Avoidant-restrictive food intake disorder and autism: epidemiology, etiology, complications, treatment, and outcome.

This review looks at the connection between autism and a feeding disorder called ARFID (avoidant-restrictive food intake disorder). Many autistic children have feeding difficulties - about 1 in 5 show signs of restrictive eating. These feeding challenges, including being sensitive to food textures and having strong food preferences, often continue into teenage years and adulthood. While various strategies exist to help autistic children with eating, there's not enough research on helping autistic teenagers and adults with these same issues.

This scoping review examines the relationship between avoidant-restrictive food intake disorder (ARFID) and autism, analyzing research published in 2022-2023. The review highlights significant overlap between these conditions, with 8.2-54.8% of children with ARFID being autistic, and 21% of autistic individuals showing avoidant-restrictive eating features. Both conditions are highly heritable and frequently co-occur with other neurodevelopmental, psychiatric, or somatic diagnoses. The review emphasizes that feeding difficulties in autistic individuals, particularly sensory sensitivities and food preferences, often persist into adulthood.

However, research on optimal support for autistic adolescents and adults with ARFID remains limited, highlighting a critical gap in treatment approaches.

Screening for ARFID should be routine in autism services, eating disorder clinics, and gender dysphoria services. Early intervention strategies for feeding difficulties should be implemented, with particular attention to sensory sensitivities and food preferences. There is an urgent need for evidence-based interventions targeting autistic adolescents and adults with ARFID features.

As a scoping review covering only 1.5 years of literature (2022-2023), the findings may not represent the full body of evidence. Sample sizes and specific methodologies of included studies are not detailed in the abstract, limiting assessment of study quality.

There is considerable overlap between the features of avoidant-restrictive food intake disorder (ARFID) and autism. The purpose of this scoping review is to provide an overview of studies published on ARFID and autism in 2022 and the first half of 2023. ARFID and autism are highly heritable conditions that often co-occur. In a large autism cohort, 21% of participants and 17% of their parents presented with avoidant-restrictive features.

Of children diagnosed with ARFID, 8.2-54.8% are autistic. More than half of individuals with ARFID also have other neurodevelopmental, psychiatric, or somatic diagnoses. Anxiety, depression, sleep disorders, and learning difficulties are particularly common co-occurring issues. Various strategies have been developed to support autistic children with feeding difficulties.

It appears that their feeding difficulties, particularly sensory sensitivities, food preferences, and mealtime rituals and routines frequently persist into adolescence and adulthood, but research on optimal support for adults and adolescents is still scarce. Untreated ARFID in autistic individuals may lead to serious complications. Individuals seeking specialist care for autism, eating disorders, or gender dysphoria should be screened for ARFID. More research is needed on how to support autistic adolescents and adults with features of ARFID.