Short report: An examination of behavioral factors linked to picky eating in autistic children.
Wallisch Anna, Nowell Sallie, Zhang E, Boyd Brian, Tenenbaum Elena, Zucker Nancy, Bakula Dana, Davis Ann
What this study means for families
This study looked at 110 autistic children aged 3-6 years to see if those with picky eating had different behaviors than those without. Children with picky eating showed more aggressive behaviors and more withdrawn behaviors. This suggests that when helping children with eating difficulties, it's important to also consider their emotional and behavioral needs. Early identification by doctors can help families get support from feeding specialists.
Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.
Research summary
This cross-sectional study examined behavioral differences between autistic children aged 3-6 years with (n=80) and without (n=30) parent-reported picky eating. Data were collected from diagnostic evaluations at a medical center. Results indicated that children with picky eating demonstrated significantly higher levels of aggression (externalizing behavior) and withdrawal (internalizing behavior) compared to non-picky eaters. The findings suggest that behavioral profiles may be important considerations when developing treatment plans for eating difficulties in autism.
The study highlights the potential role of diagnosticians in identifying eating issues early and facilitating referrals to feeding specialists to prevent negative health consequences.
Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.
Key findings
- 1
Autistic children with picky eating showed significantly more aggressive behaviors compared to non-picky eaters
Confidence: moderateRelevance: high - 2
Autistic children with picky eating demonstrated significantly more withdrawal behaviors compared to non-picky eaters
Confidence: moderateRelevance: high
Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.
Clinical implications
Clinicians should assess both internalizing and externalizing behaviors when evaluating eating difficulties in autistic children. Comprehensive treatment plans should address behavioral challenges alongside feeding interventions. Early identification during diagnostic evaluations can facilitate timely referrals to feeding specialists, potentially preventing negative health outcomes.
Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.
Limitations
Small sample size with uneven groups (80 vs 30). Cross-sectional design limits causal inferences. Reliance on parent-reported picky eating rather than standardized assessment. Limited age range may restrict generalizability. No information provided about severity measures or control for confounding variables.
Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.
Original abstract
Eating difficulties are highly prevalent among autistic children and are linked to negative health consequences. While many mechanisms are thought to underly these behaviors, we know less about how internalizing and externalizing behaviors relate to eating difficulties in autism. The purpose of this study was to examine how internalizing and externalizing behaviors differ between autistic children (3-6 years of age) with parent-reported picky eating ( = 80) and without picky eating ( = 30). Data was drawn from intake paperwork and assessments completed as part of an autism diagnostic evaluation at a large medical center.
Results suggested that picky eaters, when compared to non-picky eaters, had significantly more difficulties with aggression and withdrawal. Our study findings suggest that understanding the behavioral profiles associated with picky eating may be particularly useful when devising treatment plans. Furthermore, diagnosticians who may be the first to gather both eating and behavioral symptom data can initiate referrals to feeding specialists to help prevent some of the negative health consequences associated with these eating behaviors.Lay AbstractMany autistic children have trouble with eating (e.g. not eating a wide variety of foods) which can lead to later health issues. While there are many factors that are thought to relate to these eating issues, one factor we know less about are internalizing behaviors, or being worried, anxious, or sad, and externalizing behaviors, or issues with attending to a task or aggressive behaviors.
In this study, we looked at differences in externalizing and internalizing behaviors in autistic children, who were 3-6 years of age, with picky eating (80 children with picky eating) and without picky eating (30 children without picky eating). Our results suggested that autistic children with picky eating had more issues with an externalizing and an internalizing behavior than autistic children without picky eating. Our findings are important because both externalizing and internalizing behaviors are likely important factors to consider when supporting an autistic child with eating difficulties and their family. Practitioners who diagnose autism may also be the first to gather both eating and behavioral information and may help to refer the child to a feeding specialist to prevent later issues.
Evidence Grade
limited
Grade assigned by AutismInsights based on study type and published abstract.
Study Details
- Journal
- Autism : the international journal of research and practice
- Year
- 2026
- PMID
- 41738769
- DOI
- 10.1177/13623613261418948
MeSH Terms