Feeding and eating problems in children and adolescents with autism: A scoping review.
Jessica Baraskewich, Kristin M von Ranson, Adam McCrimmon and 1 others
PMID 33653157WHAT IT FOUND
Feeding problems, especially food selectivity driven by sensory issues, are pervasive in autistic youth.
True eating disorders involving weight or shape concerns are rarely studied, yet evidence suggests higher risk. Clinicians must distinguish between sensory-based refusal and body-image pathology to avoid misdiagnosis and select appropriate treatment.
Key findings
01Food selectivity is the most common feeding issue, with atypical eating behaviors found to be five times more common in autistic youth than those with other disorders and fifteen times more common than in typically developing peers.
02Sensory sensitivity, particularly to food texture, is a strong contributing factor to food refusal, with smooth or consistent textures often preferred over lumpy or complex foods.
03Only three of the included studies examined weight, shape, or body image concerns, but those that did suggest autistic youth may be at higher risk for eating disorders compared to peers.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Most included studies used cross-sectional designs, limiting understanding of how these problems develop or change over time. The review excluded qualitative studies, potentially missing context on parent-child feeding dynamics. Inconsistent terminology across studies made it difficult to compare findings directly. Studies involving participants with co-occurring medical conditions (like gastrointestinal disorders) were excluded, so results may not apply to the full range of autistic youth. Only a small number of studies examined body image or weight concerns, leaving a major gap in understanding eating disorders in this population.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research.
The easy way to misread this
Do not assume that food refusal in an autistic child is solely due to autism traits or sensory issues. The review highlights that true eating disorders involving weight or shape concerns are under-studied but present. A thorough assessment is needed to distinguish between sensory-based feeding problems and pathology-driven eating disorders, as this distinction dictates treatment.