Food selectivity and neophobia in children with autism spectrum disorder and neurotypical development: a systematic review.

This systematic review examines the prevalence of food selectivity and food neophobia (FN) in children with autism spectrum disorder (ASD) compared to children with neurotypical development (NTD) up to age 14. Analysis of 17 clinical studies found consistent evidence that children with ASD exhibit greater food selectivity—characterized by limited food variety and higher rates of food refusal—than children with NTD. However, findings on FN, defined as the fear or avoidance of trying new foods, were mixed, with only about half of the studies reporting higher FN in children with ASD; one study including siblings as controls suggested FN is more pronounced in ASD. Altered sensory processing, particularly atypical oral sensitivity, was frequently associated with eating difficulties in children with ASD, indicating sensory factors may underlie selective eating behaviors. The review highlights the need for further research comparing FN within family contexts and emphasizes early assessment of sensory-related eating issues to guide nutritional interventions.