Beyond Food Selectivity: Feeding Problems, Nutritional Status, and Parental Quality of Life in Autism Spectrum Disorder.

PURPOSE: This study aimed to evaluate the feeding-related behaviors of children and adolescents with Autism Spectrum Disorder (ASD), identify feeding-related factors from caregivers' perspectives, and investigate associations among nutritional status, quality of life, and behavioral problems.

METHODS

This cross-sectional study included 48 children and adolescents with ASD and their parents. Feeding behaviors, feeding problems, parental feeding strategies, caregiver quality of life, and dietary intake patterns were assessed using validated questionnaires (BAMBI, STEP, FSQ, QoLA, and a food frequency questionnaire).

RESULTS

The mean age of the children was 8.98 ± 3.86 years, 75.0% were male, and 33.3% were classified as overweight/obese. The mean total BAMBI score was 40.25 ± 8.24, with the highest score observed in the limited variety sub-dimension (20.6 ± 5.87), indicating that restricted food variety was the most prominent feeding concern. Among the STEP sub-dimensions, nutrition-related behavioral problems had the highest mean score (3.27 ± 3.12), while the highest FSQ score was found in the child control of intake sub-dimension (19.33 ± 6.14). The mean QoLA Part A and Part B scores were 91.0 ± 16.53 and 59.88 ± 19.27, respectively. A significant positive correlation was found between BAMBI and STEP total scores (p = 0.009), whereas BAMBI total score was negatively correlated with QoLA Part A score (p = 0.039). STEP total score was positively associated with the QoLA Part B score (p = 0.004).

CONCLUSION

Food selectivity and feeding problems are common in children and adolescents with ASD and are associated with lower parental quality of life in both affected individuals and their caregivers, highlighting the need for early, family-centered multidisciplinary nutritional interventions.