Atypical eating behaviors in children and adolescents with autism, ADHD, other disorders, and typical development

Background: Previous research has not yet examined the prevalence of atypical eating behaviors in children and adolescents with autism compared to those with ADHD, other disorders, and typical development. Method: The sample comprised 2102 children: 1462 with autism, 327 with other disorders (e.g., ADHD, intellectual disability, language disorder, and learning disability), and 313 typical children, 1-18 years of age (mean 7.3). Atypical eating behaviors were assessed with the Checklist for Autism Spectrum Disorder based on a standardized parent interview conducted by licensed psychologists. Results: Atypical eating behaviors were significantly more common in autism (70.4%) than in children with other disorders (13.1%) and typical children (4.8%). For children with autism who had atypical eating behaviors, the most common behavior was limited food preferences (88%), followed by hypersensitivity to food textures (46%), other peculiar patterns most often eating only one brand of food (27%), pocketing food without swallowing (19%), and pica (12%). Grain products and/or chicken (usually nuggets) were the preferred foods for 92% of children with autism who had limited food preferences. For children with autism who had atypical eating behaviors, 25% had three or more atypical eating behaviors (vs. 0% for children with other disorders or typical development). Only children with autism had pica or pocketed food. Conclusions: The number and types of atypical eating behaviors found only in children with autism and not in children with other disorders or typical development should alert clinicians to the possibility of autism and the need to evaluate for autism in order to facilitate early identification and access to evidence-based treatment.