SELECTIVE EATING IN AUTISM SPECTRUM DISORDER: A MULTICENTER STUDY ON PATTERNS, ASSOCIATED FACTORS, AND THERAPEUTIC APPROACHES
DOI:
https://doi.org/10.56238/arev8n1-006Keywords:
Autism Spectrum Disorder, Selective Eating, Pediatrics, Children, AdolescentsAbstract
Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social interaction, communication, and repetitive behaviors, with genetic and environmental causes. Among the various behaviors of individuals with ASD, selective eating stands out, which is related to stereotyped behavior and limitations in social interaction. Objective: To analyze the patterns of selective eating, dietary restrictions, and emotional and family aspects related to the eating habits of children and adolescents with ASD. Methodology: Observational study, cross-sectional in nature and with a quantitative approach, carried out through the application of structured questionnaires to caregivers of children and adolescents diagnosed with ASD, attending specialized institutions. Statistical analysis included multivariate tests to identify significant associations between sociodemographic, clinical, and behavioral variables. Results: 402 caregivers participated in the study. The prevalence of selective eating was high (67.91%), with a preference for foods rich in carbohydrates and proteins. The presence of professional support, especially from nutritionists and speech therapists, showed a statistically significant association with a reduction in restrictive eating behaviors. Frequent reports included difficulties during meals and negative effects on the emotional well-being of caregivers and family members. Conclusion: The findings reinforce the importance of interdisciplinary and individualized interventions in the management of selective eating in individuals with ASD, integrating nutritional support, speech therapy, and psychosocial support. The study contributes to expanding knowledge about the eating challenges in this population and provides support for the improvement of public policies and care practices aimed at comprehensive care.
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[1] Lord C, Brugha TS, Charman T, Cusack J, Dumas G, Frazier T, et al. Autism spectrum disorder. Nat Rev Dis Primers 2020;6. https://doi.org/10.1038/s41572-019-0138-4. DOI: https://doi.org/10.1038/s41572-019-0138-4
[2] Garcia-Cabau C, Bartomeu A, Tesei G, Cheung KC, Pose-Utrilla J, Picó S, et al. Mis- splicing of a neuronal microexon promotes CPEB4 aggregation in ASD. Nature 2025;637:496–
503. https://doi.org/10.1038/s41586-024-08289-w. DOI: https://doi.org/10.1038/s41586-024-08289-w
[3] Symeonides C, Vacy K, Thomson S, Tanner S, Chua HK, Dixit S, et al. Male autism spectrum disorder is linked to brain aromatase disruption by prenatal BPA in multimodal investigations and 10HDA ameliorates the related mouse phenotype. Nat Commun 2024; 15:6367. https://doi.org/10.1038/s41467-024-48897-8. DOI: https://doi.org/10.1038/s41467-024-48897-8
[4] Maenner MJ, Warren Z, Williams AR, Amoakohene E, Bakian AV, Bilder DA, et al. Prevalence and characteristics of Autism spectrum disorder among children aged 8 years - Autism and Developmental Disabilities Monitoring network, 11 sites, United States, 2020. MMWR Surveill Summ 2023;72:1–14. https://doi.org/10.15585/mmwr.ss7202a1. DOI: https://doi.org/10.15585/mmwr.ss7202a1
[5] Salari N, Rasoulpoor S, Rasoulpoor S, Shohaimi S, Jafarpour S, Abdoli N, et al. The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta- analysis. Ital J Pediatr 2022; 48:112. https://doi.org/10.1186/s13052-022-01310-w. DOI: https://doi.org/10.1186/s13052-022-01310-w
[6] Hodis B, Mughal S, Saadabadi A. Autism Spectrum Disorder. StatPearls, Treasure Island (FL): StatPearls Publishing; 2025.
[7] Rosen NE, Lord C, Volkmar FR. The diagnosis of autism: From kanner to DSM-III to DSM-5 and beyond. J Autism Dev Disord 2021;51:4253–70. https://doi.org/10.1007/s10803- 021-04904-1. DOI: https://doi.org/10.1007/s10803-021-04904-1
[8] Cermak SA, Curtin C, Bandini LG. Food selectivity and sensory sensitivity in children with autism spectrum disorders. J Am Diet Assoc 2010;110:238–46. https://doi.org/10.1016/j.jada.2009.10.032. DOI: https://doi.org/10.1016/j.jada.2009.10.032
[9] Panerai S, Ferri R, Catania V, Zingale M, Ruccella D, Gelardi D, et al. Sensory profiles of children with Autism Spectrum Disorder with and without feeding problems: A comparative study in Sicilian subjects. Brain Sci 2020;10:336. https://doi.org/10.3390/brainsci10060336. DOI: https://doi.org/10.3390/brainsci10060336
[10] Zulkifli MN, Kadar M, Hamzaid NH. Weight status and associated risk factors of mealtime behaviours among children with autism spectrum disorder. Children (Basel) 2022; 9:927. https://doi.org/10.3390/children9070927. DOI: https://doi.org/10.3390/children9070927
[11] Kozak A, Czepczor-Bernat K, Modrzejewska J, Modrzejewska A, Matusik E, Matusik
P. Avoidant/restrictive food disorder (ARFID), food neophobia, other eating-related behaviours and feeding practices among children with autism spectrum disorder and in non-clinical sample: A preliminary study. Int J Environ Res Public Health 2023;20. https://doi.org/10.3390/ijerph20105822. DOI: https://doi.org/10.3390/ijerph20105822
[12] Adams SN, Verachia R, Coutts K. A blender without the lid on”: Mealtime experiences of caregivers with a child with autism spectrum disorder in South Africa. The South African journal of communication disorders. Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings 2020:e1–9. DOI: https://doi.org/10.4102/sajcd.v67i1.708
[13] Zhang L, Xu Y, Sun S, Liang C, Li W, Li H, et al. Integrative analysis of γδT cells and dietary factors reveals predictive values for autism spectrum disorder in children. Brain Behav Immun 2023; 111:76–89. https://doi.org/10.1016/j.bbi.2023.03.029. DOI: https://doi.org/10.1016/j.bbi.2023.03.029
[14] Ramos E. Métodos Quantitativos Aplicados à Segurança Pública. Belém: 2008.
[15] Fávero L, Belfiore PP, Silva FL, Da C. Análise de dados: modelagem multivariada para tomada de decisões. 2009.
[16] Pestana H. ANÁLISE DE DADOS PARA CIÊNCIAS SOCIAIS A Complementaridade do SPSS 6 a EDIÇÃO Revista, Atualizada e Aumentada MARIA HELENA PESTANA JOÃO NUNES GAGEIRO. Edições Silabo, Lda; 2014.
[17] Centers for Disease Control and Prevention (CDC). Prevalência e identificação precoce do transtorno do espectro autista entre crianças de 4 a 8 anos — Rede de Monitoramento, 16 locais, Estados Unidos, 2022. MMWR Surveill Summ. 2025 Abr 17;74(2):1-17. Available in: https://stacks.cdc.gov/view/cdc/177099.
[18] Hamdani Y, Kassee C, Walker M, Lunsky Y, Gladstone B, Sawyer A, et al. Roadblocks and detours on pathways to a clinical diagnosis of autism for girls and women: A qualitative secondary analysis. Womens Health (Lond Engl) 2023;19:17455057231163761. https://doi.org/10.1177/17455057231163761. DOI: https://doi.org/10.1177/17455057231163761
[19] Okoye C, Obialo-Ibeawuchi CM, Obajeun OA, Sarwar S, Tawfik C, Waleed MS, et al. Early diagnosis of autism spectrum disorder: A review and analysis of the risks and benefits. Cureus 2023;15:e43226. https://doi.org/10.7759/cureus.43226. DOI: https://doi.org/10.7759/cureus.43226
[20] Gale-Grant O, Chew A, Falconer S, França LGS, Fenn-Moltu S, Hadaya L, et al. Clinical, socio-demographic, and parental correlates of early autism traits in a community cohort of toddlers. Sci Rep 2024;14:8393. https://doi.org/10.1038/s41598-024-58907-w. DOI: https://doi.org/10.1038/s41598-024-58907-w
[21] Valenzuela-Zamora AF, Ramírez-Valenzuela DG, Ramos-Jiménez A. Food selectivity and its implications associated with gastrointestinal disorders in children with autism spectrum disorders. Nutrients 2022; 14:2660. https://doi.org/10.3390/nu14132660. DOI: https://doi.org/10.3390/nu14132660
[22] Mandecka A, Regulska-Ilow B. The importance of nutritional management and education in the treatment of autism. Rocz Panstw Zakl Hig 2022;73:247–58. https://doi.org/10.32394/rpzh.2022.0218. DOI: https://doi.org/10.32394/rpzh.2022.0218
[23] Byrska A, Błażejczyk I, Faruga A, Potaczek M, Wilczyński KM, Janas-Kozik M. Patterns of food selectivity among children with autism spectrum disorder. J Clin Med 2023;12. https://doi.org/10.3390/jcm12175469. DOI: https://doi.org/10.20944/preprints202307.0875.v1
[24] Oliveira ET. A intervenção fonoaudiológica em crianças com transtorno do espectro do autismo que apresentam dificuldade alimentar: revisão integrativa da literatura. Belo Horizonte; Universidade Federal de Minas Gerais: 2022.
[25] Thompson K, Wallisch A, Nowell S, Meredith J, Boyd B. Short report: The role of oral hypersensitivity in feeding behaviors of young autistic children. Autism 2023; 27:1157–62. https://doi.org/10.1177/13623613221135091. DOI: https://doi.org/10.1177/13623613221135091
[26] Sharp WG, Berry RC, McCracken C, Nuhu NN, Marvel E, Saulnier CA, et al. Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature. J Autism Dev Disord 2013; 43:2159–73. https://doi.org/10.1007/s10803-013-1771-5. DOI: https://doi.org/10.1007/s10803-013-1771-5
[27] Bandini LG, Anderson SE, Curtin C, Cermak S, Evans EW, Scampini R, et al. Food selectivity in children with autism spectrum disorders and typically developing children. J Pediatr 2010;157:259–64. https://doi.org/10.1016/j.jpeds.2010.02.013. DOI: https://doi.org/10.1016/j.jpeds.2010.02.013
[28] Ismail NAS, Ramli NS, Hamzaid NH, Hassan NI. Exploring eating and nutritional challenges for children with autism spectrum disorder: Parents’ and special educators’ perceptions. Nutrients 2020;12:2530. https://doi.org/10.3390/nu12092530. DOI: https://doi.org/10.3390/nu12092530
