# The Development of the Food Averse Questionnaire: A Measure of Food Avoidance in Children With and Without Autistic Spectrum Conditions

## TL;DR

This study created a questionnaire to measure food avoidance in children, finding that children with autism show more severe eating issues than typically developing children.

## Contribution

The study introduces the Food AVERSE questionnaire, a new tool to assess avoidant eating behaviors in children with and without autism.

## Key findings

- The Food AVERSE questionnaire has three subscales: avoidant, rigid-inflexible, and texture-sensitive eating.
- Children with autism spectrum conditions (ASC) showed higher levels of food avoidance and feeding difficulties compared to typically developing children.
- Feeding problems in children with ASC often begin before an autism diagnosis is made.

## Abstract

The aim of this study was to 1) develop a measure of avoidant eating behaviours for both typically developing children (TD), and those with Autism Spectrum Conditions (ASC), and 2) to examine whether these current behaviours are associated with reports of early feeding difficulties in both populations. In study one (n = 336) parents of 4‐ to 14‐year‐old children completed a series of questions about food avoidance. Three subscales of food avoidance were identified with a total scale of 31 items; avoidant, rigid‐inflexible, and texture sensitive. Analyses found that scores on these subscales were associated with related measures of picky eating, food neophobia, sensory sensitivity and cognitive inflexibility, as well as lower fruit, vegetable, dairy and protein consumption. In study two, 225 children aged 4–14 years and their parents were recruited (143 TD and 78 ASC). Children with ASC were more likely to have feeding problems during the transition to family foods and in the toddler eating period in comparison to TD children. Additionally, children with ASC showed, at the time of the study, higher avoidance, rigid‐inflexible eating and texture‐sensitive eating behaviours than TD children. This study has developed a reliable scale for food avoidance for children with and without ASC diagnoses. Food avoidance is more severe in children with ASC than in TD children and these difficulties may start before them receiving an ASC diagnosis. Further work is needed to examine the usefulness of this scale in clinical and nonclinical populations.

The Food AVERSE questionnaire measures avoidant eating in children aged 4–14 years. It has three subscales which measure food avoidance, rigid‐inflexible eating and texture‐sensitive eating. The scale is a useful measure to look at avoidant eating across different children and has been tested on both typically developing and autistic children.

The Food AVERSE questionnaire is a novel scale to measure avoidant eating behaviours in children with and without ASC.The Food AVERSE questionnaire comprises three factors; food avoidance, rigid‐inflexible and texture sensitive.Children with ASC had higher scores on the Food AVERSE Questionnaire and were also reported to have more problems with feeding before their diagnosis.This scale can be used in clinical and nonclinical samples of children to measure different aspects of food avoidance.

The Food AVERSE questionnaire is a novel scale to measure avoidant eating behaviours in children with and without ASC.

The Food AVERSE questionnaire comprises three factors; food avoidance, rigid‐inflexible and texture sensitive.

Children with ASC had higher scores on the Food AVERSE Questionnaire and were also reported to have more problems with feeding before their diagnosis.

This scale can be used in clinical and nonclinical samples of children to measure different aspects of food avoidance.