Food Selectivity and Sensory Sensitivity in Children with Autism Spectrum Disorders

Abstract

Autism spectrum disorders (ASDs) comprise a complex set of related developmental disorders that are characterized by impairments in communication, social interaction, and repetitive behaviors. Impairments in sensory processing are also extremely common. The prevalence of ASDs is increasing and is currently estimated to affect 1 in 150 children. ASDs are considered to be a major health and educational problem, affecting many areas of daily living, including eating. Children with ASDs are often described as picky or selective eaters. This paper provides a comprehensive narrative review of the empirical literature over the last 25 years on food selectivity and nutritional adequacy in children with ASDs. The possible contributions of sensory factors, such as sensory sensitivity, to food selectivity are discussed. The need for an interdisciplinary approach to managing atypical eating patterns in children with ASD is highlighted.

Clinical differences in children with autism spectrum disorder with and without food selectivity

“…In line with the study of Bandini et al (2010), we did not observe the high frequency consumption of a single food in our sample: only 9 parents of the FS group reported that their child consumed a single food more than 4-5 times daily. Studies have hypothesized sensory sensitivity as a possible mechanism underlying food selectivity (Cermack et al, 2010;Mazurek et al, 2013;Suarez et al, 2013). A recent longitudinal follow-up study examining the relationship between food selectivity and sensory over-responsivity in 52 children with ASD, at baseline and after 20 months, reported that higher level of overresponsivity were associated with fewer foods accepted and this association appeared to be stable over time (Suarez et al, 2013).…”

“…Some studies have observed that gastrointestinal (GI) problems are common in ASD and, even though the results are contrasting, food selectivity may contribute to GI problems in a portion of these individuals (Chaidez, Hansen, & Hertz-Picciotto, 2014;Gorrindo et al, 2012;Horvath & Perman, 2002;Ibrahim, Voigt, Katusic, Weaver, & Barbaresi, 2009;Maenner et al, 2012;Mazefsky, Schreiber, Olino, & Minshew, 2014;Mazurek et al, 2013;Mouridsen, Isager, & Rich, 2013;Nikolov et al, 2009;Valicenti-McDermott, McVicar, Cohen, Wershil, & Shinnar, 2008;Whitehouse, Maybery, Wray, & Hickey, 2001). Furthermore, it has been suggested that sensory processing problems, such as sensory sensitivity, which are common among individuals with ASD, could be possible mechanisms underlying food selectivity (Cermack, Curtin, & Bandini, 2010;Mazurek et al, 2013;Suarez et al, 2013). In fact, determining factors of food selectivity are often associated with texture, taste, temperature, smell preferences and consistency (Williams et al, 2000).…”

Narratives of mothers of children with autism spectrum disorders: focus on eating behavior

“…Hazen et al 22 and Cermak et al 4 estimated the prevalence of sensory processing disorders to range from 69 to 95% in children of various ages with ASD. In this study, however, the dietary profile of the children reflected the families' preferences.…”

“…3 Furthermore, sensory factors such as smell, texture, color and temperature may contribute to this behavior. [4][5][6] A literature review of seven descriptive studies found the prevalence of eating problems in children with ASD to range between 46 and 89% in the patients evaluated. 7 The most common problems found in those studies were: limited food intake; refusal to eat certain foods or selectivity related to the texture, smell and taste of food; inflexibility regarding the use of utensils, brands and packaging; and behavioral and nutritional problems.…”

“…7 A later review covering the preceding 25 years and including 12 intervention studies with designs and methods based on food records, questionnaires, or interviews involving parent reports confirmed selectivity as a significant issue in ASD, emphasizing its association with sensory dysfunctions. 4 A recent meta-analysis indicated that children with ASD are four times more likely to have eating problems compared to their peers with typical development (odds ratio [OR] = 5.11; 95% confidence interval [95%CI] 3.74-6.97). 8 All the above-mentioned studies dealt with eating problems in patients with ASD from the perspective of the healthcare professional/ physician, with no information on the perceptions and concerns of parents in relation to the eating habits of individuals with ASD.…”