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Short Report: An Examination of Behavioral Factors Linked to Picky Eating in Autistic Children

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Title: Short Report: An Examination of Behavioral Factors Linked to Picky Eating in Autistic Children
Language: English
Authors: Anna Wallisch (ORCID 0000-0003-0951-8810), Sallie Nowell (ORCID 0000-0002-6132-4661), E. Zhang (ORCID 0000-0002-9468-4890), Brian Boyd, Elena Tenenbaum, Nancy Zucker, Dana Bakula, Ann Davis
Source: Autism: The International Journal of Research and Practice. 2026 30(6):1615-1619.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 5
Publication Date: 2026
Sponsoring Agency: National Center for Advancing Translational Sciences (NCATS) (DHHS/NIH), Clinical and Translational Science Awards (CTSA) Program
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (DHHS/NIH)
Contract Number: KL2TR002367
F32HD101311
Document Type: Journal Articles
Reports - Research
Descriptors: Eating Disorders, Autism Spectrum Disorders, Young Children, Psychological Patterns, Aggression, Withdrawal (Psychology), Behavior Problems, Mental Health
Assessment and Survey Identifiers: Childhood Autism Rating Scale, Kaufman Brief Intelligence Test, Bayley Mental Development Index
DOI: 10.1177/13623613261418948
ISSN: 1362-3613
1461-7005
Abstract: Eating difficulties are highly prevalent among autistic children and are linked to negative health consequences. While many mechanisms are thought to underly these behaviors, we know less about how internalizing and externalizing behaviors relate to eating difficulties in autism. The purpose of this study was to examine how internalizing and externalizing behaviors differ between autistic children (3-6 years of age) with parent-reported picky eating (n = 80) and without picky eating (n = 30). Data was drawn from intake paperwork and assessments completed as part of an autism diagnostic evaluation at a large medical center. Results suggested that picky eaters, when compared to non-picky eaters, had significantly more difficulties with aggression and withdrawal. Our study findings suggest that understanding the behavioral profiles associated with picky eating may be particularly useful when devising treatment plans. Furthermore, diagnosticians who may be the first to gather both eating and behavioral symptom data can initiate referrals to feeding specialists to help prevent some of the negative health consequences associated with these eating behaviors.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1506532
Database: ERIC
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  Value: <anid>AN0193858185;f9d01jun.26;2026May21.02:15;v2.2.500</anid> <title id="AN0193858185-1">Short report: An examination of behavioral factors linked to picky eating in autistic children </title> <p>Eating difficulties are highly prevalent among autistic children and are linked to negative health consequences. While many mechanisms are thought to underly these behaviors, we know less about how internalizing and externalizing behaviors relate to eating difficulties in autism. The purpose of this study was to examine how internalizing and externalizing behaviors differ between autistic children (3–6 years of age) with parent-reported picky eating (n = 80) and without picky eating (n = 30). Data was drawn from intake paperwork and assessments completed as part of an autism diagnostic evaluation at a large medical center. Results suggested that picky eaters, when compared to non-picky eaters, had significantly more difficulties with aggression and withdrawal. Our study findings suggest that understanding the behavioral profiles associated with picky eating may be particularly useful when devising treatment plans. Furthermore, diagnosticians who may be the first to gather both eating and behavioral symptom data can initiate referrals to feeding specialists to help prevent some of the negative health consequences associated with these eating behaviors. Many autistic children have trouble with eating (e.g. not eating a wide variety of foods) which can lead to later health issues. While there are many factors that are thought to relate to these eating issues, one factor we know less about are internalizing behaviors, or being worried, anxious, or sad, and externalizing behaviors, or issues with attending to a task or aggressive behaviors. In this study, we looked at differences in externalizing and internalizing behaviors in autistic children, who were 3–6 years of age, with picky eating (80 children with picky eating) and without picky eating (30 children without picky eating). Our results suggested that autistic children with picky eating had more issues with an externalizing and an internalizing behavior than autistic children without picky eating. Our findings are important because both externalizing and internalizing behaviors are likely important factors to consider when supporting an autistic child with eating difficulties and their family. Practitioners who diagnose autism may also be the first to gather both eating and behavioral information and may help to refer the child to a feeding specialist to prevent later issues.</p> <p>Keywords: autism; eating behaviors; externalizing behavior; internalizing behavior</p> <hd id="AN0193858185-2">Introduction</hd> <p>Mealtime or eating difficulties affect 67%–83% of autistic children based on parent reports ([<reflink idref="bib13" id="ref1">13</reflink>]). Eating difficulties in autism are varied and may present as food selectivity, food refusal, food aversion, or rigid mealtime routines, to name a few ([<reflink idref="bib14" id="ref2">14</reflink>]). These eating difficulties are troublesome as they can be linked to negative health consequences, including malnutrition, obesity, gastrointestinal (GI) issues (e.g. constipation), and eating disorders (e.g. anorexia nervosa, Avoidant/Restrictive Food Intake Disorder [ARFID]) in autism. The heterogeneity in symptom presentation of eating difficulties in childhood makes it difficult to determine the best course of treatment for autistic children to prevent later negative health outcomes.</p> <p>One challenge to addressing the eating difficulties in autism is the multifactorial nature of the underlying mechanisms involved. Factors such as sensory processing, executive function, restricted and repetitive behaviors, internalizing behaviors (e.g. anxiousness), externalizing behaviors (e.g. aggression), and autism severity are thought to underly eating difficulties in autism ([<reflink idref="bib6" id="ref3">6</reflink>]; [<reflink idref="bib9" id="ref4">9</reflink>]; [<reflink idref="bib14" id="ref5">14</reflink>]). While sensory processing has received more attention from the field, studies are beginning to link internalizing and externalizing behaviors in autistic children to feeding difficulties (e.g. [<reflink idref="bib3" id="ref6">3</reflink>]; [<reflink idref="bib4" id="ref7">4</reflink>]). It is important to examine differences in both internalizing and externalizing behaviors in autistic children because these behaviors are implicated in pediatric feeding disorders, as well as other eating disorders (e.g. ARFID, anorexia nervosa) that often co-occur with autism. Furthermore, both ARFID and anorexia nervosa are linked to mental health conditions like depression and anxiety. While there is an overlap between autism and eating disorders, we have yet to fully understand how internalizing and externalizing behaviors differentiate children with and without eating difficulties in autism, especially at an early age. This understanding may aid in tailoring childhood interventions to prevent future negative health outcomes.</p> <p>While fewer studies exist, recent research reports suggest that internalizing and externalizing behaviors likely influence eating difficulties in autistic children. For example, [<reflink idref="bib3" id="ref8">3</reflink>] found that internalizing behaviors such as negative affective and anxiety issues differentiated young autistic children (aged 18 months–5 years) with and without parent-reported eating difficulties. Other studies have found a link between increased GI symptoms and internalizing behaviors in autism ([<reflink idref="bib4" id="ref9">4</reflink>]) and that younger children with co-occurring GI symptoms presented with increased externalizing behavior (i.e. aggression), whereas older children with co-occurring GI symptoms presented with increased internalizing behaviors (i.e. withdrawn, anxious, somatic complaints; [<reflink idref="bib8" id="ref10">8</reflink>]). What is especially concerning is that school-aged autistic children with co-occurring internalizing behaviors often had higher waist-height ratios, an indication of future health and cardiovascular issues ([<reflink idref="bib7" id="ref11">7</reflink>]). This underscores the importance of understanding early childhood behaviors associated with mealtime difficulties in autism to prevent poor health outcomes.</p> <p>Currently, there is no standard of care for treating eating difficulties in autistic children, and our current treatment approaches are associated with high rates of treatment resistance ([<reflink idref="bib12" id="ref12">12</reflink>]). To develop effective interventions, we need to better understand the underlying factors implicated in eating difficulties in autism. Therefore, the purpose of this study was to examine differences in behavioral factors between autistic children with and without eating difficulties in the form of picky eating.</p> <hd id="AN0193858185-3">Methods</hd> <p>We performed a secondary analysis with data from a large medical center affiliated autism diagnostic clinic. Data from 110 autistic children were drawn from intake paperwork parents completed prior to the autism diagnostic evaluation. Children were included if they met our age range (3–6 years of age) criterion, had complete data on the Behavior Assessment System for Children (BASC; [<reflink idref="bib15" id="ref13">15</reflink>]), our measure of interest, and responded to an intake question regarding dietary history. We selected this age range because it is common for 1- to 2-year-old children to exhibit picky eating regardless of autism ([<reflink idref="bib5" id="ref14">5</reflink>]). We grouped children into "picky eaters" (<emph>n</emph> = 80) or "non-picky eaters" (<emph>n</emph> = 30) based on parent selection of "picky eater" on a multiple response question on intake paperwork that stated, "Dietary history. Check all that apply."</p> <p>We first examined group differences on child age, autism severity (i.e. Childhood Autism Rating Scale, 2<sups>nd</sups> edition [CARS-2]; [<reflink idref="bib16" id="ref15">16</reflink>]), cognitive ability (i.e. Kaufman Brief Intelligence Test-2 [KBIT; [<reflink idref="bib11" id="ref16">11</reflink>]] or Bayley III [[<reflink idref="bib2" id="ref17">2</reflink>]] composite scores), and if the child was on a special diet with an independent sample <emph>t</emph>-test or chi-square to examine potential group differences and covariates needed in our analyses. Last, we used an independent samples <emph>t</emph>-test to examine group differences on the BASC Clinical and Adaptive indices (i.e. Adaptability, Aggression, Anxiety, Attention Problems, Atypicality, Depression, Functional Communication, Hyperactivity, Social Skills, Somatization, and Withdrawal). Given the multiple comparisons, we used a Benjamini Hochberg correction and a false discovery rate of 0.05. There is no community involvement to report in this study.</p> <hd id="AN0193858185-4">Results</hd> <p>When examining group differences on child age, CARS severity scores, and cognitive ability to determine group similarity and potential covariates, independent <emph>t</emph>-test results suggested there were no significant group differences on child age (<emph>t</emph>(<reflink idref="bib108" id="ref18">108</reflink>) = −0.13, <emph>p</emph> = 0.90), autism severity (<emph>t</emph>(<reflink idref="bib46" id="ref19">46</reflink>) = 0.58, <emph>p</emph> = 0.36), or cognitive ability (<emph>t</emph>(<reflink idref="bib105" id="ref20">105</reflink>) = −1.55, <emph>p</emph> = 0.12). The chi-square test suggested no differences between the picky eater (<emph>n</emph> = 4) and non-picky eater (<emph>n</emph> = 1) groups in the number of children on a special diet (χ<sups>2</sups>(<reflink idref="bib1" id="ref21">1</reflink>) = 0.14, <emph>p</emph> = 0.71). See Table 1. Therefore, we did not add any covariates to the model.</p> <p>Table 1. Participant demographics.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th /><th /><th align="left">Picky eaters (<italic>n</italic> = 80)</th><th align="left">Non-picky eaters (<italic>n</italic> = 30)</th><th /></tr><tr><th align="left">Variable</th><th align="left"><italic>N</italic></th><th align="left"><italic>M</italic> (<italic>SD</italic>)</th><th align="left"><italic>M</italic> (<italic>SD</italic>)</th><th align="left"><italic>p</italic>-value</th></tr></thead><tbody><tr><td>Age (months)</td><td>110</td><td>51.4 (10.2)</td><td>51.1 (11.1)</td><td>0.90</td></tr><tr><td>Cognitive ability</td><td>48</td><td>84.0 (14.1)</td><td>88.5 (17.4)</td><td>0.36</td></tr><tr><td>CARS-2T score</td><td>102</td><td>48.7 (5.7)</td><td>46.1 (7.4)</td><td>0.07</td></tr><tr><th /><th /><th align="left">% (n)</th><th align="left">% (n)</th><th /></tr><tr><td>Female<xref ref-type="table-fn" rid="tfn2">a</xref></td><td>110</td><td>21.3 (17)</td><td>33.3 (10)</td><td>0.19</td></tr><tr><td>Race and ethnicity<xref ref-type="table-fn" rid="tfn2">a</xref>,<xref ref-type="table-fn" rid="tfn3">b</xref></td><td>100</td><td /><td /><td /></tr><tr><td> American Indian Alaskan Native</td><td /><td>5.0 (4)</td><td>0 (0)</td><td>0.21</td></tr><tr><td> Asian</td><td /><td>6.3 (5)</td><td>3.3 (1)</td><td>0.55</td></tr><tr><td> Black</td><td /><td>22.5 (18)</td><td>6.7 (2)</td><td>0.06</td></tr><tr><td> White</td><td /><td>71.3 (57)</td><td>50.0 (15)</td><td>0.04</td></tr><tr><td> Hispanic/Latino</td><td /><td>18.8 (15)</td><td>13.3 (4)</td><td>0.50</td></tr><tr><td> Do not wish to provide</td><td /><td>5.0 (4)</td><td>0 (0)</td><td>0.21</td></tr><tr><td>On a special diet<xref ref-type="table-fn" rid="tfn2">a</xref></td><td>110</td><td>5.0 (4)</td><td>3.3 (1)</td><td>0.71</td></tr></tbody></table> </ephtml> </p> <p>1 Sample sizes less than 110 reflect missing data due to the assessment not being completed or entered into this database.</p> <ulist> <item>2 χ<sups>2</sups> p-value.</item> <item>3 Participants could choose more than one race and ethnicity.</item> </ulist> <p>When examining group differences on the BASC indices, results suggested the picky eating group had significantly higher scores on the Aggression (<emph>t</emph>(65.58) = −2.55, <emph>p</emph> = 0.004), depression (<emph>t</emph>(<reflink idref="bib108" id="ref22">108</reflink>) = −2.11, <emph>p</emph> = 0.04), hyperactivity (<emph>t</emph>(<reflink idref="bib108" id="ref23">108</reflink>) = −2.29, <emph>p</emph> = 0.02), and withdrawal indices (<emph>t</emph>(68.98) = −3.49, <emph>p</emph> < 0.001). However, when using the Benjamini Hochberg–corrected critical value of 0.014, only Aggression and Withdrawal remain significant. All other BASC indices were not significantly different between groups (See Table 2).</p> <p>Table 2. BASC subscales by group.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th /><th align="left">Picky eaters (<italic>n</italic> = 80)</th><th align="left">Non-picky eaters (<italic>n</italic> = 30)</th><th align="left"><italic>p</italic>-value</th><th align="left">Cohen's <italic>d</italic></th></tr><tr><th /><th align="left"><italic>M</italic> (<italic>SD</italic>)</th><th align="left"><italic>M</italic> (<italic>SD</italic>)</th><th /><th /></tr></thead><tbody><tr><td>Adaptability</td><td>37.5 (9.8)</td><td>40.2 (8.9)</td><td>0.19</td><td>0.29</td></tr><tr><td>Aggression</td><td>57.6 (13.5)</td><td>51.4 (7.9)</td><td>0.004<xref ref-type="table-fn" rid="tfn5">*</xref></td><td>0.56</td></tr><tr><td>Anxiety</td><td>50.5 (13.1)</td><td>49.0 (7.3)</td><td>0.44</td><td>0.11</td></tr><tr><td>Attention problems</td><td>64.0 (10.2)</td><td>62.3 (8.3)</td><td>0.41</td><td>0.18</td></tr><tr><td>Atypicality</td><td>68.9 (14.9)</td><td>65.7 (12.5)</td><td>0.29</td><td>0.23</td></tr><tr><td>Depression</td><td>58.4 (12.1)</td><td>53.3 (9.0)</td><td>0.04</td><td>0.48</td></tr><tr><td>Functional communication</td><td>34.5 (9.2)</td><td>36.4 (9.1)</td><td>0.34</td><td>0.21</td></tr><tr><td>Hyperactivity</td><td>62.9 (12.0)</td><td>57.3 (9.5)</td><td>0.02</td><td>0.52</td></tr><tr><td>Social skills</td><td>35.9 (8.6)</td><td>37.2 (9.5)</td><td>0.52</td><td>0.14</td></tr><tr><td>Somatization</td><td>48.9 (9.8)</td><td>48.8 (7.9)</td><td>0.98</td><td>0.01</td></tr><tr><td>Withdrawal</td><td>69.2 (14.1)</td><td>60.5 (10.6)</td><td><0.001<xref ref-type="table-fn" rid="tfn5">*</xref></td><td>0.70</td></tr></tbody></table> </ephtml> </p> <ulist> <item>4 Benjamini Hochberg critical value is 0.014.</item> <item>5 Significant finding with adjusted <emph>p</emph>-value.</item> </ulist> <hd id="AN0193858185-5">Discussion</hd> <p>Our results suggest autistic children with parent-reported picky eating are significantly more likely to have differences in both internalizing and externalizing behaviors than autistic children who were not reported by their parents as picky eaters. Specifically, picky eaters were more likely to exhibit aggression and withdrawal (i.e. avoidance of others). Picky eating is prominent in autistic children, and our study findings suggest that understanding the behavioral profiles associated with picky eating may be particularly useful when devising treatment plans.</p> <p>Our findings align with previous studies suggesting the influence of both externalizing and internalizing behaviors on eating behaviors in autism. For example, [<reflink idref="bib8" id="ref24">8</reflink>] found that aggression was associated with GI symptoms in young autistic children (2–5 years), and withdrawal was associated with GI symptoms in older autistic children (6–18 years), and our study also found an association between aggression, withdrawal, and picky eating across 3–6 year olds. Of note, [<reflink idref="bib8" id="ref25">8</reflink>] found an association between picky eating and somatic complaints, whereas our study found that levels of somatization were similar regardless of picky eating (i.e. <emph>p</emph> = 0.98). It is possible, based on this prior research finding that autistic children are responding behaviorally to GI discomfort. This may be first expressed through externalizing behaviors like aggression and then transition to more internalizing behaviors like withdrawal; however, further research is needed. Clinically, it is important to consider GI discomfort when assessing internalizing and externalizing behavioral symptoms in autistic children who present with eating difficulties. The report of these symptoms during a diagnostic evaluation should prompt further questioning and possible referrals to feeding specialists and gastroenterologists.</p> <p>Alternatively, it may be that the presence of internalizing and externalizing behaviors is sequelae of fundamental capacities of emotion awareness and regulation. The demands of eating and participating in mealtime activities may be particularly taxing for children who struggle to manage fear and/or frustration in the face of unexpected deviations in food appearance or taste. This demand may potentially result in initial challenging behaviors through aggression or lead to more withdrawal.</p> <p>Our study also adds to the emerging body of knowledge about the relationship between cognitive skills, adaptive behaviors, and picky eating in autistic children. We did not find differences between our picky and non-picky groups by overall cognitive standard scores. This is consistent with many study findings reporting that IQ is not related to picky eating ([<reflink idref="bib1" id="ref26">1</reflink>]); however, the amount of missing data on cognitive scores in our dataset may have impacted these findings.</p> <p>Understanding the behavioral factors potentially underlying picky eating behaviors in young autistic children is critical to creating more efficacious interventions. Overall, this study suggests multiple internalizing, externalizing, and adaptive behaviors associated with picky eating in autism at an early age. While externalizing behaviors may be more observable, our findings also suggest the importance of accounting for internalizing behaviors in young autistic children exhibiting eating difficulties. These findings have implications for diagnosticians who may be the first to gather both eating and behavioral symptom data and initiate referrals in young autistic children. The findings may also have implications for developing personalized behavioral interventions for autistic children.</p> <hd id="AN0193858185-6">Limitations and future directions</hd> <p>While our study reported on a relatively large sample of autistic children and compared children with and without parent-reported picky eating, our picky eating group was much larger than our non-picky eating group. This high prevalence of picky eating is representative of the literature but provides less data for comparison. Furthermore, we relied on parent report to identify picky eating rather than using standardized eating behavior assessments, which may have introduced bias to our characterization of groups. Future studies should use both parent report and formal assessments to better characterize eating behaviors. A strength of our study is the use of a standardized assessment (i.e. the BASC) to examine behavioral profiles; however, future studies could use more objective measures that rely less on parent report (e.g. biosensors to understand physiological arousal and autonomic responses) to better understand internalizing behaviors, especially in minimally verbal children. Future studies should also investigate sex differences since autistic females are often underidentified and may be more at risk of health consequences associated with picky eating (e.g. [<reflink idref="bib10" id="ref27">10</reflink>]). Since picky eating in autism is multifactorial, future studies should continue to examine other factors underlying eating behaviors (e.g. sensory processing, oral hypersensitivity, insistence on sameness, repetitive behaviors, oral motor skills, verbal ability; for review, see [<reflink idref="bib14" id="ref28">14</reflink>]), as well as how these factors differ between autistic and non-autistic children, and across autistic children with other co-occurring conditions. Last, future eating behavior research should include stakeholder perspectives to better understand the lived experience of picky eating in autism.</p> <ref id="AN0193858185-7"> <title> References </title> <blist> <bibl id="bib1" idref="ref21" type="bt">1</bibl> <bibtext> Baraskewich J., von Ranson K. M., McCrimmon A., McMorris C. A. (2021). Feeding and eating problems in children and adolescents with autism: A scoping review. 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Western Psychological Services.</bibtext> </blist> </ref> <ref id="AN0193858185-8"> <title> Footnotes </title> <blist> <bibtext> Anna Wallisch</bibtext> </blist> <blist> <bibtext>Graph</bibtext> </blist> <blist> <bibtext>https://orcid.org/0000-0003-0951-8810 Sallie Nowell</bibtext> </blist> <blist> <bibtext>Graph</bibtext> </blist> <blist> <bibtext>https://orcid.org/0000-0002-6132-4661 E Zhang</bibtext> </blist> <blist> <bibtext>Graph https://orcid.org/0000-0002-9468-4890</bibtext> </blist> <blist> <bibtext> Anna Wallisch: Conceptualization; Formal analysis; Investigation; Methodology; Project administration; Writing—original draft.Sallie Nowell: Conceptualization; Methodology; Writing—original draft; Writing—review & editing.E Zhang: Methodology; Writing—original draft; Writing—review & editing.Brian Boyd: Conceptualization; Methodology; Writing—review & editing.Elena Tenenbaum: Resources; Writing—review & editing.Nancy Zucker: Resources; Writing—review & editing.Dana Bakula: Resources; Writing—review & editing.Ann Davis: Conceptualization; Methodology; Resources; Writing—review & editing.</bibtext> </blist> <blist> <bibtext> The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research reported here was supported by the CTSA grant from NCATS awarded to Frontiers Clinical and Translational Science Institute (# KL2TR002367) and the Eunice Shriver National Institute of Child Health and Human Development of the National institutes of Health under award # F32HD101311. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH or NCATS.</bibtext> </blist> <blist> <bibtext> The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.</bibtext> </blist> </ref> <aug> <p>By Anna Wallisch; Sallie Nowell; E Zhang; Brian Boyd; Elena Tenenbaum; Nancy Zucker; Dana Bakula and Ann Davis</p> <p>Reported by Author; Author; Author; Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib13" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib14" firstref="ref2"></nolink> <nolink nlid="nl3" bibid="bib12" firstref="ref12"></nolink> <nolink nlid="nl4" bibid="bib15" firstref="ref13"></nolink> <nolink nlid="nl5" bibid="bib16" firstref="ref15"></nolink> <nolink nlid="nl6" bibid="bib11" firstref="ref16"></nolink> <nolink nlid="nl7" bibid="bib108" firstref="ref18"></nolink> <nolink nlid="nl8" bibid="bib46" firstref="ref19"></nolink> <nolink nlid="nl9" bibid="bib105" firstref="ref20"></nolink> <nolink nlid="nl10" bibid="bib10" firstref="ref27"></nolink>
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  Data: Short Report: An Examination of Behavioral Factors Linked to Picky Eating in Autistic Children
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  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Anna+Wallisch%22">Anna Wallisch</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-0951-8810">0000-0003-0951-8810</externalLink>)<br /><searchLink fieldCode="AR" term="%22Sallie+Nowell%22">Sallie Nowell</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-6132-4661">0000-0002-6132-4661</externalLink>)<br /><searchLink fieldCode="AR" term="%22E%2E+Zhang%22">E. Zhang</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-9468-4890">0000-0002-9468-4890</externalLink>)<br /><searchLink fieldCode="AR" term="%22Brian+Boyd%22">Brian Boyd</searchLink><br /><searchLink fieldCode="AR" term="%22Elena+Tenenbaum%22">Elena Tenenbaum</searchLink><br /><searchLink fieldCode="AR" term="%22Nancy+Zucker%22">Nancy Zucker</searchLink><br /><searchLink fieldCode="AR" term="%22Dana+Bakula%22">Dana Bakula</searchLink><br /><searchLink fieldCode="AR" term="%22Ann+Davis%22">Ann Davis</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Autism%3A+The+International+Journal+of+Research+and+Practice%22"><i>Autism: The International Journal of Research and Practice</i></searchLink>. 2026 30(6):1615-1619.
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  Label: Availability
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  Data: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
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  Label: Peer Reviewed
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  Data: Y
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  Label: Page Count
  Group: Src
  Data: 5
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2026
– Name: SourceSuprt
  Label: Sponsoring Agency
  Group: SrcSuprt
  Data: National Center for Advancing Translational Sciences (NCATS) (DHHS/NIH), Clinical and Translational Science Awards (CTSA) Program<br />Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (DHHS/NIH)
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  Label: Contract Number
  Group: NumCntrct
  Data: KL2TR002367<br />F32HD101311
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  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Eating+Disorders%22">Eating Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Autism+Spectrum+Disorders%22">Autism Spectrum Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Young+Children%22">Young Children</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+Patterns%22">Psychological Patterns</searchLink><br /><searchLink fieldCode="DE" term="%22Aggression%22">Aggression</searchLink><br /><searchLink fieldCode="DE" term="%22Withdrawal+%28Psychology%29%22">Withdrawal (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Behavior+Problems%22">Behavior Problems</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Health%22">Mental Health</searchLink>
– Name: SubjectThesaurus
  Label: Assessment and Survey Identifiers
  Group: Su
  Data: <searchLink fieldCode="SU" term="%22Childhood+Autism+Rating+Scale%22">Childhood Autism Rating Scale</searchLink><br /><searchLink fieldCode="SU" term="%22Kaufman+Brief+Intelligence+Test%22">Kaufman Brief Intelligence Test</searchLink><br /><searchLink fieldCode="SU" term="%22Bayley+Mental+Development+Index%22">Bayley Mental Development Index</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1177/13623613261418948
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1362-3613<br />1461-7005
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Eating difficulties are highly prevalent among autistic children and are linked to negative health consequences. While many mechanisms are thought to underly these behaviors, we know less about how internalizing and externalizing behaviors relate to eating difficulties in autism. The purpose of this study was to examine how internalizing and externalizing behaviors differ between autistic children (3-6 years of age) with parent-reported picky eating (n = 80) and without picky eating (n = 30). Data was drawn from intake paperwork and assessments completed as part of an autism diagnostic evaluation at a large medical center. Results suggested that picky eaters, when compared to non-picky eaters, had significantly more difficulties with aggression and withdrawal. Our study findings suggest that understanding the behavioral profiles associated with picky eating may be particularly useful when devising treatment plans. Furthermore, diagnosticians who may be the first to gather both eating and behavioral symptom data can initiate referrals to feeding specialists to help prevent some of the negative health consequences associated with these eating behaviors.
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  Data: As Provided
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  Label: Entry Date
  Group: Date
  Data: 2026
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  Label: Accession Number
  Group: ID
  Data: EJ1506532
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        Value: 10.1177/13623613261418948
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