Could picky eating be a sign of autism?
Could unusual speech patterns or pronunciation be a sign?
This week, researchers have published findings that suggest either or both could be the case.
The "picky eating" study was conducted by researchers in the UK, and is published in the journal Pediatrics. A According to the website Disability Scoop:
Kids with autism tend to be picky eaters even at very young ages, opening a window into what could be an early sign of the developmental disorder, researchers said Monday.
The speech study, published in The Proceedings of the National Academy of Sciences, describes a new software system that can analyze speech patterns and discern - to a limited degree - which children are autistic. According to the Canadian publication Globe and Mail:
...new research suggests that an automated system may one day take some of the guesswork out of detecting the neural disorder in young children by recognizing deviations from the norm in voice recordings.
As always, the headlines proclaim a bit more than is really appropriate. And as is often the case in autism-related research, the headlines appear to provide parents with tools that really aren't all that useful.
For example, picky eating MAY go along with autism. Then again, it may not. It may be a sign of any number of issues, from sensory problems to allergies to physical anomalies. Or it may just be that your child is a picky eater, as so many children are.
Similarly, the software developed to distinguish vocal patterns is only sometimes right -- and speech delays or problems can be the result of many different issues. In fact, some of the speech differences that are identified through the speech software could be the result of mild delays that will disappear on their own.
At present, then, it seems reasonable for parents to keep an eye open for developmental concerns, and to bring those concerns to their pediatrician's attention. Of course serious eating issues should be addressed immediately. But it's important to remember that children really do develop at different speeds, have different tastes and different abilities.
Not every difference is a sign of autism.
I think this is a good example of sensationalism in the press. I don’t have a subscription to Pedriatrics, so I can only read the abstract of the study… not the actual conclusions. The wording the news article, however essentally mirrors the abstract; but it also contains some jazzing up of the language to make the whole thing seem more significant. With that, it really runs the risk of causing the reader to jump to erroneous conclusions about what the study showed. I’m willing to speculate that the conclusions of the scientists involved in the study are far more tentative and conservative than the implications alluded to by the article in the press. Thank you, Lisa, for posting the links to both.
Both these studies point out that children who are later diagnosed with ASD may be demonstrably different from typically-developing children at a young age; in particular, the group of children who were later diagnosed with ASD were already significantly different by the time they were first evaluated at six months of age in terms of feeding behavior. This is in agreement with the results of the first prospective study of the development of autism which showed that children with ASD were already fundamentally different from their peers by the time they reached their first birthdays, although parents seemed generally unable to recognize the early signs:
http://www.ncbi.nlm.nih.gov/pubmed/20410715
http://imfar.confex.com/imfar/2010/webprogram/Paper7432.html
Since I believe vaccinations cause much of autism, I have to believe that no one is safe from damage and that it would be hard to believe we have normal and we have autistic, there are probably many , many more that fall in the middle with various symptoms. This way of thinking would eliminate most “normals” from comparisons in any study along side of ASD children. No NT vaccinated child should qualify as a participant in a control group, likely he is experiencing some level of damage. Normal is no longer a working adjective, unless you have an unvaccinated child , and then you would never call him normal, because he offers little to nothing to compare to any vaccinated child. No behavioral similarities, learning similarities, motor similarities, it’s a small “different” group, far from today’s acceptance of “normal”. All of my kids, with exception to the baby have quirks or language delays,motor delays,feeding difficulities ,while one gets all A+’s and scored this time in the top 99th in the nation in both reading and math, he’s not exactly normal, he’s obsessive to a fault, hence all A+’s! Are feeding issues a result of vaccination, probably, is it autism, probably not. Are the ever growing population of speech delayed children autistic, probably not, again, damaged. Whether we believe it’s vaccine, or some other environmental exposure, it’s not RIGHT for so many kids to have these issues. Talk to the great grandmom, she will tell you no one had children with these problems…ask her before she gets her flu shot!
I am endowed with Asperger’s
I am a “picky eater”. I do not know how representative of the autism community I am, but if I can give an insight of how I perceive food and flavor, perhaps it may help somebody…
If I were to mix a mild acid solution, say from vinegar or lemon juice, and stick a pH strip in the solution, it would change color to a shade proportional to how acidic the solution was. If I were to pour baking soda in the solution, it would fizz like crazy, and if I remeasured the pH again it would be less acidic.
If I were to take another container of the acid solution and pour sugar into it, I would not expect it to fizz, and when I stuck the pH strip in, it would still show full acidity.
My tongue is like the pH strip; it is not “fooled” by adding sugar. If it was too sour, adding sugar will not make it less sour. I observe that neurotypicals DO think adding more sugar makes things less sour, therefore there must be a fundamental difference between how I process flavors and how neurotypicals process flavors; all I can figure is the sugar taste receptors must be able to “shut down” the sour taste receptors. I am not saying I am totally unable to block unwanted flavors with sugar; if I add about two heaping or six level teaspoons of sugar to a standard six ounce cup of coffee I can mask the bitter alkaloid taste of the caffeine.
So to me, a fresh, beautiful apple is too sour to eat. Don’t even consider giving me an orange! Tomatoes are out of the question too.
Then there is the burning spice problem. I define “burning” spices as ones containing capsaicin or similar chemicals which the plants create as insecticide. A short list would include all of the peppers; chili, black pepper, jalapeņos, etc, plus horseradish and even cinnamon.
I basically have zero tolerance for burning spices. Oddly, for most of them, especially the various peppers, I do not even perceive a flavor, only a painful burning sensation. The burning sensation is not limited to the tongue, either; I will feel the burn all the way down.
I perceive an ubiquitous leavening agent, sodium acid pyrophosphate, which is found in everything from donuts to biscuit mixes, to cause a burning sensation. This one I find most baffling; my family claims they perceive no flavor and no burning sensation at all, yet to me some brands of luscious looking chocolate covered donuts are inedible. The sensation is not like an acid, it is more like a burning spice or chemical burn, like I was eating pure phosphorus.
None of the artificial sweeteners work for me. Cyclamates are cloyingly sweet, and aspartame isn’t sweet. Saccharin tastes like gasoline. I understand neurotypicals find clear alcohols like vodka tasteless; to me all alcohol tastes like turpentine.
Leftover meats are a big problem. I speculate that some kind of oxidation reaction must occur in meat when it is left in the refrigerator overnight. After the flavor change occurs, I find the meat gag-awful, especially chicken. If the meat is smothered in gravy or drippings or in a stew or soup, something which keeps the air off of it, it stays palatable. I avoid exposed leftover meat like vampires avoid daylight!
So let’s put some typical food in front of me, say at a summer picnic. The hot dogs are uncomfortably spicy, but I’ll eat them if that is all there is. The barbecue sauce is probably too spicy. The catsup, depending on the brand, my be too spicy. A salad of fresh fruits is too sour to eat, especially if it contains blueberries, kiwi fruits or strawberries. Lettuce is nasty, I can only eat it if I hide the bitter flavor with a ton of salad dressing.
I will like the hamburgers and potato salad, but only if they don’t have pepper. I will like Kentucky Fried Chicken, but it is just at the edge of the amount of black pepper I can tolerate, and the mashed potatoes from KFC are completely inedible because they have pepper or horseradish or some other nasty burning spice in them. I may be able to eat pizza with Italian sausage, but can’t touch pepperoni. On some brands of pizza I can’t even tolerate the sauce. I can tolerate some brands of bratwurst.
Food is almost never salty enough for me; I get the impression I like roughly twice as much salt in food as normal people do.
I am not saying I like bland food; I actually enjoy aromatic spices and strong flavors, like many of the Italian spices and strong flavors like blue cheese or anchovies. Besides, when I can perceive the tiniest amounts of spice, food is seldom bland to me! For me, eating is an adventure; I never know what I can’t eat. If something is quite sour, it will hit my taste bud so hard, I will actually startle. Some foods will give me goosebumps as I try to choke them down.
As I led into the blog with, just because my perceptions of flavor are odd, does not mean every autistic person has the same perception, but it may explain a few picky eaters out there. My oldest son, who is so far out on the spectrum he does not function well as an adult, dumps a ton of pepper on his food; go figure.
Thus far I haven’t even touched on food sensitivities; both I and my eldest son get violent migraine-like headaches with vomiting when we eat the wrong foods, and it is difficult to even figure out which foods are the culprits. For instance, I can eat foods with nitrites in them, like ham or hot dogs, but if I eat a lot of nitrite laden food for several days in a row, and then stop eating nitrites, I will get a violent migraine. I am also more likely to get upset stomachs, and to have unbearable gas and gas pains with embarrassing flatulence, far in excess of other family members who ate the same meal.
It is normal instinctive behavior to avoid foods which have made you sick and puke, so never be surprised if your child will suddenly stop eating some food he used to like (or at least tolerate).
I just read your comment Bill to my son, he agrees with you for the most part, with exception to potato salad, which got an “ewww”. He eats steaks, chicken,burgers, bendy bacon, scrambled eggs and corn. He will eat mashed potatoes “if” they are organic russets or idahos, if they are riced then mashed with no sign of a “lump”. He has been enticed with the prospect of money to eat fruit, and has tried , but can’t, he gags at the smell of bread,rolls,chocolate etc.. he will eat cake if it’s homemade and has whipped cream on it. He does like hot sauce and steak sauce. That’s it, no vegetables, no fruits, no fruit drinks. He will eat spaghetti, however he detects something in jarred that he does not like, so I have to make it straight up with tomato paste. He has never tried to eat a tomato or a pickle or a piece of lettuce. I never understood why I couldn’t offer him something from the night before, even if reheated he “knows” and won’t eat it, thanks for your “a bit yucky” explanation! This child’s favorite foods until he was two were homemade chicken potpie,and caesar salad, he can not stand to smell them now,let alone eat them.
Barbaraj,
Gosh, it’s not very healthy to not eat any fruits or vegetables (though you mentioned corn and potatoes at least!)
Have you tried dried fruits, like raisins and dried apricots? I like prunes too, (but they don’t like me!)
I also like bananas.
Actually I dislike most potato salads too; the kind I tolerate is made with mayonnaise, little or no vinegar, chopped up hard boiled eggs (with the yolk blended into the mayonnaise), salt, and sometimes chopped celery, (though I would prefer it without the celery).
I dislike tomato paste because it is too acidic for me; I eat spaghetti with white sauces or gravy or soy sauce.
It’s so interesting… our son will eat ANY kind of fruit (except melon), but outside of a million helpings of fruit, if allowed, would self limit to breakfast cereals, crackers/breads, peanut butter and jelly, bagels and cream cheese, pizza and the occasional pancake.
But pasta – NO WAY!
We’ve pushed very hard to get him to eat a wider variety of proteins, and to at least touch a few veggies, rice, etc. So he’ll now eat small portions of meats (chicken, beef, pork), a few peas, a nibble of broccolli or carrot.
Neither Tom NOR his NT sister will touch potatoes; even french fries aren’t interesting to them.
Bizarrely, though, Tom – and NOT Sara – will eat salsa, ginger cookies, coconut, and garlic bread. Sara insists on only the plainest flavors, but loves meat.
You explain it – I can’t!!
Lisa
BTW – we have video and pix of our son gobbling a very wide variety of food at a very young age (peas, lasagna, etc.). It wasn’t until he was about two and a half or three that he started self limiting.
From what I can gather, this is a fairly typical pattern for kids in general – and of course if you go to any restaurant you’ll find a “kids menu” which consists of the same 3-4 “kid friendly items” over and over again: mac and cheese, chicken nuggets, hot dog, etc.
While I’ve been told (by my mom, among others) that if you start ‘em young on a variety of foods they’ll never become picky eaters – but mom was wrong!
Lisa
Yes, picky eating and unusual speech patterns may or may not be signs of autism. However, these are exactly the types of concerns parents of young children raise with pediatricians only to be told “you worry too much” and later learn their child has sensory processing disorder and oral/verbal apraxia, which can be associated with autism or stand on their own. Early intervention can make a huge difference. What’s more, a child with oral/verbal dyspraxia may have undiagnosed motor planning and organizational issues that affect him in other ways. Maybe we should call them “development screens” and teach professionals to recognize that what is a “delay” may actually be a disability. For instance, kids with oral/verbal apraxia do not simply “catch up”: they do not imitate well, which necessitates specific speech therapy techniques.
Nancy – are there screening tests for determining whether an eating or speech difference/delay is significant at a very young age? could they be administered by a pediatrician in the office? IMO, a three year old “picky eater” is about as normal as apple pie – but yet I’m sure there are specific symptoms for apraxia or sensory issues that could be relatively easily detected…
Lisa
My understanding of the language study is to try to devise a computer=based system for sorting various language development patterns precisely in order to see whether or not some very specific ones are related consistently to autism and whether or not others are related consistently to other developmental issues. Definitive findings along these lines (if there are any) would eventually lead to the development of diagnostic programs that would essentially take the pediatrician’s “don’t worry, it’s normal” attitudes out of the equation.
I’m less sure about where the picky eating study is going, but I think it’s quite possible that the news article sensationalizes it quite a bit and that makes it even more difficult for me, as a layperson, to try to put it into an appropriate perspective. Like Lisa, my son ate everything and ate well until about age 3 1/2. After that, he began self-limiting his choices. Now, as an adult, he does have some digestive problems with spicy foods and acidic foods (like citris fruits and tomatoes). As I remember, some of these were the first things he began to elminate out of his diet, so I suspect he was having difficulties with them early on but couldn’t adequately tell us what he was feeling in his tummy after he ate them until much later.
Bill, yes, I have tried “everything”. He has ibs, is also quick to become nauseated and throw up , so I never force him to try, I just offer. It sounds okay, like it’s under some control but it’s not, if he doesn’t get what he has in “mind”, he screams a chant of “I’m hungry”..which could either go on for hours or turn violent. Food is a big issue, a huge starting point for meltdowns with him.
I find that being well fed, btw, seems to limit some behaviors, so I sure try to not let him become “hungry”. We are doing pretty well with the two eggs, and whether a coincidence or not, I am becoming a believer in the need for cholesterol to promote better “connections”.
My son became a picky eater when his autistic symptoms started. He selected down to 6 unhealthy foods and a half gallon of milk a day. No amount of effort would get him to try a new food.
He would throw up when I sat next to him eating something he did not like.
Prior to the symptoms he ate everything we presented. All healthy foods.
Its funny that these symptoms and picky eater habits started hours after his vaccines where he had an adverse reaction.
Fast forward to today after years of hard work he eats healthy and we avoid allergens. The gluten free/casein free/soy free diet helped immensely.
That is interesting, I am a bit lazy, and do need to make a better effort to make his food choices healthier. I’m just so not up for a fight. I do share the story, it started after the dtap hib, I just thought he was sickened, and had read enough to believe his t cells were affected (like a mini induced aids) and that eventually he would perk up, yet with those beautiful blue eyes hazed over and lids at half mast, language started to decrease until it was gone, and his stomach became the issue. I slept with him until he was four, changing diapers sometimes five times during the night. News just said, “Baltimore has some well deserved recognition..a 98% compliance rate for vaccines..I hope I can enjoy the herd as I refuse to vaccinate the baby. Tic a bit, as we had chicken pox in school this spring, in vaccinated children, my six year old, who stopped immunizations after the asthma issue was not vaccinated and didn’t get it! The note sent home seemed to pronounce the acceptance of this disease ,saying “and the children were vaccinated”..like we’d stone ‘em if they weren’t.
I understand everyone’s concern not to sensationalize these new reports. However, they do reflect two topics that most parents discuss with a pediatrician. Most doctors are not given specific enough (or any in some cases) training and information about DD, particularly ASD. I have two children who experienced both speech issues and eating concerns. Both of the respective doctors dismissed my concerns as coming from an over-anxious mother. Both times, they turned out to be wrong. I’m not saying this is a fool proof method of early warning or diagnosis. No one can say that since each person with ASD is unique. However, I would rather see further testing done here, in two established areas recognized by many with ASD, to provide a more credible means of discussing this with doctors. I think many doctors who are juggling many patients would like to see another tool available to them to make referrals as well. As for the speech program, if a recorded speech pattern causes a child to be qualified for ST earlier, is there really any harm in that? I see the difference in my two sons and their speech patterns. While they are two different people, they are still related. My youngest qualified for ST MUCH earlier than his brother and the difference is startling. I would like to see more research, testing and development done without the sensationalized hype and desperate need for a sound-bite for media purposes. I think it holds more promise that the head circumfrence test and the like from the recent past.