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Childhood autism, feeding problems and failure to thrive in early infancy

Seven case studies

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Abstract

Despite longstanding clinical experience of unusual feeding difficulties in children with autism, there is no published literature describing their association with early onset FTT. This paper examines literature that may link feeding problems and abnormal growth with developmental and psychiatric conditions and describes seven cases of children with autism, who showed growth failure caused by severe feeding problems starting in the first year of life. Inadequacies in existing classifications systems are highlighted. The presence of severe or atypical feeding problems and FTT in infancy should alert professionals to possible underlying ASD. The aetiology of feeding disorders in autism appears to involve an unusually complex interactional model with biological vulnerabilities due to dysfunction in sensory, cognitive and emotional response interacting with dysfunctional attachment and learnt behaviours to produce a severe and intractable problem. Effective treatment therefore requires a novel multifaceted approach that can address each of these areas.

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Abbreviations

ASD:

Autistic spectrum disorder

ED:

Eating disorder

AN:

Anorexia nervosa

SE:

Selective eating

RE:

Restrictive eating

FTT:

Failure to thrive

FR:

Food refusal

FP:

Food phobia

PE:

Picky eating

PEB:

Perseverant eating behaviour

BMI:

Body mass index

OCD:

Obsessive compulsive disorder

ITFA:

Inappropriate texture for age

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Acknowledgements

I would like to thank Professor Christopher Gillberg for his very helpful comments.

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Authors and Affiliations

  1. St. George’s Healthcare NHS Trust, St. George’s Hospital, Rm 2.35, 2nd Floor Clare House, Blackshaw Road, London, SW17 0QT, UK

    Daphne V. Keen

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Correspondence to Daphne V. Keen.

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Keen, D. Childhood autism, feeding problems and failure to thrive in early infancy. Eur Child Adolesc Psychiatry 17, 209–216 (2008). https://doi.org/10.1007/s00787-007-0655-7

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