An Overview of Feeding Difficulties in Children with Autism Spectrum Disorder: A Narrative Review
Valmin Ramos-Silva
*
Postdoctoral Training in Education, Pediatric Nutrition, and Pediatric Intensive Care Medicine, Research Group, State University of Minas Gerais, Hospital Padre Humberto (MEPES), Anchieta, Espírito Santo, Brazil.
Inocencia Peralta
Faculty of Universidad Central del Paraguay, Ciudad del Este, Paraguay.
Ariselma Magalhães Peçanha
Hospital Padre Humberto (MEPES), Anchieta, Espírito Santo, Brazil.
Rafael Henrique Alves de Miranda
Hospital Padre Humberto (MEPES), Anchieta, Espírito Santo, Brazil.
Thiago Barcelos da Silva
Hospital Padre Humberto (MEPES), Anchieta, Espírito Santo, Brazil.
Laura Guimarães Távora de Oliveira
Hospital Padre Humberto (MEPES), Anchieta, Espírito Santo, Brazil, Program in Pediatrics, Hospital São José do Avaí, Itaperuna, Rio de Janeiro, Brazil and Graduate Program in Pediatric Neurology, Afya, Vitória, Espírito Santo, Brazil.
Wendell Costa Bila
Undergraduate Program in Physical Education and Graduate Program in Biosciences and Human Health, State University of Minas Gerais, Divinópolis Campus, Minas Gerais, Brazil.
Janine Pereira-Silva
Child and Adolescent Health Sciences, FAESA School of Medicine, Vitória, Espírito Santo, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aims: To critically synthesise current scientific evidence on feeding difficulties in children with autism spectrum disorder (ASD), considering the sensory, behavioural, gastrointestinal, nutritional, and oral-motor domains.
Study Design: Structured critical narrative review informed by recent reviews, with or without meta-analysis.
Methodology: A targeted PubMed/MEDLINE search was used to identify recent English-language reviews, with or without meta-analysis, relevant to feeding difficulties in children and adolescents with autism spectrum disorder. Medical Subject Headings (MeSH) and free-text terms related to autism spectrum disorder, feeding behaviour, food selectivity, sensory processing, gastrointestinal symptoms, nutritional status, and oral-motor function were combined using the Boolean operators AND and OR. Reviews addressing at least one of the five predefined domains were considered, and evidence was synthesised descriptively and thematically.
Results: Feeding difficulties in children with ASD were consistently characterised as multidimensional. Sensory processing alterations, particularly responses to texture, taste, smell, temperature, appearance, and consistency, showed the most consistent association with food refusal and restricted dietary variety. Behavioral rigidity, repetitive behaviours, gastrointestinal symptoms, nutritional inadequacies, and oral-motor impairments contributed to the persistence and clinical impact of feeding problems. Reported consequences included reduced dietary diversity, risk of micronutrient inadequacies, impaired growth in some subgroups, and adverse effects on family dynamics. Isolated interventions showed limited and heterogeneous effectiveness, whereas individualised multidisciplinary management was more consistent with the multifactorial nature of these difficulties.
Conclusion: A multidimensional understanding of feeding difficulties in children with ASD is essential for comprehensive clinical assessment and for planning individualised, evidence-based interventions aimed at improving nutritional, functional, and quality-of-life outcomes.
Keywords: Autism spectrum disorder, feeding difficulties, food selectivity, sensory processing, feeding behaviour, nutritional status, gastrointestinal symptoms, oral-motor function, dietary diversity, multidisciplinary care