Prevalence of Four Types of Feeding Problems in Children Under Three with ASD Compared to Children with Language Delay

Saturday, May 13, 2017: 12:00 PM-1:40 PM
Golden Gate Ballroom (Marriott Marquis Hotel)
P. Towle1, L. Seiverling2, H. Hendy3 and J. Pantelides4, (1)Westchester Insitute for Human Development, Valhalla, NY, (2)Psychology, St Mary's Hospital for Children, Bayside, NY, (3)Penn State University, Schuylkill, PA, (4)Penn State University, State College, PA

Feeding problems such as selective eating in children with autism spectrum disorder (ASD) have been shown to be higher in prevalence compared to typically developing children and children with other developmental delays (prevalence estimates 46% - 89%, Ledford & Gast (2006)). The majority of studies investigating this have had samples of children over the age of three years. There are some studies that suggest that feeding problems start very early in ASD, but they are either very general in description (Dominick et al., 2007; Olsson et al., 2013), spanned large age ranges without separate analyses for infants and toddlers (Field et al., 2003; Williams et al., 2005), or used children referred specifically to feeding clinics (Williams, Gibbons, & Schreck, 2005). The issue of a comparison group is important, as well, since it will be important to know if children with ASD differ from other children who might be also prone to feeding problems (e.g., children with other disabilities such as language delay). More specific information is available for older children with ASD, showing that children with ASD are selective by a variety of dimensions including food texture, taste or smell, foods mixed together, brands, or food shape (Hubbard et al., 2014).

Objectives:  To compare the prevalence of four types of feeding problems for children with ASD under the age of three years, compared to children with non-ASD language delay (LD). Goal 2: To explore demographic variables (gender, age of first evaluation, and neighborhood income) for their associations with the four feeding problems.

Methods: Chart review study of 78 children with ASD and 85 children with Language Delay (LD). Each early intervention chart contained a full psychological and speech-language report. Inter-rater reliability (30% of charts) was found to be excellent, ranging from .62 to .85, for the following feeding problems: food selectivity by texture, food selectivity by food type, refusal to eat new foods, and food over-stuffing.

Results: For each problem, a 2X2 Chi-square analysis showed that children with ASD showed significantly higher prevalence rates than children with LD. A 2X2 ANCOVA compared number of children’s four feeding problems across diagnosis group (ASD, LD), gender (male, female), with age of first evaluation and neighborhood income serving as covariates. There was a significant gender effect, with male children showing more of the four feeding problems than did female children (male mean = .59, SD = .89; female mean = .16, SD = .43). No significant effects were found for age of first evaluation or neighborhood income.

Conclusions: Results suggest that children with ASD are at significantly greater risk during their first three years of life for each of four types of feeding problems: problems with food texture, and food type, new food refusal, and food over-stuffing. Prevalence rates for feeding problems found for the children with ASD in the present study were similar to those of previous estimates with various types of comparison groups.