![]() Inclusion criteria included the child being in good health and free from diseases or disorders that could affect dietary and/or physical activity habits (e.g., diabetes, cystic fibrosis, chronic GI illness, cerebral palsy, etc.). Participants were recruited via public listings on the Internet, outreach to local community programs (e.g., schools, YMCAs), existing participant databases at the UMMS-Shriver Center, autism support organizations, and the assistance of the Interactive Autism Network (IAN) Research Database at the Kennedy Krieger Institute. Participants in the Children’s Activity and Meal Patterns Study (CHAMPS) included children with ASDs and typically developing children ages 3–11 years. We also assessed whether food selectivity was associated with inadequate nutrient intake, given that this would have important implications for nutritional management. We hypothesized that children with ASDs would exhibit more food selectivity than typically developing children and food selectivity would decline with age in typically developing children but would not be associated with age in children with ASDs. We operationalized food selectivity to include three domains: 1) food refusal 2) limited food repertoire and 3) high frequency single food intake. To address these gaps, we developed a definition of food selectivity based on our clinical experience and pilot studies that describe eating patterns of children with ASDs. The lack of a standardized definition of food selectivity limits assessment or ability to compare across populations of children. The term “food selectivity” has been used variously to refer to food refusal, decreased variety, and restricted intake to a few frequently eaten foods, with a variety of approaches employed to categorizing food, such as focusing on nutritional components (e.g., high protein, high starch) or sensory aspects (e.g., sticky, sweet). These are often described as overly selective, with aversions to specific textures, colors, smells, and temperatures and rigidity with respect to specific brands of foods. Parental and anecdotal clinical reports as well as a few research studies 2, 19 have suggested that children with ASDs have unusual eating habits. These methodological problems extend to selective eating in children with ASDs. There is no standard operational definition for picky or selective eating. ![]() 14 – 17 Direct measures of food intake have not previously been used to define picky eating. Most studies of food selectivity in typically developing children have assessed whether a child is a picky eater based upon parental report, usually with a single question 8 – 13 or several items that tap specific picky/selective eating behaviors. We sought to operationalize the definition of food selectivity, to compare food selectivity between typically developing children and children with ASDs, and to examine the relationship between food selectivity and nutritional adequacy. ![]() In addition, the relationship of food selectivity to nutritional adequacy is unknown. 1, 2 Despite numerous reports that focus on pickiness, rigidity, selective eating, and mealtime food refusals in children with ASDs, 3 – 7 a standardized definition of food selectivity is lacking. Food selectivity is more commonly reported in children with developmental disabilities than in typically developing children, particularly in children with autism spectrum disorders (ASDs). ![]() Food selectivity or “picky eating” is often observed in young children and a frequent cause for parental concern. ![]()
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