Feeding and Swallowing Issues in Autism Spectrum Disorders

Abstract

Children with autism spectrum disorder (ASD) often experience difficulties related to communication and behaviour. However, their feeding issues are most distressing to their families and healthcare professionals as they impact on the children’s adaptive function and health. In comparison to typically developing children, those with ASD experience significantly more feeding difficulties. Children with ASD may display distinctive feeding difficulties and atypical feeding behaviours that include picky eating, limited independent feeding, need for increased feeding times, and a highly restrictive food repertoire. Many of these feeding difficulties continue into childhood, persist in adolescence, and even spill over into adulthood. This proves to be a formidable challenge, as feeding is an essential component for healthy nutrition, growth, and development. This article will highlight how particular food items that are eaten and preferred by affected children may be contributing to their exhibited feeding difficulties. Next, it will be shown how the children’s restrictive diets supplant more healthy food options. When this is combined with the children’s noted reduced physical activity, the consequences are especially serious, as they include not only malnutrition but also give rise to childhood obesity. In sum, it will be demonstrated that feeding difficulties in young children with ASD are not well understood nor managed. The dearth of knowledge about feeding issues in this population affects both assessment choices and, specifically, management practices – aspects that will be elaborated on in this article. Conclusions will include suggested future directions for enhancing and complementing knowledge of these issues for stakeholders.

Dietary intake and gastrointestinal symptoms are altered in children with Autism Spectrum Disorder: the relative contribution of autism-linked traits

“…This study also has several limitations. The questionnaires such as FFQ, International Physical Activity Questionnaire Short-Form (IPAQ-SF), and Children’s Sleep Habits Questionnaire (CSHQ) completed by parents may be subject to social desirability bias and recall bias [ 15 , 95 ]. Future studies are encouraged to apply specific biochemical parameters as a surrogate for measuring dietary intake.…”

“…Most published studies exploring the relationship between autism-related traits and feeding problems focused on feeding behaviors rather than food intake and diet quality [ 15 , 16 ]. However, the relationship between autistic traits – autism severity and feeding behaviors differed according to evaluation tools.…”

Body Composition and Anthropometric Measurements in Children and Adolescents with Autism Spectrum Disorder: A Case–Control Study in Lebanon

“…Previous studies have highlighted that the increased prevalence of unhealthy weight among children with ASD is often linked to atypical eating patterns [ 52 ]. In fact, children with ASD, often referred to as picky eaters, experience more feeding difficulties compared to typically developing controls [ 53 ]. They tend to eat selectively, demonstrating a preference for starches, fast food, sugary beverages, and snacks over fruits and vegetables [ 54 ].…”

The “FEEDS (FEeding Eating Deglutition Skills)” over Time Study in Cardiofaciocutaneous Syndrome

“…The literature has demonstrated how ASD children experience increased food selectivity, along with mealtime-related behavioural problems that further exacerbate caregivers' distress. In this context, a combination of medical and behavioural intervention in highly structured settings has been demonstrated to be supportive for feeding issues in children with ASD [45].…”