Idiosyncratic food preferences of children with autism spectrum disorder in England

Objectives: To obtain a better understanding of feeding difficulties experienced by children with autism spectrum disorder (ASD). Methodology: Parents/caregivers (n = 325) of children (3-16 years) diagnosed with ASD living in England participated in an online questionnaire investigating early feeding history, food preferences and mealtime environment. Results: The most common feeding problem was the transition from weaning foods to textured food. Food appearance mainly determined food acceptance with over half the children (n = 152) being specific about the colour of their food. Nearly 65% (n = 191) were particular about food presentation, including specific brands and food packaging. Sensory attributes and texture of food affected food acceptance. There were clear preferences for crunchy or dry foods, followed by food with a smooth consistency. Nearly 80% (n = 223) repeatedly chose the same foods from a limited range. For specific food groups, the clear favourite among the study population was refined carbohydrates (64.4%, n = 186). A large proportion of children had tactile sensitivity, where 60% (n = 176) disliked having their hands/face dirty. Over 70% (n = 205) of children disliked strong odours, indicating the importance of the sensory attributes to food and the mealtime environment. Less than 40% (n = 108) of children were seen by a dietitian and the most common concern was the limited variety of foods and dietary intake. Conclusion: The study highlighted the need for nutritional monitoring and intervention where long-term idiosyncratic feeding behaviour may contribute to nutritional deficiencies.