A Comparison of Food Refusal Related to Characteristics of Food in Children with Autism Spectrum Disorder and Typically Developing Children
Open accessAbstract
Parents of children with autism spectrum disorder (ASD) frequently report child food refusal based on characteristics of food. Our study sought to determine whether parent report of food refusal based on the characteristics of food was greater in children with ASD than in typically developing children, associated with a greater percentage of foods refused of those offered, and associated with fruit and vegetable intake. A modified food frequency questionnaire was used to determine overall food refusal as well as fruit and vegetable intake. Parent-reported food refusal related to characteristics of food (eg, texture/consistency, temperature, brand, color, shape, taste/smell, foods mixed together, or foods touching other foods) was compared between 53 children with ASD and 58 typically developing children aged 3 to 11 years in the Children's Activity and Meal Patterns Study (2007-2008). Children with ASD were significantly more likely to refuse foods based on texture/consistency (77.4% vs 36.2%), taste/smell (49.1% vs 5.2%), mixtures (45.3% vs 25.9%), brand (15.1% vs 1.7%), and shape (11.3% vs 1.7%). No differences between groups were found for food refusal based on temperature, foods touching other foods, or color. Irrespective of ASD status, the percentage of foods refused of those offered was associated with parent reports of food refusal based on all characteristics examined, except temperature. Food refusal based on color was inversely associated with vegetable consumption in both groups. Routine screening for food refusal among children with ASD is warranted to prevent dietary inadequacies that may be associated with selective eating habits. Future research is needed to develop effective and practical feeding approaches for children with ASD.
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Hubbard et al. report ASD children often reject food based on texture or consistency and when ingredients are combined, while these factors are less significant for neurotypical children.
“Similarly, Hubbard et al. report that ASD children often reject food based on texture or consistency and when ingredients are combined, while these factors are less significant for NT children [41].”
From Unraveling the Connections: Eating Issues, Microbiome, and Gastrointestinal Symptoms in Autism Spectrum Disorder (2025) · cites this paper as [41]
Common factors for food refusal that are greater in children with ASD compared with TD include texture/consistency, taste/smell, mixtures, brand, and shape.
“Common factors for food refusal that are greater in children with ASD compared with TD include texture/consistency, taste/smell, mixtures, brand, and shape (Hubbard et al., 2014)”
From Behavioral, Perceptual, and Neural Alterations in Sensory and Multisensory Function in Autism Spectrum Disorder (2015) · cites this paper as Hubbard et al., 2014
These dysfunctions in sensory processing, due to alterations in connectivity and synaptic architecture, predispose children with ASD to present sensory hypersensitivities, especially oral sensory sensitivity.
“These dysfunctions in sensory processing, due to alterations in connectivity and synaptic architecture, predispose children with ASD to present sensory hypersensitivities, especially oral sensory sensitivity [58].”
From Food Selectivity and Its Implications Associated with Gastrointestinal Disorders in Children with Autism Spectrum Disorders (2022) · cites this paper as [58]
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- Authors
- Hubbard, K. L., Anderson, S. E., Curtin, C., Must, A., & Bandini, L. G.
- Affiliations
- Tufts University (US)
- The Ohio State University (US)
- University of Massachusetts Chan Medical School (US)
- Corresponding author
- Hubbard, Kristie L.
- Venue
- Journal of the Academy of Nutrition and Dietetics
- Publisher
- Elsevier BV
- Published
- 2014-12
- Volume
- 114
- Issue
- 12
- Pages
- 1981-1987
- ISSN
- 2212-2672 (ISSN-L)
- PMC
- PMC4252256
- OpenAlex
- W2085567239
- Cited by
- 201
- References
- 24
- Citations by year
- 2026: 20 · 2025: 13 · 2024: 33 · 2023: 26 · 2022: 22 · 2021: 20 · 2020: 10 · 2019: 15 · 2018: 17 · 2017: 9 · 2016: 7 · 2015: 8
- FWCI
- 6.11
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the Academy of Nutrition and Dietetics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship@UMassChan (submittedVersion)
- Funders
- National Institutes of Health (DK046200)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK046200-14, P30DK046200)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD004147-33A2, HD048989, P30HD004147, R21HD048989)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- autism spectrum disorder, food refusal, food properties, taste and smell, food color, fruit and vegetable intake, picky eating, nutritional adequacy, children
- MeSH terms
- Energy Intake, Child, Child Behavior, Child Development Disorders, Pervasive, Child, Preschool, Choice Behavior, Cross-Sectional Studies, Diet, Female, Food Preferences, Fruit, Humans, Male, Surveys and Questionnaires, Vegetables, Linear Models
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