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Autism Features and Gender-Specific Eating Behaviour Problems throughout Childhood: The Generation R Study
Objectives: To examine the relationship between autism features and eating behaviour throughout chilhood in a general population sample.
Methods: In this subset (N=3066) of the Generation R study [8] we assessed autism features by the Child Behavior Checklist (CBCL) at age 3 and the Social Responsiveness Scale (SRS) at age 6. Parental report of eating behavior was assembled at age 4 by the Child Eating Behavior Questionnaire (CEBQ) and at age 9 with the CEBQ and one scale of the Dutch Eating Behavior Questionnaire (DEBQ).
Results: Per each 1-point increase in autism features at age 3 (CBCL), children scored 0.06 points higher on Emotional Undereating (95%CI: 0.04; 0.08), 0.05 points higher on Food Fussiness (95%CI: 0.03; 0.08), 0.03 points higher on Slow Eating (95%CI: 0.01; 0.05), 0.04 points higher on Emotional Overeating (95%CI: 0.02; 0.06) and 0.02 points lower on Enjoyment of Food (95%CI: -0.04;-0.00) at age 4 in adjusted models. No gender differences were found.
Children scored per 1-point increase in autism features at age 3 years (CBCL), 0.04 points higher on Emotional Undereating (95%CI: 0.01; 0.06) and 0.03 points higher on Emotional Overeating (95%CI: 0.01; 0.05) at 9 years in adjusted models. In girls, autism features related with increased Emotional Overeating at age 9 years, in contrast to boys.
Each 1-point increase in autism features at age 6 years (SRS), associated with a 0.23 points higher score on Emotional Undereating (95%CI: 0.03; 0.43), 0.30 points higher on Emotional Overeating (95%CI: 0.11; 0.50), 0.29 points lower on Enjoyment of Food (95%CI: -0.47; -0.10), and 0.48 points higher on Food Responsiveness (95%CI: 0.29; 0.76) at age 9 in adjusted models. Whereas in girls, autism features associated with increased Emotional Undereating, Emotional Overeating and reduced Enjoyment of Food, this relation was absent in boys.
Conclusions: This study indicates that autism features in the general population are associated with eating behavior problems throughout childhood, thus not only in clinical populations. Early childhood autism features may predispose eating behavior difficulties, especially in girls.