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

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

Kevin Ashley  1 , Mary Beth Steinfeld  2 , Gregory S Young  1 , Sally Ozonoff  1
Affiliations

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

Kevin Ashley et al. J Dev Behav Pediatr. 2020 Apr.

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.

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Figures

Figure 1:
Figure 1:
Total feeding problems frequency as a function of age and outcome group.
See this image and copyright information in PMC

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