Self-Reported Food Selectivity in Adolescents and Young Adults with Autism Spectrum Disorders

Background:

Picky eating is a prevalent problem in children with autism spectrum disorders (ASD). Food selectivity can negatively impact a child’s nutritional intake and BMI, interfere with parent-child relationships, and increase family stress. Although picky eating has been well documented in children with ASD, less is known about food selectivity in adolescents and young adults.

Objectives:

To examine self-reported food selectivity in adolescents and young adults with ASD.

Methods:

Participants included 65 adolescents/young adults with ASD (12-28 years) and 59 adolescents/young adults with neurotypical development (12-23 years). Diagnoses were confirmed with ADOS and ADI, and groups were matched on age, VIQ, PIQ, FSIQ (all IQ scores ≥ 75), and socioeconomic status. Exclusion criteria for the ASD group included any known comorbid medical, genetic, or neurological disorder that may affect cognitive functioning. Participants completed the self-report Adult/Adolescent Sensory Profile (AASP; Brown and Dunn, 2002).

Results:

Adolescents and young adults with ASD were more likely to be classified as food neophobic or afraid of eating new/unfamiliar foods when compared to typically developing peers (χ²=6.51, p<.001). The adolescents and young adults with ASD were also more likely to report disliking textured foods, such as applesauce, cottage cheese, or chunky peanut butter (p<.001, η²=.17). This group difference remained significant after accounting for more global avoidance of tactile stimuli (p=.001, η²=.08). Finally, the ASD group was less likely to enjoy strong tastes, such as spices in foods or strong mints/candies (p<.005, η²=.06), but this difference appears to be accounted for by more generally diminished sensory seeking behaviors that cut across sensory modalities.

Conclusions:

When reporting on their own food selectivity and eating behaviors, adolescents and young adults with ASD described a preference for familiar foods and a dislike of foods with particular textures or strong tastes. Although globally lower sensory seeking behaviors accounted for the preference for milder foods, broader sensory avoidance did not explain the reported dislike of food textures. These findings suggest that there is something uniquely unpleasant about food textures for these individuals with ASD, and that this sensory experience may underlie food preferences and picky eating. These data also demonstrate the utility of the taste and food items within the Oral Sensory domain on the AASP (a standardized and commonly used clinical tool) as measures of food neophobia and food preference. Further research examining specific aspects of foods and taste processing (e.g., textures, flavors) is needed to fully understand the causes of food selectivity in adolescents and adults with ASD.