Sensory processing ability and eating behaviour in children with autism

Abstract

Background: During the past decade the prevalence of autistic spectrum disorders (ASD) has increased to 1% of the UK population. Anecdotal reports of children with ASD suggest they are atypical selective eaters who restrict their food intake based on idiosyncratic pre-requisites of texture and food presentation. Research has previously focused on the nutritional adequacy of such diets rather than underlying sensory processing capabilities that are known to be impaired in up to 90% of children with ASD (Leekham et al., 2007). Sensory processing skills, eating behaviour and parent-child relationships are intersecting aspects of ASD; and each play a role in achieving maximum potential in developing daily living skills. Previous research, relating sensory processing ability and eating behaviour, is limited. The aim of the study was to explore the relationship between sensory processing ability and eating behaviour in children with ASD. Methods: This analytical, exploratory study used purposive sampling, through approach of a parental support group for children with ASD in October 2009. Consent was sought from parents or guardians to complete two questionnaires; the validated Short Sensory Profile (SSP) and an eating behaviour questionnaire (EBQ) developed by the author and consisting of eight domains and four open questions. The domains of the EBQ were taste, texture, smell, behaviour, sound, environment, vision and touch. The domains were selected to reflect the SSP, and as a result of qualitative research from parental and specialist input and literature. Results of both questionnaires were statistically analysed using SPSS. Domains within each questionnaire were presented as mean (SD) and performance related data (SSP only) was presented as ‘typical performance’, ‘probable difference’ and ‘definite difference’ to indicate the degree of sensory processing difficulty (Dunn, 1999). Spearman Rank Correlation coefficient was used to explore correlations between domains within the two questionnaires. Ethical approval was gained from Leeds Metropolitan University Research Ethics Committee. Results: All parents (n = 20) participated in the study; completing questionnaires for 20 children (18 male, two female), mean age 10.8(2.6) years. Results of the SSP indicated that 71% of children in the study had sensory processing difficulties, of which auditory filtering (83%) and tactile sensitivity (68%) were ‘definite’ problem areas. Within the eating behaviour questionnaire, mealtime behaviour, vision, taste and smell were common areas that caused difficulty in daily life. Significant correlations between 20% of factors on the SSP and eating questionnaire were noted, the highest being SSP-taste/smell and EBQ taste (r = 0.9, P < 0.001) and SSP-taste/smell and EBQ vision (r = 0.9, P < 0.001). Discussion: This pilot study confirmed previous reports of sensory processing difficulties in children with autism (Tomcheck and Dunn, 2007) and provides preliminary data indicating a potential relationship between aspects of sensory processing ability and eating behaviour. Validation of the eating behaviour questionnaire is now required to establish a true link between these two areas and provide a sound basis for further longitudinal research that can accurately examine the impact of behaviour on eating in children with ASD and potential shifts in behaviour over time. Conclusion: This pilot study provides preliminary data linking sensory processing difficulty and eating behaviour and provides a basis for further research that supports effective and early interventions that improve quality of life, skills and prospects for those with ASD.