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Avoidant/restrictive food intake disorder and autism spectrum disorder: clinical implications for assessment and

Fadila Farag1, Annemarie Sims1, Katy Strudwick1

  • 1Department of Paediatric Neurosciences, Evelina London Children's Hospital, St Thomas' Hospital, London.

Developmental Medicine and Child Neurology
|August 18, 2021
PubMed

Insights

Avoidant/Restrictive Food Intake Disorder (ARFID) is more common in young children, particularly those with autism spectrum disorder (ASD). Early identification and nutritional support are crucial for managing ARFID and its associated challenges.

Area of Science:

  • Pediatric Gastroenterology
  • Neurodevelopmental Disorders
  • Clinical Psychology

Background:

  • Avoidant/Restrictive Food Intake Disorder (ARFID) presents significant challenges in pediatric feeding, impacting nutrition, development, and psychosocial well-being.
  • Tertiary feeding services manage complex cases requiring specialized multidisciplinary input.
  • Understanding the clinical and neurodevelopmental profiles of children with ARFID is essential for effective assessment and management.

Purpose of the Study:

  • To examine the clinical and neurodevelopmental presentations of children diagnosed with ARFID.
  • To identify factors associated with ARFID diagnosis and nutritional inadequacy.
  • To inform clinical assessment and management strategies for ARFID in children.

Main Methods:

  • A case-control study included 536 patients (mean age 6y 10mo) treated at a tertiary multidisciplinary feeding service.
  • Data on ARFID diagnosis, demographics, comorbidities (including ASD), and nutritional status were extracted from electronic patient records.
  • Statistical analysis identified predictors of ARFID and nutritional inadequacy.

Main Results:

  • Forty-nine percent of children met ARFID criteria; others had different feeding or developmental issues.
  • ARFID was more prevalent in younger children (4-9 years) and those with comorbid autism spectrum disorder (ASD).
  • Younger age, comorbid ASD, and male sex predicted ARFID. Male sex and limited diet predicted nutritional inadequacy.

Conclusions:

  • Young children with ARFID warrant suspicion for comorbid ASD.
  • Nutritional deficiencies in children with ARFID and ASD are common but correctable with supplementation.
  • Early identification and management of nutritional deficits are critical for children with ARFID.
Abstract

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