Data For Food Selectivity in Children with ASD: An Investigation of Sensory, Motor, and Behavioral Aspects

<b>Introduction:</b> Food selectivity is highly prevalent in children with Autism Spectrum Disorder (ASD), characterized by strong food preferences and aversions. Sensory, gastrointestinal, motor, and behavioral factors may contribute to selective patterns. Although there is growing interest in the topic, there are still gaps in the literature regarding the interaction between these different factors.<b>Objective:</b> to investigate sensory, motor, gastrointestinal, and behavioral aspects involved in food selectivity in children with ASD.<b>Method:</b> This was a descriptive, exploratory, and quantitative study conducted with caregivers of children with ASD, aged between 2 years and 6 years and 11 months, who agreed to participate by signing a consent. Data were collected through an electronic questionnaire and analyzed using descriptive statistics<b>Results:</b> Responses were obtained from 152 caregivers. According to them, 92.1% of the children refuse to try new foods; 49.7% only accept foods from specific brands or packages; 51.3% do not tolerate mixed foods on the plate; 83.4% do not eat vegetables and 63.6% reject fruits; 57.7% only accept foods at specific temperatures; 47.0% only eat foods of certain colors and 47.0% prefer crunchy foods. Some children have extremely restricted diets, accepting only two or three types of food. Strong indications of tactile hyperreactivity were observed in a significant portion of the children (85.4% show discomfort when touching different textures; 76.2% feel uncomfortable when they are dirty; 70.9% do not tolerate washing, combing or cutting their hair; 67.5% have difficulty cutting their nails and 55.6% have difficulty brushing their teeth). Auditory and olfactory sensitivities were also found in more than 60% of the children. Regarding chewing, 32.5% keep food in their mouths for long periods; 34.7% chew on only one side of the mouth; and 66.9% swallow without chewing properly, with frequent episodes of choking occurring in 30.7% of the children. Motor agitation was observed in 56.3% of the children; 43.7% have tantrums or cry, making eating difficult. Ritualistic behaviors were observed in nearly 50% of the children, and 31.3% refuse to eat outside the home. Regarding gastrointestinal symptoms, 30.5% frequently vomit after meals; 41.7% have gas or abdominal distension, and 43.7% have constipation. Only 19.2% have some type of allergy or intolerance diagnosed.<br><br><b>Conclusion:</b> This study highlighted the multifaceted nature of food selectivity in children with ASD. The results reinforce the significant impact of sensory sensitivities, oral-motor limitations, gastrointestinal alterations, behavioral challenges, and rigid eating patterns on food acceptance and meal dynamics. These difficulties compromise not only nutritional status but also negatively affect family routines, social participation, and the child's quality of life.

**引言：** 自闭症谱系障碍（Autism Spectrum Disorder, ASD）儿童普遍存在食物择食行为，其特征为强烈的食物偏好与食物厌恶。感觉统合、胃肠道、运动及行为因素可能与该择食模式的形成相关。尽管学界对该主题的关注度日益提升，但现有文献中针对这些不同因素间的交互作用仍存在研究空白。
**研究目的：** 探讨自闭症谱系障碍儿童食物择食行为涉及的感觉、运动、胃肠道及行为层面相关因素。
**研究方法：** 本研究为描述性、探索性定量研究，研究对象为年龄介于2岁至6岁11个月的自闭症谱系障碍儿童照护者，所有参与者均签署知情同意书并同意参与本研究。数据通过电子问卷收集，并采用描述性统计方法进行分析。
**研究结果：** 本研究共回收152名照护者的有效反馈。据照护者反馈，92.1%的儿童拒绝尝试新食物；49.7%的儿童仅接受特定品牌或包装的食物；51.3%的儿童无法容忍餐盘内的混合食物；83.4%的儿童拒绝食用蔬菜，63.6%的儿童排斥水果；57.7%的儿童仅接受特定温度的食物；47.0%的儿童仅食用特定颜色的食物，另有47.0%的儿童偏好酥脆质地的食物。部分儿童的饮食限制极为严苛，仅能接受2至3种食物。
大量儿童表现出显著的触觉过度反应：85.4%的儿童在接触不同质地物品时会感到不适；76.2%的儿童在身体沾污时会感到不适；70.9%的儿童无法耐受洗头、梳头或理发；67.5%的儿童存在剪指甲困难的问题，55.6%的儿童刷牙存在困难。超过60%的儿童还存在听觉与嗅觉敏感问题。
在咀嚼行为方面，32.5%的儿童会长时间将食物含在口中；34.7%的儿童仅用单侧口腔咀嚼；66.9%的儿童未充分咀嚼便吞咽食物，其中30.7%的儿童频繁出现呛噎情况。56.3%的儿童存在运动躁动问题；43.7%的儿童会通过发脾气或哭闹的方式阻碍进食。近50%的儿童表现出仪式化进食行为，31.3%的儿童拒绝在家庭以外的场所进食。
胃肠道症状方面，30.5%的儿童餐后频繁呕吐；41.7%的儿童存在胀气或腹胀问题，43.7%的儿童存在便秘症状。仅有19.2%的儿童被诊断出某种类型的过敏或食物不耐受。
**研究结论：** 本研究凸显了自闭症谱系障碍儿童食物择食行为的多维度复杂性。研究结果证实，感觉敏感、口腔运动功能受限、胃肠道异常、行为障碍及刻板进食模式，均会对食物接受度及用餐过程产生显著负面影响。这些进食困难不仅会损害儿童的营养状况，还会对家庭日常作息、儿童的社会参与度及生活质量造成消极影响。