Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other feeding and eating problems (e.g. disordered eating, fear of trying new foods, and insistence on specific food presentation) are also common in this population. This scoping review describes the nature and extent of feeding and eating problems in autistic youth and reports characteristics of autistic youth who experience such issues. Thirty-four studies were included in the current review, with almost all studies (91%) investigating feeding problems. Only 9% of studies examined concern with weight, shape, and/or body image, but several authors noted that disordered eating attitudes and behaviors may occur more frequently in those with autism than their peers without autism. No common individual characteristics (e.g. cognitive functioning and autism symptom severity) were identified for youth who experience feeding or eating problems. Although differentiating “feeding” from “eating” problems is critical for accurate identification and treatment of these issues, the existing literature has failed to do so. We propose that in future research “eating problems” be used when behaviors involve preoccupation with food, eating, or body image, and “feeding problems” be used when such preoccupation is absent.

Lay abstract

Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other, broader difficulties with feeding and eating (eating disorder symptoms such as restricting food intake or preoccupation with body shape or weight and insistence on specific food presentation) are also common in autistic individuals. Here, we describe the nature and extent of feeding and eating problems in youth with autism. We found no common characteristics (such as severity of autism symptoms) that best describe autistic youth who experience problems with feeding or eating. Almost all studies we reviewed focused on problems with feeding (selective or picky eating), and only a few studies focused on eating disorder symptoms (concern with weight, shape, and/or body image). However, some researchers reported that eating disorder symptoms may occur more often in autistic individuals compared to their peers without autism. Many studies used the terms “feeding” and “eating” problems interchangeably, but understanding the difference between these problems is important for researchers to be consistent, as well as for proper identification and treatment. We suggest future researchers use “eating problems” when behaviors involve preoccupation with food, eating, or body image, and “feeding problems” when this preoccupation is absent. We highlight the importance of understanding whether feeding or eating problems are separate from autism traits, and the role of caregivers and other adults in the child’s treatment. Considerations for health-care providers to assist with diagnosis and treatment are also provided.

中文翻译：

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自闭症儿童和青少年的喂养和饮食问题：范围界定审查

挑食和回避食物等喂养问题在患有自闭症的青少年中很常见。其他喂养和饮食问题（例如饮食失调、害怕尝试新食物以及坚持特定的食物呈现方式）在这一人群中也很常见。这份范围审查描述了自闭症青少年喂养和饮食问题的性质和程度，并报告了经历此类问题的自闭症青少年的特征。当前的审查纳入了 34 项研究，几乎所有研究 (91%) 都调查了喂养问题。只有 9% 的研究考察了对体重、体形和/或身体形象的关注，但一些作者指出，自闭症患者比非自闭症同龄人更容易出现饮食失调的态度和行为。对于经历喂养或饮食问题的青少年，没有发现共同的个体特征（例如认知功能和自闭症症状严重程度）。尽管区分“喂养”和“吃”问题对于准确识别和治疗这些问题至关重要，但现有文献却未能做到这一点。我们建议，在未来的研究中，当行为涉及对食物、饮食或身体形象的关注时，使用“饮食问题”；当不存在这种关注时，使用“喂养问题”。

外行摘要

挑食和回避食物等喂养问题在患有自闭症的青少年中很常见。其他更广泛的喂养和饮食困难（饮食失调症状，例如限制食物摄入或过分关注身体形状或体重以及坚持特定的食物呈现）在自闭症患者中也很常见。在这里，我们描述了自闭症青少年的喂养和饮食问题的性质和程度。我们没有发现最能描述患有喂养或饮食问题的自闭症青少年的共同特征（例如自闭症症状的严重程度）。我们回顾的几乎所有研究都集中在喂养问题（选择性或挑食），只有少数研究集中在饮食失调症状（关注体重、体形和/或身体形象）。然而，一些研究人员报告说，与没有自闭症的同龄人相比，自闭症患者可能更容易出现饮食失调症状。许多研究交替使用“喂养”和“饮食”问题这两个术语，但了解这些问题之间的区别对于研究人员保持一致以及正确识别和治疗非常重要。我们建议未来的研究人员在行为涉及对食物、饮食或身体形象的关注时使用“饮食问题”，而在不存在这种关注时使用“喂养问题”。我们强调了解喂养或饮食问题是否与自闭症特征无关的重要性，以及照顾者和其他成年人在儿童治疗中的作用。还提供了医疗保健提供者协助诊断和治疗的注意事项。