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Published in: European Child & Adolescent Psychiatry 4/2008

01-06-2008 | ORIGINAL CONTRIBUTION

Childhood autism, feeding problems and failure to thrive in early infancy

Seven case studies

Author: Dr. Daphne V. Keen

Published in: European Child & Adolescent Psychiatry | Issue 4/2008

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Abstract

Despite longstanding clinical experience of unusual feeding difficulties in children with autism, there is no published literature describing their association with early onset FTT. This paper examines literature that may link feeding problems and abnormal growth with developmental and psychiatric conditions and describes seven cases of children with autism, who showed growth failure caused by severe feeding problems starting in the first year of life. Inadequacies in existing classifications systems are highlighted. The presence of severe or atypical feeding problems and FTT in infancy should alert professionals to possible underlying ASD. The aetiology of feeding disorders in autism appears to involve an unusually complex interactional model with biological vulnerabilities due to dysfunction in sensory, cognitive and emotional response interacting with dysfunctional attachment and learnt behaviours to produce a severe and intractable problem. Effective treatment therefore requires a novel multifaceted approach that can address each of these areas.
Literature
1.
go back to reference Ahearn WH, Castine T, Nault K, Green G (2001) An assessment of food acceptance in children with autism or pervasive developmental disorder-not otherwise specified. J Autism Dev Disord 31:505–511PubMedCrossRef Ahearn WH, Castine T, Nault K, Green G (2001) An assessment of food acceptance in children with autism or pervasive developmental disorder-not otherwise specified. J Autism Dev Disord 31:505–511PubMedCrossRef
2.
go back to reference Bernard-Bonnin A-C (2006) Feeding problems of infants and toddlers. Can Fam Physician 52:1247–1251PubMed Bernard-Bonnin A-C (2006) Feeding problems of infants and toddlers. Can Fam Physician 52:1247–1251PubMed
3.
go back to reference Boddy J, Skuse D, Andrews B (2000) The developmental sequelae of nonorganic failure to thrive. J Child Psychol Psychiatr 41:1003–1014CrossRef Boddy J, Skuse D, Andrews B (2000) The developmental sequelae of nonorganic failure to thrive. J Child Psychol Psychiatr 41:1003–1014CrossRef
4.
go back to reference Bolte S, Ozkara N, Poustka F (2002) Autistic spectrum disorders and low body weight: is there really a systematic association? Int J Eat Disord 31:349–351PubMedCrossRef Bolte S, Ozkara N, Poustka F (2002) Autistic spectrum disorders and low body weight: is there really a systematic association? Int J Eat Disord 31:349–351PubMedCrossRef
5.
go back to reference Burklow KA, Phelps AN, Schultz JR, McConnell K, Rudolf C (1998) Classifying complex pediatric feeding disorders. J Pediatr Gastroenterol Nutr 27:143–147PubMedCrossRef Burklow KA, Phelps AN, Schultz JR, McConnell K, Rudolf C (1998) Classifying complex pediatric feeding disorders. J Pediatr Gastroenterol Nutr 27:143–147PubMedCrossRef
6.
go back to reference Chatoor I, Schaefer S, Dickson I, Egan J (1984) Non-organic failure to thrive: a developmental perspective. Pediatr Ann 13:829–835, 838, 840–842 Chatoor I, Schaefer S, Dickson I, Egan J (1984) Non-organic failure to thrive: a developmental perspective. Pediatr Ann 13:829–835, 838, 840–842
7.
go back to reference Cole TJ, Freeman JV, Preece MA (1995) Body mass index reference curves for the UK, 1990. Arch Dis Child 73:25–29PubMed Cole TJ, Freeman JV, Preece MA (1995) Body mass index reference curves for the UK, 1990. Arch Dis Child 73:25–29PubMed
8.
go back to reference Crist W, Napier-Phillips A (2001) Mealtime behaviours of young children: a comparison of normative and clinical data. J Dev Behav Pediatr 22:279–286PubMed Crist W, Napier-Phillips A (2001) Mealtime behaviours of young children: a comparison of normative and clinical data. J Dev Behav Pediatr 22:279–286PubMed
9.
go back to reference Dahlgren SO, Gillberg C (1989) Symptoms in the first two years of life. A preliminary population study of infantile autism. Eur Arch Psychiatry Neurol Sci 238:169–174PubMedCrossRef Dahlgren SO, Gillberg C (1989) Symptoms in the first two years of life. A preliminary population study of infantile autism. Eur Arch Psychiatry Neurol Sci 238:169–174PubMedCrossRef
10.
go back to reference Douglas J (2000) The management of selective eating in young children. In: Southall A, Schwartz A (eds) Feeding problems in children. Radcliffe Medical press, Oxford, pp 141–152 Douglas J (2000) The management of selective eating in young children. In: Southall A, Schwartz A (eds) Feeding problems in children. Radcliffe Medical press, Oxford, pp 141–152
11.
go back to reference Fisman S, Steele M, Short J, Byrne T, Lavallee C (1996) Case study: anorexia nervosa and autistic disorder in an adolescent girl. J Am Acad Child Adolesc Psychiatry 35:937–940PubMed Fisman S, Steele M, Short J, Byrne T, Lavallee C (1996) Case study: anorexia nervosa and autistic disorder in an adolescent girl. J Am Acad Child Adolesc Psychiatry 35:937–940PubMed
12.
go back to reference Fox C, Joughin C (2002) Childhood onset eating problems: findings from research. Royal College of Psychiatrists, Cromwell Press, UK Fox C, Joughin C (2002) Childhood onset eating problems: findings from research. Royal College of Psychiatrists, Cromwell Press, UK
14.
go back to reference Gillberg C, Billstedt E (2000) Autism and Asperger syndrome: coexistence with other clinical disorders. Acta Psychiatr Scand 102:321–330PubMedCrossRef Gillberg C, Billstedt E (2000) Autism and Asperger syndrome: coexistence with other clinical disorders. Acta Psychiatr Scand 102:321–330PubMedCrossRef
15.
go back to reference Harris G (2000) Developmental, regulatory and cognitive aspects of feeding disorders. In: Southall A, Schwartz A (eds) Feeding problems in children. Radcliffe Medical press, Oxford, pp 77–89 Harris G (2000) Developmental, regulatory and cognitive aspects of feeding disorders. In: Southall A, Schwartz A (eds) Feeding problems in children. Radcliffe Medical press, Oxford, pp 77–89
16.
go back to reference Harris G, Blissett J, Johnson R (2000) Food refusal associated with illness. J Child Psychol Psychiatr Rev 5:148–156CrossRef Harris G, Blissett J, Johnson R (2000) Food refusal associated with illness. J Child Psychol Psychiatr Rev 5:148–156CrossRef
17.
go back to reference Hebebrand J, Hennighausen K, Nau S, Himmelmann G, Schulz E, Schafer H, Remschmidt H (1997) Low body weight in male children and adolescents with schizoid personality disorder or Asperger’s disorder. Acta Psychiatr Scand 96:64–67PubMedCrossRef Hebebrand J, Hennighausen K, Nau S, Himmelmann G, Schulz E, Schafer H, Remschmidt H (1997) Low body weight in male children and adolescents with schizoid personality disorder or Asperger’s disorder. Acta Psychiatr Scand 96:64–67PubMedCrossRef
18.
go back to reference Hennighausen K, Rischmuller B, Heseker H, Remschmidt H, Hebebrand J (1999) Low body mass indices in adolescents with obsessive-compulsive disorder. Acta Psychiatr Scand 99:267–273CrossRef Hennighausen K, Rischmuller B, Heseker H, Remschmidt H, Hebebrand J (1999) Low body mass indices in adolescents with obsessive-compulsive disorder. Acta Psychiatr Scand 99:267–273CrossRef
19.
go back to reference Holtkamp K, Konrad K, Kaiser N, Ploenes Y, Heussen N, Grzella I, Herpertz-Dahlmann B (2005) A retrospective study of SSRI treatment in adolescent anorexia nervosa: insufficient evidence for efficacy. J Psychiatr Res 39:303–310PubMedCrossRef Holtkamp K, Konrad K, Kaiser N, Ploenes Y, Heussen N, Grzella I, Herpertz-Dahlmann B (2005) A retrospective study of SSRI treatment in adolescent anorexia nervosa: insufficient evidence for efficacy. J Psychiatr Res 39:303–310PubMedCrossRef
20.
go back to reference Jacobi C, Agras WS, Bryson S, Hamer LD (2003) Behavioural validation, precursors and concomitants of picky eating in childhood. J Am Acad Child Adolesc Psychiatry 42:76–84PubMedCrossRef Jacobi C, Agras WS, Bryson S, Hamer LD (2003) Behavioural validation, precursors and concomitants of picky eating in childhood. J Am Acad Child Adolesc Psychiatry 42:76–84PubMedCrossRef
21.
go back to reference Karlsson A, Gillberg C, Karlberg P (1989) Abnormalities of growth in 7–18-year-old psychiatric patients. J Am Acad Child Adolesc Psychiatry 28:269–273PubMedCrossRef Karlsson A, Gillberg C, Karlberg P (1989) Abnormalities of growth in 7–18-year-old psychiatric patients. J Am Acad Child Adolesc Psychiatry 28:269–273PubMedCrossRef
22.
go back to reference Kasese-Hara M, Wright C, Drewett R (2002) Energy compensation in young children who fail to thrive. J Child Psychol Psychiatr 43:449–456CrossRef Kasese-Hara M, Wright C, Drewett R (2002) Energy compensation in young children who fail to thrive. J Child Psychol Psychiatr 43:449–456CrossRef
23.
go back to reference Latif A, Heinz P, Cook R (2002) Iron deficiency in autism and Asperger syndrome. Autism 6:103–114PubMedCrossRef Latif A, Heinz P, Cook R (2002) Iron deficiency in autism and Asperger syndrome. Autism 6:103–114PubMedCrossRef
24.
go back to reference Mathison B, Skuse D, Wolke D, Reilly S (1989) Oral motor dysfunction and failure to thrive among inner city infants. Dev Med Child Neurol 31:293–302CrossRef Mathison B, Skuse D, Wolke D, Reilly S (1989) Oral motor dysfunction and failure to thrive among inner city infants. Dev Med Child Neurol 31:293–302CrossRef
25.
go back to reference Mouridsen SE, Rich B, Isager T (2002) Body mass index in male and female children with infantile autism. Autism 6:197–205PubMedCrossRef Mouridsen SE, Rich B, Isager T (2002) Body mass index in male and female children with infantile autism. Autism 6:197–205PubMedCrossRef
26.
go back to reference Nicholls D, Christie D, Randall L, Lask B (2001) Selective eating: symptom, disorder or normal variant. Clin Child Psychol Psychiatry 6:257–270CrossRef Nicholls D, Christie D, Randall L, Lask B (2001) Selective eating: symptom, disorder or normal variant. Clin Child Psychol Psychiatry 6:257–270CrossRef
27.
go back to reference Raiten DJ, Massaro T (1986) Perspectives on the nutritional ecology of autistic children. J Autism Dev Disord 16:133–143PubMedCrossRef Raiten DJ, Massaro T (1986) Perspectives on the nutritional ecology of autistic children. J Autism Dev Disord 16:133–143PubMedCrossRef
28.
go back to reference Ramsay M, Zelazo PR (1988) Food refusal in failure-to-thrive infants: nasogastric feeding combined with interactive behavioural treatment. J Pediatr Psychol 13:329–347PubMedCrossRef Ramsay M, Zelazo PR (1988) Food refusal in failure-to-thrive infants: nasogastric feeding combined with interactive behavioural treatment. J Pediatr Psychol 13:329–347PubMedCrossRef
29.
go back to reference Råstam M (1992) Anorexia nervosa in 51 Swedish adolescents: premorbid problems and comorbidity. J Am Acad Child Adolesc Psychiatry 31:819–829PubMed Råstam M (1992) Anorexia nervosa in 51 Swedish adolescents: premorbid problems and comorbidity. J Am Acad Child Adolesc Psychiatry 31:819–829PubMed
30.
go back to reference Raynor P, Rudolf MCJ (1996) What do we know about children who fail to thrive? Child Care Health Dev 22:241–250PubMedCrossRef Raynor P, Rudolf MCJ (1996) What do we know about children who fail to thrive? Child Care Health Dev 22:241–250PubMedCrossRef
31.
go back to reference Rudolf MCJ (2001) Long term outcome of failure to thrive in infancy: a systematic review. Presentation at the Royal College of Paediatrics and Child Health annual scientific meeting, 2001 Rudolf MCJ (2001) Long term outcome of failure to thrive in infancy: a systematic review. Presentation at the Royal College of Paediatrics and Child Health annual scientific meeting, 2001
32.
go back to reference Rudolf MCJ, Hochberg Z (1990) Are boys more vulnerable to psychosocial growth retardation? Dev Med Child Neurol 32:1022–1025PubMedCrossRef Rudolf MCJ, Hochberg Z (1990) Are boys more vulnerable to psychosocial growth retardation? Dev Med Child Neurol 32:1022–1025PubMedCrossRef
33.
go back to reference Shearer TR, Larson K, Neuschwander J, Gedney B (1982) Minerals in the hair and nutrient intake of autistic children. J Autism Dev Disord 12:25–34PubMedCrossRef Shearer TR, Larson K, Neuschwander J, Gedney B (1982) Minerals in the hair and nutrient intake of autistic children. J Autism Dev Disord 12:25–34PubMedCrossRef
34.
35.
go back to reference Sobanski E, Marcus A, Hennighausen K, Hebebrand J, Schmidt MH (1999) Further evidence for a low body weight in male children and adolescents with Asperger’s disorder. Eur Child Adolesc Psychiatry 8:312–314PubMedCrossRef Sobanski E, Marcus A, Hennighausen K, Hebebrand J, Schmidt MH (1999) Further evidence for a low body weight in male children and adolescents with Asperger’s disorder. Eur Child Adolesc Psychiatry 8:312–314PubMedCrossRef
36.
go back to reference Steward DK, Moser DK, Ryan-Wenger N (2001) Biobehavioural characteristics of infants with failure to thrive. J Pediatr Nurs 16:162–171PubMedCrossRef Steward DK, Moser DK, Ryan-Wenger N (2001) Biobehavioural characteristics of infants with failure to thrive. J Pediatr Nurs 16:162–171PubMedCrossRef
37.
go back to reference Tolia V (1995) Very early onset nonorganic failure to thrive in infants. J Pediatr Gastroenterol Nutr 20:73–80PubMedCrossRef Tolia V (1995) Very early onset nonorganic failure to thrive in infants. J Pediatr Gastroenterol Nutr 20:73–80PubMedCrossRef
38.
go back to reference Velosa JF, Riddle MA (2000) Pharmacological treatment of anxiety disorders in children and adolescents. Child Adolesc Clin N Am 1:119–133 Velosa JF, Riddle MA (2000) Pharmacological treatment of anxiety disorders in children and adolescents. Child Adolesc Clin N Am 1:119–133
39.
go back to reference Wentz E, Lacey JH, Waller G, Råstam M, Turk J, Gillberg C (2005) Childhood onset neuropsychiatric disorders in adult eating disorders. A pilot study. Eur Child Adolesc Psychiatry 14:431–437PubMedCrossRef Wentz E, Lacey JH, Waller G, Råstam M, Turk J, Gillberg C (2005) Childhood onset neuropsychiatric disorders in adult eating disorders. A pilot study. Eur Child Adolesc Psychiatry 14:431–437PubMedCrossRef
40.
go back to reference Williams PG, Dalrymple N, Neal J (2000) Eating habits of children with autism. Pediatr Nurs 26:259–264PubMed Williams PG, Dalrymple N, Neal J (2000) Eating habits of children with autism. Pediatr Nurs 26:259–264PubMed
40.
go back to reference Wing L, Leekam SR, Libby SJ, Gould J, Larcome M (2002) The diagnostic interview for social and communication disorders: background, inter-rater reliability and clinical use. J Child Psychol Psychiatr 43:307–325CrossRef Wing L, Leekam SR, Libby SJ, Gould J, Larcome M (2002) The diagnostic interview for social and communication disorders: background, inter-rater reliability and clinical use. J Child Psychol Psychiatr 43:307–325CrossRef
42.
go back to reference World Health Organisation (1993) International classification of mental health and behavioural disorders, 10th edn. WHO, Geneva World Health Organisation (1993) International classification of mental health and behavioural disorders, 10th edn. WHO, Geneva
43.
go back to reference Wright C, Birks E (2000) Risk factors for failure to thrive: a population-based survey. Child Care Health Dev 26:5–16PubMedCrossRef Wright C, Birks E (2000) Risk factors for failure to thrive: a population-based survey. Child Care Health Dev 26:5–16PubMedCrossRef
Metadata
Title
Childhood autism, feeding problems and failure to thrive in early infancy
Seven case studies
Author
Dr. Daphne V. Keen
Publication date
01-06-2008
Publisher
D. Steinkopff-Verlag
Published in
European Child & Adolescent Psychiatry / Issue 4/2008
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-007-0655-7

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