The Co-Occurrence of Autism and Avoidant/Restrictive Food Intake Disorder (ARFID): A Prevalence-Based Meta-Analysis.

This research looked at how often autism and a serious eating problem called ARFID occur together. They found that about 1 in 6 people with ARFID also have autism, and about 1 in 9 autistic people have ARFID. This is much higher than expected, suggesting these conditions often go together. The research suggests that when a child has one condition, doctors should check for the other.

This meta-analysis examined the co-occurrence between autism and Avoidant/Restrictive Food Intake Disorder (ARFID) across 21 studies involving 7,442 participants. Results showed that 16.27% of individuals with ARFID also had autism diagnoses, while 11.41% of autistic individuals met criteria for ARFID. These rates substantially exceed general population prevalence for both conditions, indicating significant overlap. Gender and ethnicity were identified as important sources of variation in ARFID studies.

The findings suggest both conditions share underlying characteristics and support clinical screening practices where individuals presenting with one condition are assessed for the other.

Results support implementing dual screening protocols in clinical settings - assessing for ARFID in autistic individuals and autism in those with ARFID. Clinicians should consider these co-occurring conditions when developing treatment plans, particularly given the shared underlying characteristics between autism and ARFID.

Insufficient data to examine co-occurrence across different ARFID subtypes or provide population comparisons. Limited number of autism studies (only 3) compared to ARFID studies (18). Wide confidence intervals suggest substantial variability between studies.

Avoidant/restrictive food intake disorder (ARFID) is a feeding and eating disorder characterized by extensive avoidance and/or restriction of food. Existing research demonstrates that ARFID is over-represented in Autistic populations and vice-versa, with both groups exhibiting shared characteristics. This meta-analysis investigated the co-occurrence between ARFID and autism via determination of autism prevalence in ARFID populations, and ARFID prevalence in Autistic groups. This review systematically identified literature evaluating those with ARFID and Autistic individuals.

Literature was searched for using SCOPUS, MEDLINE, and Web of Science. Selected publications included Autistic individuals and those with ARFID who either received a formal diagnosis of autism and/or ARFID or met clinical threshold cut-off scores on validated autism and/or ARFID questionnaires. Prevalence was reported in proportion-based values alongside 95% confidence intervals (CIs). This meta-analysis identified 21 studies (kARFID = 18 papers; kAutism = 3 papers) comprising of n = 7442 participants (nARFID = 1708; nAutism = 5734).

Prevalence of autism diagnoses was 16.27% in those with ARFID (95% CI = 8.64%-28.53%), and ARFID prevalence in Autistic groups was 11.41% (95% CI = 2.89%-35.76%). Gender and ethnicity served as significant sources of heterogeneity in ARFID papers. There was insufficient data to provide comparator values or prevalence across study population and distinct underpinning drivers of ARFID. Meta-analytic findings highlight significant rates of co-occurrence between autism and ARFID, suggesting that in clinical settings, it may be beneficial to consider screening Autistic individuals for ARFID and vice-versa.

Future research should further investigate co-occurrence across ARFID profiles, gender, and ethnicity.