Sensory processing and eating behaviours in autism: A systematic review

Abstract

Objectives:The aim of this study was to assess the relationship between sensory processing and a broad range of eating behaviours across the lifespan. Methods:Five electronic databases of published and unpublished quantitative studies were systematically searched, evaluated for risk of bias and synthesised according to identified eating outcomes.Results: Across 25 studies, there was consistent evidence of a relationship between sensory processing and a range of eating behaviours. There was early evidence for the particular role of taste/smell sensitivities, as well as hypersensitivities, although future research is needed looking at different sensory patterns and modalities. There was also tentative evidence to suggest this relationship extends across development. Discussion: Study findings are discussed in relation to implications for sensory-based eating and feeding interventions and the development of eating disorders. Methodological and conceptual limitations are discussed and suggestions for future research are made to address these limitations. A broader investigation of multi-sensory issues and clearly defined eating behaviours, including disordered eating in clinically diagnosed samples, will allow for a more comprehensive and robust understanding of the relationship between sensory processing and eating behaviours in autism.

Modulation of the thermosensory system by oxytocin

“…Similarly, the taste perception is also atypical in patients with ASD with increased sensitivity to food texture as well as specific taste preferences for acidic tastes and greater sensitivity to aftertastes, leading to selective eating behaviors (Chen et al, 2022 ; Nimbley et al, 2022 ).…”

Challenges and opportunities for conceptualizing intuitive eating in autistic people

“…On many other occasions, I eat SO much”; Trevisan et al, 2021, p. 3486). Given this, research presents compelling evidence of a strong association between differing interoceptive ability and/or sensory sensitivities and eating and feeding concerns in the autistic population, including food selectivity and/or neophobia (i.e., reluctance to eat and/or avoidance of novel foods; Baraskewich et al, 2021; Carpita et al, 2022; Nimbley et al, 2022).…”

“…Scholars and autism advocates are increasingly raising concerns over the assumption of neuro‐normative experiences in the IE literature, as well as feeding and eating research, practice, and policy (Cobbaert & Rose, 2023; Collings, 2023; Longhurst & Clark, 2022; Preyde, 2017). Furthermore, although many treatment goals should remain consistent across neurotypical and autistic groups (e.g., improved quality of life, reduced disordered eating behaviors, and/or ED pathology), the processes and/or behaviors through which these goals are achieved may differ for autistic people (see Nimbley, Maloney, & Duffy, 2023). Therefore, we outline future research directions to explore IE in the autistic population in a way which meaningfully integrates their needs and experiences.…”

“…Autistic individuals are identified to be disproportionately at risk for disordered eating behaviors and/or eating disorder (ED) pathology (see Westwood & Tchanturia, 2017 for review), and may therefore benefit from employing adaptive eating‐related strategies (i.e., behaviors that confer benefit above‐and‐beyond the absence of pathological eating; Kinnaird, Norton, Pimblett, et al, 2019; Kinnaird, Norton, Stewart, & Tchanturia, 2019; Linardon et al, 2021). Furthermore, autistic people have a range of unique needs and experiences that often necessitate interventions with an autism‐specific approach (Brede et al, 2020, 2022; Kinnaird, Stewart, & Tchanturia, 2019; Nimbley, Gillespie‐Smith, et al, 2023). Accumulating research does, however, find this population to present poorer treatment outcomes and to report unique instances of iatrogenic harm in current treatment (Babb et al, 2021, 2022; Weir et al, 2022), as many autistic eating behaviors are erroneously pathologized (Longhurst & Clark, 2022; see also Camm‐Crosbie et al, 2019).…”

Avoidant-restrictive food intake disorder and autism: epidemiology, etiology, complications, treatment, and outcome

“…Mealtime issues particularly associated with autism in adulthood include food selectivity, preference for certain brands of food, mealtime rituals and routines, and difficulties in social eating situations [43]. Sensory sensitivities, particularly sensitivity to the texture, taste, and smell of food, are more common among autistic women compared with autistic men and nonautistic women [44]. Vitally, the unique sensory needs of autistic people need to be integrated into clinical practice, as sensory issues do challenge the improvement of nutritional status and the treatment of other co-occurring symptoms.…”