Understanding feeding problems in autistic children: Exploring the interplay between internalizing symptoms and sensory features

• Published in: Autism : the international journal of research and practice Vol. 26; no. 8; pp. 2165 - 2174
• Main Authors: Crippa, Alessandro, Colombo, Paola, De Cosmi, Valentina, Mazzocchi, Alessandra, Scaglioni, Silvia, Spolidoro, Giulia Carla Immacolata, Bettocchi, Silvia, D’Oria, Veronica, Viganò, Nicole, Mani, Elisa, Molteni, Massimo, Agostoni, Carlo
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.11.2022; SAGE PUBLICATIONS, INC
• Subjects: Autism Spectrum Disorders; Autistic children; Behavior Problems; Behaviour disordered children; Child Behavior; Child Behavior Checklist; Eating behavior; Eating Disorders; Emotional Problems; Foreign Countries; Individual Characteristics; Infants; Internalization; Internalizing disorders; Medical diagnosis; Perceptual Impairments; Preschool Children; Sensory perception; Sensory processes; Sensory stimulation; Symptoms (Individual Disorders); Toddlers; Italy; mealtime behaviors; preschool; internalizing problems; autism spectrum disorder; sensory profile; feeding problems
• ISSN: 1362-3613; 1461-7005
• DOI: 10.1177/13623613221080227

Feeding/behavior problems are highly prevalent in autistic children. This study aimed to explore the interplay between autistic features, sensory processing patterns, emotional/behavioral difficulties, and feeding problems in children with a clinical diagnosis of autism spectrum disorder. Ninety-nine children aged 1.5–5 years were assessed using the Children’s Eating Behavior Inventory (CEBI), the Child Behavior Checklist, the Revised Sensory Profile—Second Edition (SP-2), and the Food Frequency Questionnaire. The sample was divided into two subgroups based on the presence of feeding behavior problems as rated by parents on the CEBI. Children with feeding problems showed more severe internalizing symptoms and were more reactive to sensory stimuli than children without feeding problems. We also found a significant relationship between higher levels of autistic features and greater feeding behavior problems. A mediation analysis model indicated that this relationship was mediated by sensory processing, as reflected by SP-2 quadrants scores. Although preliminary, these findings suggest that children with higher levels of autistic features could be at greater risk of developing feeding behavior problems only if they also have a higher sensory sensitivity to environmental stimuli. Lay abstract This study adds to a growing body of research documenting feeding problems in autistic children. Our results indicate that children aged 1.5–5 years with feeding problems may present with elevated internalizing difficulties and alterations in sensory processing when compared to same-age children without feeding problems. Our study also proposes that sensory processing may be an important, mediating factor in the relationship between autism features and feeding problems. The present work suggests, therefore, that implementers should thoroughly consider the sensory profile of autistic children prior to intervening on feeding behaviors. In particular, based on these preliminary findings, feeding interventions could benefit from environments designed to support children who can find them noisy and overwhelming.