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Cited by 221Child Nutrition and Feeding IssuesEating Disorders and BehaviorsAutism Spectrum Disorder Research

Feeding and Eating Problems in Children and Adolescents with Autism: A Scoping Review

Open access
Baraskewich, Jessica, von Ranson, Kristin M, McCrimmon, Adam, McMorris, Carly A·2021·Autism
DOI 10.1177/1362361321995631PMC PMC8323334
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Abstract

Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other feeding and eating problems (e.g. disordered eating, fear of trying new foods, and insistence on specific food presentation) are also common in this population. This scoping review describes the nature and extent of feeding and eating problems in autistic youth and reports characteristics of autistic youth who experience such issues. Thirty-four studies were included in the current review, with almost all studies (91%) investigating feeding problems. Only 9% of studies examined concern with weight, shape, and/or body image, but several authors noted that disordered eating attitudes and behaviors may occur more frequently in those with autism than their peers without autism. No common individual characteristics (e.g. cognitive functioning and autism symptom severity) were identified for youth who experience feeding or eating problems. Although differentiating “feeding” from “eating” problems is critical for accurate identification and treatment of these issues, the existing literature has failed to do so. We propose that in future research “eating problems” be used when behaviors involve preoccupation with food, eating, or body image, and “feeding problems” be used when such preoccupation is absent. Lay abstract: Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other, broader difficulties with feeding and eating (eating disorder symptoms such as restricting food intake or preoccupation with body shape or weight and insistence on specific food presentation) are also common in autistic individuals. Here, we describe the nature and extent of feeding and eating problems in youth with autism. We found no common characteristics (such as severity of autism symptoms) that best describe autistic youth who experience problems with feeding or eating. Almost all studies we reviewed focused on problems with feeding (selective or picky eating), and only a few studies focused on eating disorder symptoms (concern with weight, shape, and/or body image). However, some researchers reported that eating disorder symptoms may occur more often in autistic individuals compared to their peers without autism. Many studies used the terms “feeding” and “eating” problems interchangeably, but understanding the difference between these problems is important for researchers to be consistent, as well as for proper identification and treatment. We suggest future researchers use “eating problems” when behaviors involve preoccupation with food, eating, or body image, and “feeding problems” when this preoccupation is absent. We highlight the importance of understanding whether feeding or eating problems are separate from autism traits, and the role of caregivers and other adults in the child’s treatment. Considerations for health-care providers to assist with diagnosis and treatment are also provided.

AI snapshot

Written from the paper’s full text.

TL;DR

This scoping review synthesized 34 studies on feeding and eating problems in autistic youth and found that almost all research focused on feeding problems, especially food selectivity, while only 9% examined weight, shape, and/or body image concerns. No consistent individual characteristics (e.g., cognitive functioning, autism symptom severity) were identified for youth with these problems, and the literature often used “feeding” and “eating” interchangeably.

Key findings

  • Across 34 included studies, 91% investigated feeding problems and only 9% (3 studies) examined constructs fitting the authors’ definition of eating problems involving weight, shape, and/or body image concerns.
  • Food selectivity was the most commonly investigated feeding problem: 86% of studies investigated feeding problems involving selective intake, and in studies without comparison groups, rates were high (e.g., 62% showed food selectivity in Kerwin et al., 2005; 72% showed restricted variety in Schreck & Williams, 2006).
  • Of 29 studies on selective eating, 69% (n = 20) also examined sensory sensitivities or food texture/temperature/smell/taste; most suggested food selectivity may be related to sensory impairments, with food texture identified as a strong contributing factor.
  • No common individual characteristics were identified for youth who experience feeding or eating problems; findings on cognitive functioning, adaptive functioning, and autism traits were mixed, and preliminary evidence suggested autistic youth may be at higher risk for eating problems than peers without autism.

Methods

  • Scoping review conducted and reported according to PRISMA, with systematic searches in MEDLINE, PsycINFO, and PubMed using population, age, and feeding/eating problem terms; searches were not date-restricted up to April 2020 and were limited to English, human-participant, peer-reviewed articles.
  • Inclusion required empirical research with an objective measure of feeding or eating problems, separate data for autistic participants (or equivalent diagnoses), and samples of children/adolescents aged 18 years or under, or samples with 50% or more under 18 years; studies focused exclusively on medical issues, interventions for specific behaviors, case studies, and tool-development studies were excluded.
  • The review included 34 studies, with a total sample of 4215 participants with autism; participants were recruited from community organizations, autism service organizations, and specialized clinics, and most studies (59%) were conducted in the United States.

Limitations

  • The paper states that the search was limited to empirical studies using an objective measure of feeding or eating problems, which may have excluded qualitative studies and limited understanding of unmeasured issues such as parental approach to feeding and the parent–child feeding relationship.
  • The paper states that variable terminology in the literature means some relevant empirical studies may have been inadvertently excluded, and that excluding studies of feeding/eating problems in the presence of another medical condition (e.g., gastrointestinal disorders, epilepsy) may make results less representative of the heterogeneous autistic youth population.
  • Evident from the text: most included studies (88%) used cross-sectional designs and 88% relied on parent-reported data, only three studies examined eating problems involving weight/shape/body image, and the review found no common individual characteristics, limiting conclusions about development, maintenance, and remission of these problems.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1177/1362361321995631

Cites

82 of 82 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 153 cited sources checked · 0 supported · 0 flagged

  • Findingnone given

    The existing literature has failed to differentiate "feeding" from "eating" problems.

    “Although differentiating “feeding” from “eating” problems is critical for accurate identification and treatment of these issues, the existing literature has failed to do so.”
    Quote in the paperSubstantial claim
  • Findingown data

    No common individual characteristics (e.g., cognitive functioning and autism symptom severity) were identified for youth who experience feeding or eating problems.

    “No common individual characteristics (e.g. cognitive functioning and autism symptom severity) were identified for youth who experience feeding or eating problems.”
    • Also stated in: § Lay abstract · plain
      “We found no common characteristics (such as severity of autism symptoms) that best describe autistic youth who experience problems with feeding or eating.”
    Quote in the paperSubstantial claim
  • Findingown data

    Almost all included studies (91%) investigated feeding problems.

    “with almost all studies (91%) investigating feeding problems”
    • Also stated in: § Lay abstract · plain
      “Almost all studies we reviewed focused on problems with feeding (selective or picky eating)”
    Quote in the paperNot a substantial claim
  • Findingown data

    Only 9% of included studies examined concern with weight, shape, and/or body image.

    “Only 9% of studies examined concern with weight, shape, and/or body image”
    • Also stated in: § Lay abstract · plain
      “only a few studies focused on eating disorder symptoms (concern with weight, shape, and/or body image)”
    Quote in the paperNot a substantial claim
  • Findingreasoning

    There is a limited understanding as to whether eating problems should be attributed to an individual's autism or whether an additional diagnosis is warranted.

    “there is a limited understanding as to whether such problems should be attributed to an individual’s autism or whether an additional diagnosis is warranted.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 29
  • May combine two claims. 31
  • The quote only partly states this claim. 4

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Thirty-four studies were included in the review.

    “Thirty-four studies were included in the current review”
    • Also stated in: § Results · plain
      “We included 34 studies in our review”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Findingnone given

    Many studies used the terms "feeding" and "eating" problems interchangeably.

    “Many studies used the terms “feeding” and “eating” problems interchangeably”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Twenty-two included studies appeared to use original data sets and 12 reported secondary data analysis.

    “22 studies appearing to use original data sets and 12 reporting secondary data analysis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    To the authors' knowledge, no studies have examined whether feeding problems precede eating problems in autistic youth.

    “to our knowledge, no studies have examined whether these feeding problems precede eating problems in autistic youth.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Most included studies (88%) relied on parent-reported data; 9% combined parent- and self-report, and 3% relied solely on observational data.

    “Most studies (88%) relied on parent-reported data; a small number (9%) combined parent- and self-report, and a single study (3%) relied solely on observational data.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Nearly all included studies (88%) used a cross-sectional design, while 12% collected data across multiple time-points.

    “Nearly, all studies (88%) used a cross-sectional design, although some (12%) collected data across multiple time-points.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Participant age ranged from 2 to 28 years, although the majority focused on children 8 years of age or younger.

    “Participant age ranged from 2 to 28 years, although the majority focused on children 8 years of age or younger.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The earliest included study was published in 2004, and over half (56%) were published from 2013 to 2017.

    “The earliest study was published in 2004, and over half (56%) were published from 2013 to 2017.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Most included studies (59%) were conducted in the United States, with some completed in Australia (9%), Italy, England, and Canada (6% each).

    “Most studies (59%) were conducted in the United States, with some completed in Australia (9%), as well as Italy, England, and Canada (6% each).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Participants were recruited from a variety of sources, including community organizations, autism service organizations, and specialized clinics.

    “Participants were recruited from a variety of sources (e.g. community organizations, autism service organizations, and specialized clinics).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    Most literature to date has examined the presence of autism symptoms in individuals with AN, and a few studies have examined the reverse relation.

    “Most literature to date has examined the presence of autism symptoms in individuals with AN, and a few studies have examined the reverse relation.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Most literature to date examining eating disorders in persons with autism has been conducted predominately with adults, whereas picky eating and feeding disorders have been investigated in children and youth.

    “Most literature to date examining eating disorders in persons with autism has been conducted predominately with adults, whereas picky eating and feeding disorders have been investigated in children and youth.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingcitation

    Autistic children had more mealtime behaviors related to insistence on sameness (e.g., utensils and food preparation methods) than comparison groups.

    “Autistic children had more mealtime behaviors related to insistence on sameness (e.g. utensils and food preparation methods).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Williams et al. (2005)

      Not checked in the free run.

  • The quote only partly states this claim.

    Findingcitation

    Higher food neophobia is associated with lower BMI.

    “Higher FN was associated with lower BMI”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wallace et al. (2018)

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Other studies referred to such issues as "eating problems".

    “whereas others referred to such issues as “eating problems” (e.g. Kerwin et al., 2005).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kerwin et al., 2005

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    Findingcitation

    There are no significant differences between children with autism, special needs, and typically developing children on types of food consumed or liquid intake.

    “No significant differences between groups on types of food consumed or liquid intake.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Williams et al. (2005)

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  • May combine two claims.

    Findingreasoning

    Four studies examined patterns of food selectivity across time and produced mixed results.

    “Four studies examined patterns of food selectivity across time and produced mixed results.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    One-third of studies (n = 12) examined feeding or eating problems and autism traits, with split results.

    “Finally, one-third of studies (n = 12) examined feeding or eating problems and autism traits, with split results.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Although most studies included a measure of cognitive functioning within their protocols, only four studies examined the relation between feeding/eating problems and cognitive functioning.

    “Although most studies included a measure of cognitive functioning within their protocols, only four studies examined the relation between feeding/eating problems and cognitive functioning.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Five studies characterized specific aspects of sensory processing and produced comparable results.

    “Five studies characterized specific aspects of sensory processing and produced comparable results.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Findingcitation

    Poor adaptive functioning skills are associated with more feeding issues.

    “Although only a handful of studies examined the relation between adaptive functioning and feeding or eating problems, the one study (Kuschner et al., 2015) that provided support for a negative relation (i.e. poor adaptive functioning skills associated with more feeding issues) had a much older sample than the others.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kuschner et al., 2015

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A key difference between feeding and eating disorders involves the individual's cognitive appraisal of their appearance or body image concerns.

    “a key difference between the two categories of disorders involves the individual’s cognitive appraisal of their appearance or body image concerns.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Claudino et al., 2019

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    • cites Kennedy et al., 2018

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    Premisecitation

    A commonly accepted definition of feeding disorders is "Severe disruptions in nutritional and caloric intake exceeding ordinary variations in hunger, food preference, and/or interest in eating."

    “a commonly accepted definition is “Severe disruptions in nutritional and caloric intake exceeding ordinary variations in hunger, food preference, and/or interest in eating” (Sharp et al., 2017, p. 116).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sharp et al., 2017

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The DSM-5 combined problems related to feeding and eating into one comprehensive chapter.

    “the most recent version of Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; APA, 2013) combined problems related to feeding and eating into one comprehensive chapter”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites APA, 2013

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    To date, no formal definition for feeding disorders has been established.

    “To date, no formal definition for feeding disorders has been established (Kennedy et al., 2018)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kennedy et al., 2018

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  • May combine two claims.

    Premisecitation

    Westwood and colleagues (2018) found an overrepresentation of autism symptoms in adolescent females with severe AN, with 10% meeting full criteria for autism and an additional 40% below cut-off but presenting with symptoms.

    “Westwood and colleagues (2018) found an overrepresentation of autism symptoms in adolescent females with severe AN, with 10% of their sample meeting full criteria for autism and an additional 40% who were below cut-off but presented with symptoms.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Westwood et al., 2018

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Eating disorders involve varying degrees of preoccupation with food, body weight, and/or shape, whereas in feeding disorders, the motivation may be a combination of other reasons rather than cognitive concerns related to appearance or body image.

    “eating disorders involve varying degrees of preoccupation with food, body weight, and/or shape, whereas in feeding disorders, the motivation may be a combination of other reasons”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Claudino et al., 2019

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    • cites Kennedy et al., 2018

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    Study design and conductcitation

    The review was conducted and reported according to PRISMA.

    “The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA; Moher et al., 2009)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Moher et al., 2009

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    Premisecitation

    In Suarez et al. (2014), there was a stable, significant positive relationship between FS and sensory over-responsivity, such that children with higher sensory sensitivities had higher FS.

    “There was a stable, significant relationship between FS and sensory over-responsivity”
    • Also stated in: § Results · plain
      “children with higher sensory sensitivities also had higher FS.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Suarez et al. (2014)

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    Premisecitation

    Having a neurodevelopmental condition such as autism may increase the likelihood of developing eating problems, although this relation is poorly understood.

    “Having a neurodevelopmental condition such as autism may increase the likelihood of developing eating problems, although this relation is poorly understood (Mayes et al., 2018).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Mayes et al., 2018

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    Premisecitation

    In Postorino et al. (2015), 23% of children with FS showed three sensory factors linked to FS.

    “23% showed three sensory factors”
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    • cites Postorino et al. (2015)

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In Schreck & Williams (2006), selectivity was not related to autism symptoms.

    “Selectivity was not related to autism symptoms.”
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    • cites Schreck & Williams (2006)

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    Premisecitation

    In Kalyva (2009), participants with Asperger's syndrome self-reported significantly more BN symptoms, food preoccupation, oral control, and overall eating problems than peers.

    “Specifically, participants with Asperger’s syndrome self-reported significantly more BN symptoms, food preoccupation, oral control, and overall eating problems.”
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    • cites Kalyva (2009)

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    Premisecitation

    In Kalyva (2009), parent-reported eating problems showed the same differences between groups, and mothers of adolescents with Asperger's syndrome also indicated their daughters had significantly more dieting behaviors.

    “The same differences between groups were seen in parent-reported eating problems, but mothers of adolescents with Asperger’s syndrome also indicated their daughters had significantly more dieting behaviors.”
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    • cites Kalyva (2009)

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    Premisecitation

    Beighley et al. (2013) found a general trend of decreased food selectivity as children with autism got older.

    “Beighley and colleagues (2013) found a general trend of decreased food selectivity as children with autism got older”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Beighley and colleagues (2013)

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    Interpretationcitation

    Bandini et al. (2017) suggested that the decrease in overall selectivity may be better attributed to a decrease in caregivers offering non-preferred foods.

    “suggesting that the decrease in overall selectivity may be better attributed to a decrease in caregivers offering non-preferred foods (Bandini et al., 2017).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bandini et al. (2017)

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    Premisecitation

    Matson et al. (2009) found autistic youth showed significantly higher rates of feeding problems compared to typically and atypically developing groups (i.e. developmental disability other than autism), especially with food selectivity.

    “Matson et al. (2009) found autistic youth showed significantly higher rates of feeding problems compared to typically and atypically developing groups (i.e. developmental disability other than autism), especially with food selectivity.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Matson et al. (2009)

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    Premisecitation

    In Castro et al. (2016), autistic youth aged 4-16 years differed from matched general population controls on overall levels of problematic eating behavior, but did not significantly differ in picky eating symptoms.

    “although Castro and colleagues (2016) found autistic youth (aged 4–16 years) differed from matched general population controls on overall levels of problematic eating behavior, groups did not significantly differ in their picky eating symptoms.”
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    • cites Castro and colleagues (2016)

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    Interpretationcitation

    Peverill et al. (2019) concluded that most feeding problems remitted over time in preschoolers with autism, although a small group continued to show chronic feeding problems into school age.

    “Authors concluded that, like general population children, most feeding problems remitted over time, although a small group of preschoolers with autism continued to show chronic feeding problems into school age.”
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    Premisecitation

    Råstam and colleagues (2013) found that the prevalence of restrictive eating problems consistent with a diagnosis of AN was significantly higher for children aged 9 and 12 years with ADHD and/or autism, with the highest rates in girls with co-occurring ADHD and autism.

    “Similarly, in a large population-based study, Råstam and colleagues (2013) found the prevalence of restrictive eating problems (consistent with a diagnosis of AN) was significantly higher for children (aged 9 and 12 years) with attention-deficit hyperactivity disorder (ADHD) and/or autism, with the highest rates seen in girls with co-occurring ADHD and autism.”
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    Interpretationreasoning

    The trajectory of selective eating is likely heterogeneous and complicated by other feeding/eating problems the child may be experiencing, including general mealtime behaviors and rituals around eating.

    “The trajectory of selective eating is likely heterogeneous and complicated by other feeding/eating problems the child may be experiencing, including general mealtime behaviors and rituals around eating.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Smooth creamy textures (e.g. mashed potatoes), foods that require chewing (e.g. unprocessed meat), and foods with lumps (e.g. oatmeal) were identified as problematic in autistic youth.

    “Specifically, smooth creamy textures (e.g. mashed potatoes), foods that require chewing (e.g. unprocessed meat), and foods with lumps (e.g. oatmeal) were identified as problematic (Mayes & Zickgraf, 2019).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Mayes & Zickgraf, 2019

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    Interpretationreasoning

    Together, studies that employed more rigorous measures of sensory sensitivity suggest an association between sensory sensitivity and food selectivity, with food texture representing a strong contributing factor.

    “Together, studies that employed more rigorous measures of sensory sensitivity suggest an association between sensory sensitivity and food selectivity, with food texture representing a strong contributing factor.”
    Quote in the paperSubstantial claim

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    Premisecitation

    Mayes and Zickgraf (2019) reported 70% of their sample had an IQ of ⩾80.

    “and Mayes and Zickgraf (2019) reported 70% of their sample had an IQ of ⩾80.”
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    • cites Mayes and Zickgraf (2019)

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    Premisecitation

    Johnson et al. (2014) reported 63% of their sample had an IQ of ⩾70.

    “although Johnson et al. (2014) reported 63% of their sample had an IQ of ⩾70”
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    • cites Johnson et al. (2014)

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    Premisecitation

    A similar argument has been made with respect to whether ARFID best represents a feeding or eating disorder.

    “A similar argument has been made with respect to whether ARFID best represents a feeding or eating disorder (Kennedy et al., 2018; Sharp & Stubbs, 2019).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Kennedy et al., 2018

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    • cites Sharp & Stubbs, 2019

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    Premisecitation

    The PARDI is a multi-informant, semi-structured interview that considers different rationales for food restriction (e.g., sensory sensitivity, lack of interest in eating, and fear of negative consequences).

    “This multi-informant, semi-structured interview considers different rationales for food restriction (e.g. sensory sensitivity, lack of interest in eating, and fear of negative consequences), which can be used to guide appropriate treatment approaches.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Bryant-Waugh et al., 2019

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    Premisecitation

    The Pica, ARFID, and Rumination Disorder Interview (PARDI) is a recently developed, freely available measure for assessment and treatment planning of feeding and eating problems.

    “A recently developed, freely available measure that may prove helpful for assessment and treatment planning of feeding and eating problems is the Pica, ARFID, and Rumination Disorder Interview (PARDI; Bryant-Waugh et al., 2019).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bryant-Waugh et al., 2019

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  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The PARDI appears promising for use in autistic youth based on its content and structure.

    “Although the PARDI has not yet been used in samples of youth with autism, it appears promising for use in this population based on the content and structure of the measure.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Many children without autism demonstrate food selectivity.

    “Many children without autism demonstrate food selectivity; however, such problems are typically transient and, to some extent, considered developmentally appropriate (Samuel et al., 2018).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Samuel et al., 2018

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    Premisecitation

    In children without autism, food selectivity problems are typically transient and to some extent considered developmentally appropriate.

    “Many children without autism demonstrate food selectivity; however, such problems are typically transient and, to some extent, considered developmentally appropriate (Samuel et al., 2018).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Samuel et al., 2018

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    Study design and conductreasoning

    Using objective measures is important to characterize behaviors, but valuable information on unmeasured related issues (e.g., parental approach to feeding and parent-child feeding relationship) could not be fully understood.

    “While using objective measures is important to characterize behaviors, valuable information on unmeasured related issues (e.g. parental approach to feeding and parent–child feeding relationship) could not be fully understood.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Given variable terminology in the literature, some relevant empirical studies may have been inadvertently excluded despite efforts to be inclusive.

    “Second, given the variable terminology in the literature, it is possible that, despite our efforts to be inclusive, some relevant empirical studies may have been inadvertently excluded.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Body image disturbance is an important feature of AN and BN.

    “While some evidence suggests that disordered eating behaviors are present in youth with autism, research on body image in relation to disordered eating in this population is non-existent, despite body image disturbance being an important feature of AN and BN (APA, 2013).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites APA, 2013

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    Our search was limited to empirical studies that used an objective measure of feeding or eating problems, and so may have excluded qualitative studies examining this topic.

    “First, our search was limited to empirical studies that used an objective measure of feeding or eating problems, and so may have excluded qualitative studies examining this topic.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationnone given

    Inconsistent findings across studies are likely partly attributable to sample differences (e.g., differing age ranges and diagnoses such as ASD vs PDD-NOS) and to the various measures used to assess symptoms, which have differing levels of psychometric evidence.

    “findings are likely in part attributable to sample differences (e.g. differing age ranges and diagnoses such as autism spectrum disorder (ASD) vs PDD-NOS) as well as the various measures used to assess symptoms, which have differing levels of psychometric evidence.”
    Quote in the paperSubstantial claim
56 of 56

  • The paper relies on this without support.

    Differentiating “feeding” from “eating” problems is critical for accurate identification and treatment of these issues.

    “Although differentiating “feeding” from “eating” problems is critical for accurate identification and treatment of these issues, the existing literature has failed to do so.”

  • The paper relies on this without support.

    Understanding the difference between “feeding” and “eating” problems is important for researchers to be consistent and for proper identification and treatment.

    “Many studies used the terms “feeding” and “eating” problems interchangeably, but understanding the difference between these problems is important for researchers to be consistent, as well as for proper identification and treatment.”

  • The paper relies on this without support.

    Cross-sectional designs cannot identify factors that influence the development and maintenance of a condition.

    “Given that most research in this area has used cross-sectional designs, factors that influence the development and maintenance of feeding and eating problems are unknown.”

  • The paper relies on this without support.

    The PARDI has not yet been used in samples of youth with autism.

    “Although the PARDI has not yet been used in samples of youth with autism, it appears promising for use in this population based on the content and structure of the measure.”

  • The paper relies on this without support.

    Limited research exists on the efficacy of treatments for youth with co-occurring autism and feeding or eating disorders.

    “Limited research exists on the efficacy of treatments for youth with co-occurring autism and feeding or eating disorders; however, the presence of autism has been suggested to contribute to the resistance to conventional therapies (Wallier et al., 2009).”

  • The paper relies on this without support.

    No eating disorder treatments modified for autistic youth currently exist.

    “In addition, to our knowledge, no eating disorder treatments modified for autistic youth currently exist.”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

  • Matson et al. diagnostic groups do not total the reported sample

    Minor

    The listed diagnostic groups total 112 participants, rather than the reported 114.

    Reported 114 · recomputed 112

  • Schreck and Williams diagnostic groups exceed the reported sample

    Minor

    The listed diagnostic groups total 176 participants, but the row reports a sample of 138.

    Reported 138 · recomputed 176

  • Johnson et al. diagnostic groups do not total the reported sample

    Minor

    The listed diagnostic groups total 252 participants, four fewer than the reported sample of 256.

    Reported 256 · recomputed 252

3 of 3

Cites

1 retracted

Flagged first, then by citations

Research works printed but not linked: 5

  1. Constantino J. N., 2005, The Social Responsiveness Scale (SRS)
  2. Guenther P. M., 2006, Healthy Eating Index-2005
  3. Matson J. L., 2007, Autism spectrum disorders–comorbidity–child version
  4. Råstam M., 2008, Clinical Neuropsychiatry: Journal of Treatment Evaluation, 5, 31
  5. Rutter M., 2003, Manual for the Social Communication Questionnaire

Cited by

Sorted by citations

Related

Authors
Baraskewich, J., von Ranson, K. M., McCrimmon, A., & McMorris, C. A.
Affiliations
  • University of Calgary (CA)
  • University of Calgary, Canada
Corresponding author
McMorris, Carly A
ORCID
Venue
Autism
Publisher
SAGE Publications
Published
2021-03-02
Volume
25
Issue
6
Pages
1505-1519
ISSN
  • 1362-3613 (ISSN-L)
  • 1461-7005
DOI
10.1177/1362361321995631
PMC
PMC8323334
OpenAlex
W3133881058
Semantic Scholar
7ad36100a302500ee54277c43f06ca196c1d750b
Cited by
221
References
82
Citations by year
2026: 37 · 2025: 62 · 2024: 60 · 2023: 41 · 2022: 19 · 2021: 2
FWCI
5.45
Type
journal article
Language
en
Open access
Licence
Locations
  • Autism (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords
feeding difficulties, picky eating, food avoidance, disordered eating, eating disorder symptoms, body image concern, insistence on sameness, food presentation, autistic youth, terminology distinction
MeSH terms
Problem Behavior, Autism Spectrum Disorder, Adolescent, Autistic Disorder, Body Image, Child, Feeding Behavior, Humans

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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