Date Presented 04/22/2023
Children with autism have a high occurrence of challenging eating behaviors, which can lead to negative health consequences such as obesity and malnutrition. One of the underlying mechanisms implicated in these challenging eating behaviors is differences in oral sensory processing. Therefore, this study examined picky eaters with autism and compared child and parent mealtime behaviors between children with and without oral hypersensitivity.
Primary Author and Speaker: Anna Wallisch
Contributing Authors: Kelsey Thompson, Sallie Nowell, Jessica Meredith, Brian Boyd
PURPOSE: Children with autism have a high occurrence of challenging eating behaviors, and one of the underlying mechanisms implicated in these behaviors is differences in sensory processing. This study examined picky eaters with autism and compared child and parent mealtime behaviors between children with and without oral hypersensitivity.
DESIGN: We conducted a cross sectional survey study and recruited children, 3-6 years, with a diagnosis of autism. Children were included if their parent considered their child a picky eater.
METHOD: A total of 62 parents completed an online REDCap survey that included questions from the Behavioral Pediatric Feeding Assessment Scale (BPFAS) and the oral processing subscale of the Sensory Profile-2. Based on oral processing scores, participants were divided into either the oral hypersensitive group (n = 34) or the oral non-sensitive group (n=28). We conducted a MANCOVA where group was the independent variable, mean scores on the BPFAS subscales were the dependent variables, and child cognitive ability was a covariate.
RESULTS: Children with oral hypersensitivity compared to the non-oral sensitive group had significantly higher scores on the Food Acceptance subscale of the BPFAS and parents of children in the oral hypersensitivity group reported more negative feelings around feeding their child. There were no significant differences on other BPFAS subscales.
CONCLUSION: This study suggests that children with autism who were in the oral hypersensitive group experienced more issues with food acceptance as compared to the oral non-sensitive group.
IMPACT STATEMENT: Occupational therapists (OTs) are well-versed in both sensory processing and family mealtime routines, and this research supports the need for OTs to provide personalized mealtime treatment strategies based on the child’s sensory preferences, as well as provide parents with support in managing mealtimes.
Leader, G., Tuohy, E., Chen, J. L., Mannion, A., & Gilroy, S. P. (2020). Feeding problems, gastrointestinal symptoms, challenging behavior and sensory issues in children and adolescents with autism spectrum disorder. Journal of Autism and Developmental Disorders, 50(4), 1401–1410. https://doi.org/10.1007/s10803-019-04357-7
Nadon, G., Feldman, D. E., Dunn, W., & Gisel, E. (2011). Association of sensory processing and eating problems in children with autism spectrum disorders. Autism Research and Treatment, 1–8. https://doi.org/10.1155/2011/541926
Chilman, L., Kennedy-Behr, A., Frakking, T., Swanepoel, L., & Verdonck, M. (2021). Picky eating in children: A scoping review to examine its intrinsic and extrinsic features and how they relate to identification. International Journal of Environmental Research and Public Health, 18(17), 9067. https://doi.org/10.3390/ijerph18179067
Shmaya, Y., Eilat-Adar, S., Leitner, Y., Reif, S., & Gabis, L. v. (2017). Meal time behavior difficulties but not nutritional deficiencies correlate with sensory processing in children with autism spectrum disorder. Research in Developmental Disabilities, 66(April), 27–33. https://doi.org/10.1016/j.ridd.2017.05.004