Food Selectivity in Children with Autism Spectrum Disorder and in Typically Developing Peers: Sensory Processing, Parental Practices, and Gastrointestinal Symptoms.

This study looked at eating difficulties in 408 autistic and non-autistic children aged 3-12. Autistic children showed much more food refusal, pickier eating, and stronger reactions to food textures, tastes and smells. Their parents used more controlling feeding approaches. The research found a high-risk group of children (both autistic and non-autistic) who had severe eating problems, sensory sensitivities, tummy troubles, and stressed parents who tried harder to control mealtimes.

This cross-sectional study compared food selectivity patterns between 408 children with autism spectrum disorder (ASD) and typically developing children aged 3-12 years. Children with ASD demonstrated significantly greater sensory processing difficulties, higher food refusal rates, and more limited dietary variety compared to typically developing peers. Parents of autistic children employed more controlling feeding practices. The study identified strong correlations between sensory sensitivities and feeding issues, with BMI not significantly associated with dietary restrictions.

Cluster analysis revealed a high-risk subgroup in both populations characterized by severe food selectivity, sensory sensitivities (taste, tactile, smell), gastrointestinal symptoms, and overactive parental feeding practices, suggesting need for targeted multidisciplinary interventions.

Findings support comprehensive assessment addressing sensory processing, feeding behaviors, and parental practices. Early identification of high-risk subgroups enables targeted multidisciplinary interventions. Clinical protocols should integrate sensory-based approaches with family-centered feeding strategies rather than focusing solely on nutritional outcomes.

Cross-sectional design prevents causal inferences. Study relies on parent-reported measures which may introduce bias. Sample demographics and recruitment methods not clearly described. Long-term outcomes and intervention effectiveness not assessed.

Food selectivity is a prevalent and challenging issue in childhood, particularly in children with autism spectrum disorder (ASD), which may result in restricted dietary patterns and nutrient deficiencies. This study aimed to identify high-risk subgroups of children by combining food selectivity, diet, BMI, gastrointestinal symptoms, sensory processing, and parental feeding practices in children with ASD and in typically developing children (TDC). To achieve this aim, we ran a cross-sectional, survey-based study, including 408 children (aged 3 to 12.11 years), with gender-matched groups. Both parents completed a survey on children's diet, anthropometric curves, gastrointestinal symptoms, and the Brief Autism Mealtime Behavior Inventory (BAMBI), Short Sensory Profile (SSP), and Caregiver's Feeding Style Questionnaire (CFSQ).

Data analysis included comparative tests, correlations, and k-means cluster analysis. Children with ASD exhibited significantly greater sensory processing difficulties, higher food refusal, limited food variety in the diet, and autism-related mealtime characteristics compared with TDC across all age groups. Caregivers of children with ASD reported higher controlling and contingency management feeding practices compared to the parents of the TDC. We found a strong correlation between sensory sensitivities and feeding issues.

Notably, Body Mass Index (BMI) was not significantly associated with dietary restriction or gastrointestinal symptoms. Cluster analysis revealed a high-risk sub-phenotype in both groups of children with some differences, characterized by high food selectivity, taste, tactile, and smell sensitivity, gastrointestinal symptoms, and overactive parental practices. The early identification of this subgroup might foster more tailored, multidisciplinary, and effective assessment and clinical intervention.