tummy pain and picky-eating habits. Borte keeps those child factors and adds a new parent piece—maternal orthorexia—so the picture now includes both child body cues and mom’s food rules.
Mulder et al. (2020) showed that moms with any past eating disorder score high on rigid, “autism-like” traits. Borte zooms in on one specific eating style—orthorexia—and links it straight to child feeding, updating the older finding with a sharper lens.
Older work like Ellingsen et al. (2014) tied feeding issues to sensory problems inside the child. Borte does not contradict this; it simply shows mom’s eating attitudes are another layer to check.
Why it matters
If you treat feeding issues, ask mom (or any main caregiver) about her own food rules. A quick orthorexia screen takes two minutes and may explain why some kids stay stuck despite good sensory or behavioral plans. Share results with the dietitian and consider family-wide goals instead of child-only protocols.
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02At a glance
03Original abstract
The aim is to examine the relationship between Avoidant/Restrictive Food Intake Disorder (ARFID) symptoms and sensory sensitivities in children diagnosed with Autism Spectrum Disorder (ASD), as well as the relationship between maternal orthorexia nervosa (ON) and ARFID, and to identify the factors influencing ARFID. The symptom severity of 104 children was assessed using the Childhood Autism Rating Scale (CARS), maternal ON symptoms with ORTO-11, ARFID symptoms with the Nine-Item Avoidant/Restrictive Food Intake Disorder Screening Tool (NIAS), and sensory sensitivities with the Eyuboglu Sensory Reactivity Scale (ESRS). Multiple regression analyzed predictors of NIAS scores, and moderator analysis examined whether ORTO-11 moderated the ESRS-NIAS relationship. ON was present in 58% of the mothers. Mothers with ON had significantly higher total NIAS scores and NIAS Fear subscale scores. A positive and statistically significant relationship was found between the CARS scores and the hyporeactivity and sensory-seeking subscales of the ESRS scale. When NIAS was taken as the dependent variable, a significant regression relationship was found between CARS-9 and ORTO-11. However, ORTO-11 does not play a moderating role in the effect of ESRS on NIAS. ARFID symptoms are predicted by maternal ON symptoms and CARS-9 scores in children. We emphasize the importance of evaluating the eating attitudes and food perspectives of caregivers when atypical eating behaviors are identified in the clinical follow-up of children diagnosed with ASD. Since the study was conducted solely with mothers', further research is needed to examine the effects of ON symptoms in fathers and other caregivers.
Journal of autism and developmental disorders, 2025 · doi:10.1016/j.rasd.2022.101928