An Analysis of Eating Postures in Adolescents and Young Adults Diagnosed with Autism

Background: Our study sought to look at eating posture in individuals with autism. Most of the studies in autism related to eating are concerning behavior.^1-8 One systematic review looked at interventions to improve eating, but postural analysis was not included.⁹ A few studies addressed certain components of motor behavior, posture, and techniques. Brisson et al.¹⁰ performed a retrospective study of infants who were later diagnosed with autism, and found that they demonstrated less anticipatory mouth opening when presented with a spoon than the control group; 4-6 months appeared to be the key period to recognize this delay. Studies with children with autism found that using a flipped spoon improves not only eating behavior, but oral motor processing.^11,12 In addition van den Engel-Hoek et al.¹³ analyzed the acquisition of assisted spoon feeding and provided additional data on the components. A cornerstone to understanding how prehension relates to spoon-feeding was supported in the research by Churchill et al.¹⁴ who demonstrated that reaching/grasping and spoon-feeding demonstrate similar kinematics in healthy adult subjects. David et al.¹⁵ sought to identify impairments in precision grip in children and adolescents with high-functioning autism. They found temporal dyscoordination and greater variability in precision grip when the subjects were compared to a group of typically developing age-matched peers. Memari et al.¹⁶ proposed that additional studies are necessary to discern the exact cause and differences in postures between individuals with and without autism. This premise was corroborated in a study assessing individuals with autism with and without speech delay and controls, as they found difference in motor skills.¹⁷

Objectives: The purpose of this study was to analyze eating postures in a group of individuals with autism spectrum disorders (ASD) who demonstrate expressive language impairment (ELI), and compare their eating postures to a group of age-matched peers. While eating behaviors and techniques have been studied in the autism population,^1-8 to date no research has been generated on the postures of individuals during eating. It was hypothesized that individuals with ELI-ASD would demonstrate different postures and strategies.

Methods: Nine subjects with ELI-ASD (age range 16-22 year; 1 female and 8 males) were recruited for this study. The Childhood Autism Rating Scale (CARS) was used to assess level of autism with all demonstrating "severe autism" with a a mean total score of 51.11 (SD5.54) with significant language impairment. Ten age-matched controls (18-20 year of age; 3 females and 7 males) were also recruited. During the discrete eating events each subject was video taped. Utlilizing a rubric and biomechanical analysis the following data was processed: attention to eating, hand used to hold spoon, grasp, spoon position, trunk posture, and other related movements.

Results:  Initial data analysis found significant differences between the ELI-ASD group and the control in eating including attention, grasp, and posture. Additional analysis is ongoing at this time.

Conclusions: Individuals with ELI-ASD demonstrated significantly different eating postures compared to the control group. This new line of analysis provides opportunities for intervention to ameliorate postural deficits, and improve life for individuals with autism in the realm of activities of daily living.