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

The DOI matches its Crossref record; 82 of the 82 references it cites were found in a registry or an index; none of the 153 sources its claims cite is checked for support yet.

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

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.

Overview

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.

Figures

Figure 1. PRISMA diagram results (from Moher et al., 2009).
Figure 1. PRISMA diagram results (from Moher et al., 2009).CC BY · PubMed Central

Verification

Claims the paper makes

129 Not checked yet · 29 Own result · 20 No basis given · 19 Own interpretation · 5 Own method

Verify all 153 references — free account

Show all 146 claims

  • Probably not a substantial claim. 29
  • It may state two separate claims as one. 31
  • The quote only partly states this claim. 4
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

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Self-check

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3 of 3

Citations

Cites

1 retracted

Show all 82 references

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

Items 101–200 of 221

Metadata

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
Venue
Autism
Published
2021-03-02
Volume
25
Issue
6
Pages
1505-1519
ISSN
  • 1362-3613 (ISSN-L)
  • 1461-7005
OpenAlex
W3133881058
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
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

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