Children with Persistent, Idiopathic Feeding Difficulties: An at Risk Group for Developing Autism Spectrum Disorder?

Saturday, May 14, 2016: 11:30 AM-1:30 PM
Hall A (Baltimore Convention Center)
P. Warreyn1, E. Van de Sijpe1 and I. De Groote2, (1)Ghent University, Ghent, Belgium, (2)Ghent University Hospital, Ghent, Belgium

Feeding and eating problems, e.g., food selectivity associated with taste or texture, are often reported in children with autism spectrum disorder (ASD; Field et al., 2003; Sharp et al., 2013). These feeding problems have also been linked to autism severity (Aponte et al., 2015) and are often among the first concerns reported by parents (Olsson et al. 2013). Following up infants with persistent feeding difficulties may therefore be an additional strategy to learn about early markers of and developmental trajectories into ASD. However, to our knowledge, no such studies have been conducted yet.


The aim of the current study was to assess ASD risk in a group of young children referred for persistent, idiopathic feeding difficulties.


In a period of 4 years, 32 young children (20 boys) between 12 and 73 months old, were referred to the University infant and child psychiatric unit (ICPU) with persistent feeding difficulties after medical (e.g., reflux) or organic (e.g., swallowing problems) causes were excluded by a specialised paediatric unit. Demographic characteristics (gender, age), history of the feeding problems (age and type), medical history (pregnancy and birth complications, developmental problems), details of the current feeding problems and  contextual factors were linked with  infant- and child psychiatric diagnosis of the children.


For 4 children, the parents refused a full assessment at the ICPU. Of the 28 remaining children, 4 (14%) were diagnosed with ASD (all boys), and an additional 7 (25%; 4 girls) received a working diagnosis of ASD (and will be followed up further). There were no differences between the children with (working diagnosis of) ASD and those without ASD in age of first concern, age at first consultation in the ICPU, complications during pregnancy or birth and contextual factors. Children with (working diagnosis of) ASD were less likely to have had problems with liquid food or with food intake before the age of 4 months (χ² = 8.866, p < .05 and χ² = 4.196, p < .05, respectively), but problems at other ages with other types of food were equally likely in both groups. At the moment of assessment at the ICPU, however, children with (working diagnosis of) ASD were more likely to still have problems with solid food, with or without lumps (χ² = 5.916, p < .05 and χ² = 3.962, p < .05, respectively). They were also more likely to have a language delay (χ² = 11.733) or to be sensory overreactive (χ² = 5.051, p < .05).


Children with persistent, idiopathic feeding difficulties are at increased risk for ASD. In the children with ASD, the  feeding difficulties usually started when solid food was introduced, and these problems with solid food were more persistent than in children without ASD. The current pilot study has implications for the early detection of ASD risk, and for the treatment of a subgroup of children with feeding difficulties.