Association between feeding/mealtime behavior problems and internalizing/externalizing problems in autism spectrum disorder, other neurodevelopmental disorders and typically developing children

BACKGROUND: The aim of current study was to examine the nature and prevalence of feeding problems and mealtime behavior problems in children with autism spectrum disorder (ASD) comparing to children with other neurodevelopmental disorders (NNDs) and TDchildren. We also investigated the impact of intelligence quotient (IQ) and/or emotional and behavioral problems on feeding and mealtime behavior problems. METHODS: Participants completed the following tests: Social Communication Questionnaire (SCQ), Child Behavior Checklist (CBCL), Brief Autism Mealtime Behavior Inventory (BAMBI) and Behavioral Pediatric Feeding Assessment Scale (BPFAS). RESULTS: Children with ASDshowed more feeding and mealtime behavior problems including food refusal (P<0.001, P<0.001) and limited variety of foods (P=0.014; P=0.018) compared with NDDs and TDchildren. ASDgroup showed more problems in mealtime behavior (P=0.034) and parent behaviors (P=0.028) compared to TDgroup. Internalizing (P=0.003) and externalizing (P=0.008) problems were positively related to parent frustration during mealtime in ASDgroup. CONCLUSIONS: These results suggest that routine screening for feeding and mealtime behavior problems among children with ASDis necessary to prevent dietary inadequacies that may be associated with eating habits.