Onset, Trajectory, and Pattern of Feeding Difficulties in Toddlers Later Diagnosed with Autism

J Dev Behav Pediatr. 2020 Apr;41(3):165-171. doi: 10.1097/DBP.0000000000000757.

Abstract

Objective: To examine the emergence and trajectory of feeding difficulties in young children who are later diagnosed with autism spectrum disorder (ASD).

Methods: The Behavioral Pediatrics Feeding Assessment Scale (BPFAS) was administered to a sample of 93 toddlers with an older sibling with ASD-the high-risk group-and 62 toddlers with no known familial ASD-the low-risk group-as part of a larger infant sibling study. The BPFAS was completed by parents at 15, 18, 24, and 36 months of age. At 36 months, participants underwent a diagnostic assessment and were classified into 1 of the following 4 outcome groups: ASD, nontypical development, high-risk typically developing, and low-risk typically developing. The BPFAS was scored for total frequency of feeding difficulties and autism-specific factor scores previously described in the literature.

Results: The frequency of feeding difficulties increased significantly more rapidly in the ASD group between 15 and 36 months of age, and by 36 months, they exhibited a significantly higher total frequency score than all other groups. Analysis of the factor scores revealed a similar pattern for the food acceptance and mealtime behavior domains but no significant differences in the medical/oral motor domain.

Conclusion: Feeding difficulties develop significantly more rapidly in children with ASD, with longitudinal monitoring revealing the steeper trajectory earlier than can be detected with cross-sectional analysis. Children with ASD are at risk of health and social consequences of poor feeding behavior that may potentially be minimized if addressed early and appropriately.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Autism Spectrum Disorder / complications
  • Autism Spectrum Disorder / physiopathology*
  • Child Behavior Disorders / etiology
  • Child Behavior Disorders / physiopathology*
  • Child Development / physiology*
  • Child, Preschool
  • Feeding Behavior / physiology*
  • Feeding and Eating Disorders of Childhood / etiology
  • Feeding and Eating Disorders of Childhood / physiopathology*
  • Female
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Risk
  • Siblings