# Correlates of Presence of Feeding Difficulties in Children with Autism Spectrum Disorder and Other Developmental Conditions

## TL;DR

This study finds that feeding difficulties are common in children with autism and other developmental conditions, and are linked to repetitive behaviors and lack of school enrollment.

## Contribution

The study identifies restricted and repetitive behaviors and absence of school enrollment as correlates of feeding difficulties in children with developmental conditions.

## Key findings

- Over half of the children had elevated feeding difficulty scores.
- Children not in school had significantly more feeding difficulties than those enrolled.
- Repetitive behaviors positively correlated with feeding difficulty frequency.

## Abstract

Background/Objectives: Feeding difficulties are more common in children with autism spectrum disorder (ASD) or other developmental conditions and are associated with nutritional risk and caregiver stress. However, they may be overlooked as growth tends to be preserved. We aimed to identify clinical and behavioral features associated with feeding difficulties among children with developmental conditions. Methods: This cross-sectional study included caregiver–child dyads, with children aged 1–7 years with ASD and other developmental conditions. Caregivers completed the Repetitive Behavior Questionnaire, Second Edition (RBQ-2) to assess child restricted and repetitive behaviors (RRBs) and the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) to assess feeding difficulties. Demographics, anthropometric measures and cognitive and adaptive scores were retrieved from medical records. Results: Of the 132 participants (mean age 41.8 months, range 15–67; 74.2% male) included, majority had normal weight (87.7%) and height (89.2%) z scores. Among participants, 54.5% had autism, 26.5% language delay and 18.9% other developmental diagnoses. Over half (53.0%) had elevated BPFAS scores. Children not enrolled in school showed significantly more feeding difficulties compared to those who were enrolled (32.6% vs. 16.7%, p < 0.05). The RBQ-2 total score positively correlated with the BPFAS total frequency score (r = 0.33, p = 0.01) after adjusting for gender, age and developmental diagnosis. Conclusions: Feeding difficulties were common in this sample. Higher RRBs and absence of formal schooling were associated with higher rates of feeding difficulties. Longitudinal studies are needed to ascertain the role of RRBs and school enrollment as clinical indicators associated with feeding difficulties.