Many children with developmental disabilities are at risk for development of feeding or eating disorders. Children with autistic spectrum disorders frequently display behavior patterns which may influence nutritional status directly. Among these are food selectivity (by type or texture), and food refusal. Altered sensory function in children with autism may result in profound aversions to certain tastes, textures, or smells. Thus individuals with autism often develop significantly limited food preferences, often entirely excluding one or more food groups. Adequate nourishment becomes a challenging task for parents and/or other caregivers. Children who consistently refuse food additionally should be evaluated for latent physiological causes, such as gastro-esophageal reflux disease.

Another factor which may affect nutritional status in children with autism, as well as other forms of PDD, is hyperactivity. A child who is very physically active may simply not take time to eat- or simply may not be able to consume sufficient calories to meet energy expenditure requirements.

It has been hypothesized that the etiology of autism and/or exacerbation of autistic behavior expression may be nutritionally linked. Some vitamin deficiency symptoms can mimic behaviors expressed in autism. For example, symptoms of iron deficiency anemia include poor attention span and lethargy. A small subset of children with autism may have hormone or enzyme deficiencies and/ or abnormal gastrointestinal tract structure which may interfere with digestion, absorption, and metabolism of food, subsequently leading to autism behavior expression.

Some research has suggested that autistic spectrum disorders may be linked to certain nutritional elements. Experimental therapies have been implemented which include gluten and casein free diets (on the basis that these proteins are not fully digested and may result in autistic expression), anti yeast diets (on the basis that yeast overgrowth may cause exacerbation of symptoms), ketogenic diets to decrease seizure activity, and vitamin megadosing-especially vitamin B6 with magnesium. No definitive efficacy has been established for dietary treatments.

Field, D., Garland, M., & Williams, K. (2003). Correlates of specific childhood feeding problems. Journal of Paediatrics and Child Health, 39, 299-304

Schwartz, S.M. (2003). Feeding disorders in children with developmental disabilities. Infants and Young Children, 16(3), 317-330

See www.autism-society.org/site/PageServer?pagename=BiomedicalDietaryTreatments