Selective Eating and Sensory Sensitivity in Children With ADHD: A Comparative Study of ARFID Symptom Profiles

Selective eating is commonly observed in children with neurodevelopmental conditions, particularly Attention-Deficit/Hyperactivity Disorder (ADHD). However, the clinical overlap between ADHD and Avoidant/Restrictive Food Intake Disorder (ARFID)-and its potential relevance for assessment and intervention-remains underexplored. This study aimed to compare ARFID symptom profiles between children with ADHD and typically developing peers and to assess whether sensory sensitivity is associated with selective eating within the ADHD group.

In this cross-sectional, case-control study, 231 children aged 6-12 years (138 with ADHD, 93 controls) were assessed using standardized parent-report questionnaires, including the Nine-Item ARFID Screen (NIAS), Conners' Parent Rating Scale (CPRS), Revised Child Anxiety and Depression Scale (RCADS), and Sensory Profile (SP). Hierarchical regression analyses were conducted to identify correlates of selective eating within the ADHD group, controlling for age and gender.

Children with ADHD exhibited significantly higher levels of ARFID-related picky eating and sensory processing difficulties, particularly within oral and multisensory domains. Within the ADHD group, selective eating was positively associated with ADHD symptom severity and negatively related to oral sensory sensitivity. Together, these factors explained 32.6% of the variance in picky eating scores.

Findings suggest that, beyond general sensory difficulties, oral sensory reactivity and ADHD symptom burden may be relevant correlates of selective eating in children with ADHD. These results should be interpreted cautiously, given the cross-sectional design and small sample size. Further longitudinal and mechanistic studies are warranted to understand better these associations and their implications for early screening and intervention.