Relationships Between Feeding Problems, Behavioral Characteristics and Nutritional Quality in Children with ASD

Abstract

Many children with autism spectrum disorders (ASD) have co-occurring feeding problems. However, there is limited knowledge about how these feeding habits are related to other behavioral characteristics ubiqitious in ASD. In a relatively large sample of 256 children with ASD, ages 2-11, we examined the relationships between feeding and mealtime behaviors and social, communication, and cognitive levels as well repetitive and ritualistic behaviors, sensory behaviors, and externalizing and internalizing behaviors. Finally, we examined whether feeding habits were predictive of nutritional adequacy. In this sample, we found strong associations between parent reported feeding habits and (1) repetitive and ritualistic behaviors, (2) sensory features, and (3) externalizing and internalizing behavior. There was a lack of association between feeding behaviors and the social and communication deficits of ASD and cognitive levels. Increases in the degree of problematic feeding behaviors predicted decrements in nutritional adequacy.

Behavioral and Physiological Factors Associated With Selective Eating in Children With Autism Spectrum Disorder

“…Our findings regarding repetitive behaviors, sensory reactivity, and challenging behaviors were inconsistent with those of Johnson et al (2014). Note that scores were significantly different between groups on the one item of the RBS-R that addresses repetitive behaviors during mealtime, suggesting that the repetitive behaviors of children with selective eating may not be fully captured by the RBS-R.…”

“…Consistent with previous research, variables that measured food intake were highly correlated with each other, as were those that measured sensory reactivity, repetitive behaviors, and challenging behaviors (Bandini et al, 2010;Johnson et al, 2014). These results are consistent with the suggestion that sensory hyperreactivity, repetitive behaviors, and challenging behaviors make up a cluster of symptoms that are often seen together, regardless of selective eating status (Gabriels et al, 2008).…”

“…No significant differences were observed between groups for Anxiety/ Depression or Somatic Complaints as measured by the CBCL, suggesting that selective eating is not associated with social-emotional problems as hypothesized. However, Johnson et al (2014) found significant correlations between each of these measures and scores on the BAMBI. Parent-report measures that ask about child behavior may be more likely to result in the false identification of eating problems in a child than measures derived from FFQ data.…”

“…In the literature, feeding problems have been associated with aggression, internalizing behaviors, externalizing behaviors, repetitive behaviors, anxiety, and sensory reactivity (Johnson et al, 2014;Matson, Fodstad, & Dempsey, 2009;Nadon, Feldman, Dunn, & Gisel, 2011;Paterson & Peck, 2011). This complicated presentation can lead to difficulty determining which interventions would be most effective for selective eating.…”

“…This complicated presentation can lead to difficulty determining which interventions would be most effective for selective eating. Recognizing this problem, researchers have recommended the need for multidisciplinary assessments and treatments (Johnson et al, 2014;Kral, Eriksen, Souders, & Pinto-Martin, 2013;Sharp et al, 2013). However, most interventions reported in the literature are behavioral in nature and may not take into account potential underlying causes (Kodak & Piazza, 2008;Sharp, Jaquess, Morton, & Herzinger, 2010).…”