Maria Rastam

Dublin 2013: Maria Rastam

Eating problems in childhood and the overlap with the autism spectrum disorders

Original presentation and abstract by Maria Rastam (Lund University, University of Gothenburg, Child and Adolescent Psychiatry Department, Lund, Sweden) on the association of autism spectrum disorders and eating problems in childhood and adolescence, held at the ESCAP 2013 Congress in Dublin, Sunday 7th July 2013. Several recent reports point to the fact that autistic traits have an important impact on course and prognosis of anorexia nervosa.


Eating problems are overrepresented in the early symptomatic neurodevelopmental disorders, especially the autism spectrum disorders. The autism spectrum disorders encompass developmental problems in three areas, social interaction, communication, and behavioural flexibility. Eating habits in autism include food refusal, pica, rumination, selective eating, and overeating. Selective eating is probably the most common eating problem in children with an autism spectrum disorder combined with a normal intellectual level. Selective eating can have detrimental effects on nutrition and general wellbeing of the child. Studies on the frequency of eating problems and their genetic and environmental background factors show a substantial overlap between early eating problems and the autism spectrum disorders. In the autism spectrum disorders the background factors to eating disturbances are more complex than in the general child population, and sensory abnormalities, ritualistic behaviours, and social communication problems all seem to contribute. The eating problems are often resistant to treatment, especially if underlying neurodevelopmental problems are neglected. Early eating problems in childhood may be a risk factor for the development of the clinically significant eating disorders, especially anorexia nervosa and bulimia nervosa, in adolescence and young adulthood. The clinical implications would be that the autism spectrum disorders should not be overlooked in children with eating problems. Conversely, eating problems should be considered in the early symptomatic neurodevelopmental disorders.

Keywords: autism spectrum disorders, pica, rumination, selective eating, eating disorders.

Download the full presentation here (pdf file, 25 slides).