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Research Article: Eating behaviors in preschoolers with autism spectrum disorders: associations with developmental and behavioral features and parental mental health

Date Published: 2026-10-15

Abstract:
Eating problems are highly prevalent in children with autism spectrum disorder (ASD). However, their profile during the preschool period—a critical window for establishing lifelong eating habits—remains poorly understood. This study aimed to compare the eating behaviors of preschool children with ASD and typically developing (TD) peers and to identify associated developmental, behavioral, and parental factors during this formative stage. This case-control study included 50 preschool children with ASD (aged 2–6 years) recruited from a child and adolescent psychiatry outpatient clinic and 43 age-matched TD children recruited from family health centers. ASD diagnoses were confirmed by child and adolescent psychiatrists according to DSM-5 criteria. Parents completed the Children’s Eating Behavior Questionnaire (CEBQ), the Aberrant Behavior Checklist (ABC), and the Brief Symptom Inventory (BSI). Child assessments included the Childhood Autism Rating Scale (CARS) and the Ankara Developmental Screening Inventory (ADSI). Group differences were examined using univariate analyses and multivariate analyses of covariance (MANCOVA). Within the ASD group, correlations and multivariable linear regressions examined associated factors. Complete-case sensitivity analyses were performed for variables with missing data. No significant between-group differences were observed across CEBQ subscales after adjustment for baseline differences (all p > 0.05). Within the ASD group, hyperactivity/noncompliance was positively correlated with satiety responsiveness in the primary analysis (r s =0.449, FDR-adjusted p=0.022), but not after FDR correction in the complete-case analysis (r s =0.431, adjusted p=0.066). Fine motor and cognitive-language developmental levels showed nominal associations with specific eating behavior dimensions in multivariable regressions (?=?0.333 to 0.404, p=0.012–0.043), but none remained significant after FDR correction. Complete-case analyses yielded generally similar effect estimates, with no regression associations surviving FDR correction. Parent-reported CEBQ dimensions did not differ significantly between preschool children with ASD and TD peers. Within the ASD group, developmental and behavioral characteristics showed potential associations with specific eating behaviors; however, these findings did not consistently withstand multiple-testing correction. Given the cross-sectional design and relatively small sample, the findings should be interpreted cautiously and require replication in larger longitudinal studies.

Introduction:
Eating problems are highly prevalent in children with autism spectrum disorder (ASD). However, their profile during the preschool period—a critical window for establishing lifelong eating habits—remains poorly understood. This study aimed to compare the eating behaviors of preschool children with ASD and typically developing (TD) peers and to identify associated developmental, behavioral, and parental factors during this formative stage.

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