Interrelation of food selectivity, oral sensory sensitivity, and nutrient intake in children with autism spectrum disorder: A scoping review

Background: Food selectivity is an emerging health concern among children with autism spectrum disorder (ASD). Food selectivity is used to describe food refusal, limited food choices, and/or food fussiness.Method: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-Scoping Review Guidelines to systematically identify the relationship between food selectivity and oral sensory sensitivity and the possible consequences of food selectivity on nutrient intake in children with ASD.Thirty studies were included in the review based on search terms from three online databases.Results: Assessment of food selectivity, oral sensory sensitivity, and nutrient intake was found to be focused primarily on the parent-report technique. Only a handful of studies have used Cron-bach's alpha to measure the psychometric properties. Twenty-one of the included studies re -ported a higher rate of food selectivity in children with ASD than typically developing (TD) children. Notably, several studies (n =7) have identified oral hypersensitivity (e.g., taste/smell) as a significant risk factor for food aversion and/or limited variety in children with ASD. Compared with TD children, the ASD group significantly consumed significantly fewer fruits/vegetables (n = 8). The intake of micronutrients, including vitamin A, vitamin B6, folate, vitamin B12, vitamin C, vitamin D, calcium, iron, and zinc that associates with food selectivity, was also low (n=13).Conclusion: Implementation of screening and assessment protocols using valid and reliable in-struments to identify food selectivity and oral sensory sensitivity is crucial for the medical evaluations of children with ASD.