ARTICLES
Feeding Symptoms, Dietary Patterns, and Growth in
Young Children With Autism Spectrum Disorders
AUTHORS: Alan Emond, MD, Pauline Emmett, PhD, Colin
Steer, MSc, and Jean Golding, PhD
Centre for Child and Adolescent Health, Department of
Community Based Medicine, University of Bristol, Bristol, United
Kingdom
KEY WORDS
autism, autism spectrum disorders, feeding, diet, pervasive
feeding disorder, ALSPAC
ABBREVIATIONS
ASD—autism spectrum disorder
ALSPAC—Avon Longitudinal Study of Parents and Children
OR— odds ratio
CI— confidence interval
www.pediatrics.org/cgi/doi/10.1542/peds.2009-2391
doi:10.1542/peds.2009-2391
Accepted for publication Apr 27, 2010
Address correspondence to Jean Golding, PhD, Centre for Child
and Adolescent Health, Barley House, Oakfield Grove, Bristol BS8
2BN, United Kingdom. E-mail: jean.golding@bristol.ac.uk
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2010 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The authors have indicated they have
no financial relationships relevant to this article to disclose.
PEDIATRICS Volume 126, Number 2, August 2010
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WHAT’S KNOWN ON THIS SUBJECT: Children with ASDs are often
reported to have limited food preferences and behavioral
difficulties associated with feeding. However, the age of onset of
feeding symptoms and the impact on diet and growth are poorly
understood.
WHAT THIS STUDY ADDS: Using prospectively reported data the
authors found that children with ASDs showed feeding symptoms
from infancy and had a less varied diet from 15 months of age,
but energy intake and growth were not impaired.
abstract
OBJECTIVE: To investigate the feeding, diet and growth of young chil-
dren with autism spectrum disorders (ASD).
METHOD: Data on feeding and food frequency were collected by ques-
tionnaires completed at 6, 15, 24, 38 and 54 months by participants in
the Avon Longitudinal Study of Parents and Children. A food variety
score was created, and the content of the diet was calculated at 38 m.
The feeding and dietary patterns of 79 children with ASD were com-
pared with 12 901 controls.
RESULTS: The median ages of ASD children were 28 months at referral
and 45 months at diagnosis. ASD infants showed late introduction of
solids after 6 months (p ⫽ .004) and were described as “slow feeders”
at 6 months (p ⫽ .04). From 15–54 months ASD children were consis-
tently reported to be “difficult to feed” (p ⬍ .001) and “very choosy”
(p ⬍ .001). From 15 months, the ASD group had a less varied diet than
controls, were more likely to have different meals from their mother
from 24 months, and by 54 months 8% of ASD children were taking a
special diet for “allergy.”
ASD children consumed less vegetables, salad and fresh fruit, but also
less sweets and fizzy drinks. At 38 months intakes of energy, total fat,
carbohydrate and protein were similar, but the ASD group consumed
less vitamins C (p ⫽ .02) and D (p ⫽ .003). There were no differences in
weight, height or BMI at 18 months and 7 years, or in hemoglobin
concentrations at 7 years.
CONCLUSIONS: ASD children showed feeding symptoms from infancy
and had a less varied diet from 15 months, but energy intake and
growth were not impaired. Pediatrics 2010;126:e337–e342
e337
Autism spectrum disorders (ASDs) are
characterized by impairments in so-
cial interaction and communication
and stereotypical and repetitive behav-
iors. People with ASDs are often resis-
tant to change and have a narrow
range of interests, which can extend to
the foods they like.1 Children with ASDs
are often reported to have unusual eat-
ing patterns with a restricted range of
food choices.2 However, the differ-
ences are not only a result of impair-
ments intrinsic to the child with an
ASD; a questionnaire survey of parents
of children with ASDs revealed that
family food preferences seemed to in-
fluence food selection more than the
diagnostic characteristics of autism.3
Other feeding symptoms have also
been reported. A retrospective study of
children with ASDs revealed that vom-
iting, reflux, colic, and failure to feed
were more common in those with As-
perger syndrome than in those with
other autism disorders.4
Much of the published literature has
been based on small clinical samples
with no control group, and some have
used retrospectively collected data on
feeding. We have used a population-
based cohort to investigate feeding
patterns, diet, and growth of children
with ASDs and used prospectively re-
ported data collected before the diag-
nosis of an autism disorder had been
made.
METHODS
The Avon Longitudinal Study of Parents
and Children (ALSPAC) is a longitudinal
cohort study that follows the health
and development of children who had
an expected date of delivery between
April 1991 and December 1992 and re-
sided in the Avon area of southwest
England at the time of their birth.
Mothers (n ⫽ 14 541) enrolled during
pregnancy, and those pregnancies re-
sulted in 14 062 live births, of whom
13 971 survived their first 5 years.5 Full
e338 EMOND et al
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details of the questionnaires used, the
biological samples retained, the exam-
inations, and observations of the chil-
dren are available on the ALSPAC Web
site.6 Ethical approval for the study
was obtained from the ALSPAC Law and
Ethics Committee and the local re-
search ethics committees.
Identification of Cases of ASD
The children within the ALSPAC with a
diagnosis of ASD by the age of 11 years
were identified from 2 independent
sources: (1) the clinical records of all
children in the cohort investigated for
a suspected developmental disorder
by a multidisciplinary assessment; and
(2) the national educational database
in England (Pupil Level Annual School
Census [PLASC]), which identified all
children in state schools (⬎90% of
children) who needed special educa-
tional provision because of ASDs in
2003. Details of the methods used in
the identification of ASDs and the de-
mographic characteristics of the au-
tistic children in the ALSPAC cohort
have already been reported.7 A total of
86 children were identified, giving a
prevalence of 62 per 10 000 children
aged 11 years. There were 30 children
with classical childhood autism, 15
with atypical autism, and 23 with As-
perger syndrome; 18 of the ASD cases
could not be classified. The median age
of referral was 28 months, and the me-
dian age of diagnosis of childhood au-
tism was 45 months.
Feeding and Dietary Data
Questions on the child’s feeding and
the frequency with which different
foods were eaten were included in
questionnaires completed by the main
caregiver at 6, 15, 24, 38, and 54
months. A food-variety score was cre-
ated from the food-frequency ques-
tionnaires: a total of 56 different foods
and drinks were included, and the
number of times “never” was reported
was summed to give the food-variety
score. The higher the score, the less
variety in the diet.
The content of the diet was assessed
from the food-frequency questionnaire
completed by the caregiver when the
child was 38 months of age.
Growth Data
Weight and height measurements col-
lected by health visitors as part of rou-
tine preschool-aged child health sur-
veillance were extracted from the Avon
Child Health Computer database. At the
age of 7 years, all children in the
ALSPAC were invited to a special re-
search clinic at which they were
weighed and measured.
Hemoglobin Data
Children who attended the ALSPAC re-
search clinic at 7 years of age had ve-
nous blood samples taken for hemo-
globin analysis by the HemoCue (L.E.
West, Ltd, Barking, United Kingdom)
method (n ⫽ 5859).
Statistical Analyses
Logistic regression was used to ana-
lyze associations between ASDs and
feeding patterns by using Stata 9.2
(Stata Corp, College Station, TX). Be-
cause of the strong association be-
tween gender and ASDs (odds ratio
[OR]: 6.40 [95% confidence interval
(CI): 3.42–12.14]), analyses were ad-
justed for gender. A linear relationship
was assumed for continuous variables
(food-variety score and dietary in-
takes). Effect sizes were reported for a
1-SD increase. Categorical variables
(feeding patterns) were dichotomized
according to the worst versus the rest
of the categories. Repeated measures
at different ages were analyzed simul-
taneously in a combined analysis but,
for clarity, are reported separately. In
these combined analyses, additional
adjustment was made for age, and dif-
ferences in effects across time were
assessed through an interaction test.
 ARTICLES

TABLE 1 Feeding Symptoms in Children With ASDs and Controls up to 54 Months By 24 months of age, the children with
Children With Controls, % (n) OR (95% CI) P ASDs were more likely to be having a
ASDs, % (n) different diet than the rest of their fam-
Slow feeding ily, and by 54 months 8% of the chil-
1 mo 47.3 (35) 40.0 (4894) 1.35 (0.85–2.14) .20
6 mo 40.6 (28) 30.7 (3497) 1.66 (1.02–2.69) .04 dren with ASDs were taking a special
Pooled estimate — — 1.49 (1.06–2.08) .02 diet for “allergy,” compared with 2% of
Interaction with age — — — .55 controls (OR: 3.41 [95% CI: 1.35– 8.63];
Acceptance of solids
0–3 mo 61.8 (42) 72.8 (8183) 0.60 (0.35–1.03) — P ⫽ .01). Children with ASDs were
4 mo 29.4 (20) 23.2 (2606) 1 (reference) — much more likely than controls to
ⱖ5 mo 8.8 (6) 4.0 (451) 1.93 (0.77–4.87) .004 show pica behavior at 38 and 54
Very difficult to feed
15 mo 8.1 (6) 3.4 (374) 2.71 (1.16–6.31) .02
months (Table 1).
24 mo 15.5 (11) 4.5 (467) 3.67 (1.91–7.05) ⬍.001 The food-frequency data showed that,
38 mo 11.9 (8) 5.1 (515) 2.40 (1.14–5.07) .02
compared with controls, the children
54 mo 26.2 (17) 10.0 (961) 2.90 (1.66–5.07) ⬍.001
Pooled estimate — — 2.92 (2.08–4.09) ⬍.001 in the ASD group ate fewer vegetables,
Interaction with age — — — .86 salads, and fresh fruit but also con-
Very choosy sumed fewer sweets and fizzy drinks.
15 mo 9.5 (7) 5.4 (595) 1.92 (0.87–4.21) .10
24 mo 20.0 (14) 9.5 (979) 2.45 (1.36–4.43) .003 The derived dietary data at 38 months
38 mo 28.4 (19) 14.5 (1451) 2.23 (1.30–3.81) .003 (Table 2) revealed no differences be-
54 mo 37.5 (24) 13.9 (1324) 3.47 (2.08–5.79) ⬍.001 tween children with ASDs and control
Pooled estimate — — 2.55 (1.91–3.40) ⬍.001
Interaction with age — — — .54 children in the reported intake of en-
Pica ergy, total fat, carbohydrate, proteins,
38 mo 12.3 (8) 2.3 (226) 6.09 (2.85–13.01) ⬍.001 and minerals, but the group of chil-
54 mo 12.5 (8) 0.7 (68) 21.37(9.59–47.61) ⬍.001
Pooled estimate — — 9.82 (5.66–17.03) ⬍.001
dren with ASDs had less variety in their
Interaction with age — — — .03 diet (higher variety score). The details
— indicates not applicable. of the diet are contained in the Appen-
dix, which shows that the dietary con-
tent of children with classical autism,
RESULTS that these differences were present at atypical autism, and Asperger syn-
Data on feeding and dietary patterns 15 months. From 15 months, the chil- drome were similar. Compared with
were available for 79 children with dren with ASDs had a significantly less controls, children with ASDs con-
ASDs and 12 901 controls. Actual num- varied diet, which became progres- sumed less vitamin C (P ⫽ .007) and
bers varied for each explanatory vari- sively more different than controls vitamin D (P ⫽ .004) and more iodine
able and were in the range of 64 to 74 with increasing age (interaction P ⫽ (P ⫽ .01), but estimates were impre-
for children with ASDs and 9550 to .002). The diet was least varied in chil- cise because of small sample sizes
12 249 for controls. dren with classical autism (Fig 1). At 38 within some groups.
months the food-variety score was
No group differences were apparent in There were no group differences be-
normally distributed, with a mean of
maternal diet during pregnancy, tween children with ASDs and controls
21 (SD: 6; range: 2– 48).
breastfeeding rates, or infant food- in mean weight, height, or BMI at 18
variety score at 6 months. In infancy, months and 7 years. Although children
the children subsequently diagnosed 4.0 Classical autism with ASDs had slightly lower mean hemo-
3.5 Other types of ASDs
with ASDs were more likely than con- b globin levels (122.7 vs 124.5 g/L), this dif-
3.0
trols to have late acceptance of solid ference was not significant (P ⫽ .320).
Odds ratio

2.5
food (P ⫽ .004) and to be described by 2.0
a a

their mothers as “slow feeders” (P ⫽ 1.5 DISCUSSION

.02) (Table 1). 1.0
The results of this prospective study
0.5
Between 15 and 54 months of age, the show that children on the autism spec-
0.0
children with ASDs were consistently 6 mo 15 mo 24 mo 38 mo trum demonstrated feeding symptoms
age
reported to be difficult to feed (P ⬍ from infancy and had a progressively
FIGURE 1
.001) and very choosy (P ⬍ .001). Re- Food-variety score and type of ASD (odds ratio less varied diet from 15 months of age.
sults of combined analyses suggested for a 1-SD increase). ap ⬍ .05, bp ⬍ .01. However, energy intake and growth

PEDIATRICS Volume 126, Number 2, August 2010 e339

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TABLE 2 Dietary Consumption at 38 Months in Children With ASDs Compared With Controls
ASDs (n ⫽ 64)
OR 95% CI
Variety score 1.84 1.48–2.29
Energy 0.98 0.77–1.26
Total fat 1.01 0.79–1.29
Protein 0.93 0.72–1.19
Carbohydrates 0.97 0.76–1.24
The variety score is derived from 56 food-frequency questionnaire questions and reflects the number of times that “never” was reported. The logistic regression analyses adjusted for
gender. ORs are for a 1-SD increase. Controls: n ⫽ 9796.
were not impaired. The limitation in
number of foods accepted was most
apparent in children with classical au-
tism, but no other differences were ap-
parent between different types of au-
tism disorders in feeding symptoms,
diet, or growth.
The strengths of the study are that the
sample is population based, which
provides a good normal comparative
group and that feeding data have been
collected prospectively before ASD
was diagnosed. Limitations are that
ASDs in the children were diagnosed
by clinical teams rather than by a
structured research assessment, and
the feeding and dietary data were re-
ported by the mother with no objective
validation.
The finding that breastfeeding rates of
the children with ASDs were no differ-
ent than those of controls is consistent
with the results of an earlier study
from North Dakota.8 The difficulty in ac-
cepting solids and the description of
slow feeding in infancy could be seen
as early symptoms of an autistic
child’s difficulty in accepting change.
Other feeding symptoms such as fuss-
iness became more obvious with in-
creasing age and are most marked in
the children with classical autism. The
restrictions in types of food accepted
by the child with an ASD were apparent
from 15 months of age, often before
referral for specialist autism assess-
ment, and became progressively more
obvious.
A clinical implication of these findings
is that the possibility of an ASD should
e340 EMOND et al
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Classical Autism (n ⫽ 23)
P OR 95% CI P OR
⬍.001 2.25 1.59–3.20 ⬍.001
.894 0.72 0.45–1.13 .154
.926 0.78 0.50–1.21 .260
.545 0.69 0.44–1.09 .110
.837 0.70 0.44–1.11 .131
be considered for young children who
present with feeding problems, perva-
sive food refusal, and limited food pref-
erences, and appropriate questions
should be asked about the child’s so-
cial communication, shared attention,
and stereotypic and self-stimulatory
behaviors.
For children who have ASDs and perva-
sive eating problems, effective behav-
ioral strategies need to address both
the neophobia and sensory sensitivi-
ties (color, taste, texture) of the autis-
tic child. Tools such as the Brief Autism
Mealtime Behavior Inventory (BAMBI)9
have been developed to assess feeding
problems in children with ASDs and
provide a useful objective measure to
monitor response to behavioral inter-
ventions to improve the range of foods
taken.
Clinicians and parents will be reas-
sured by the finding that, despite the
limited food preferences, the children
with ASDs took adequate amounts of
energy from their diet and grew nor-
mally. No differences were found be-
tween children with ASDs and their
peers in the balance of carbohydrates,
protein, and fats consumed, which
suggests that satiety mechanisms are
not impaired in ASDs. No differences
were apparent in minerals in the diet,
including iron and calcium. Our results
are consistent with those of recent de-
scriptive studies that also found that,
although the parents of children with
ASDs reported that they were picky
eaters and resisted trying new foods,
the measured nutrient intake of the
Atypical Autism (n ⫽ 11) Asperger Syndrome (n ⫽ 17)
95% CI P OR 95% CI P
1.36 0.78–2.36 .279 1.95 1.29–2.96 .002
1.14 0.66–1.97 .638 0.97 0.60–1.55 .884
1.18 0.69–2.04 .542 1.00 0.63–1.60 .997
1.19 0.69–2.07 .531 0.98 0.61–1.58 .947
1.08 0.62–1.89 .782 0.91 0.56–1.48 .715
children with ASDs was similar to that
of age-matched controls.10
With ⬎30 dietary components being
compared, some associations may be
have been a result of chance, so the
finding that 2 vitamins were reduced in
the ASD diet needs to be treated with
caution. The lower vitamin C intake is
derived from the lower consumption by
the children with ASDs of fruits and veg-
etables reported in the food-frequency
questionnaires. However, the children
with ASDs had similar iron intake and
hemoglobin levels to those of con-
trols. The children with ASDs also
less frequently accepted dietary
sources of vitamin D and had more
iodine in their diet, but the clinical
significance of these findings is un-
certain. In comparison, a recent
smaller, detailed study that com-
pared 3-day dietary diaries of chil-
dren with ASDs and children with typ-
ical development11 revealed that
children with ASDs consumed more
vitamins B6 and E and nondairy pro-
tein but less calcium with fewer
dairy servings.
A few autistic children in the ALSPAC
were placed on special diets after the
diagnosis of ASD had been made, with
the parents citing allergy as the rea-
son for the diet, but we did not have
information on how food allergy was
diagnosed. The dietary changes may
have been made in response to the
gastrointestinal symptoms that are re-
ported for autistic children12–15 or to
attempt to improve core autistic be-
haviors such as ability to communi-

cate. Although many parents of chil-
dren with ASDs do try special diets
for their children, a recent update of
a Cochrane review on gluten- and
casein-free diets in children with
ASDs concluded that the evidence for
the efficacy of these diets remains
poor.16
The normal dietary consumption of en-
ergy by the children with ASDs in our
study is reflected in their normal
growth parameters, consistent with
the literature on growth in children
with autism disorders.17 However, in
some societies, children with autism are
at higher risk of being overweight.18
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CONCLUSIONS
Children on the autism spectrum dem-
onstrated feeding symptoms from in-
fancy and had a less varied diet from
15 months of age, but energy intake
and growth were not impaired. Feed-
ing behavior in children with ASDs re-
flects limited interests and difficulty in
accepting change and, in an extreme
form, can present as a “pervasive eat-
ing disorder.”
ACKNOWLEDGMENTS
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Wellcome Trust, and the University of
Bristol provide core support for the
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ARTICLES
ALSPAC. This study was funded by the
Medical Research Council: all research-
ers on this study are independent from
the funding body, and there are no com-
peting interests to declare. This publica-
tion is the work of the authors, and Drs
Emond and Steer will serve as guaran-
tors for the contents of this article.
We are extremely grateful to all the
families who took part, the midwives
for help in recruiting them, and the
whole ALSPAC team, which includes in-
terviewers, computer and laboratory
technicians, clerical workers, re-
search scientists, volunteers, manag-
ers, receptionists, and nurses.
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of chronic gastrointestinal symptoms in
children with autism and autistic disorders.
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e341
APPENDIX Details of the Diet of Children With ASDs at 38 Months Compared With Controls
ASDs (n ⫽ 64) Classical Autism (n ⫽ 23) Atypical Autism (n ⫽ 11) Asperger Syndrome
(n ⫽ 17)
OR 95% CI P OR 95% CI P OR 95% CI P OR 95% CI P
Calcium 1.04 0.69–1.57 .842 1.35 0.67–2.75 .399 0.52 0.19–1.42 .202 0.92 0.41–2.06 .843
Carotene 0.74 0.56–0.99 .042 1.12 0.74–1.69 .603 0.62 0.29–1.29 .198 0.64 0.35–1.15 .136
Cholesterol 0.89 0.64–1.22 .467 0.70 0.38–1.27 .241 1.00 0.49–2.06 .990 1.60 0.97–2.62 .065
Omega-3 from fish 0.85 0.63–1.13 .265 0.97 0.62–1.53 .903 1.04 0.57–1.88 .903 1.02 0.62–1.68 .947
Docosahexaenoic acid 0.73 0.52–1.01 .061 0.98 0.62–1.54 .925 0.77 0.36–1.64 .494 0.83 0.46–1.49 .537
Eicosapentaenoic acid 0.80 0.59–1.09 .163 0.96 0.60–1.52 .847 0.96 0.51–1.81 .904 0.96 0.57–1.62 .878
Folate 0.74 0.51–1.07 .111 0.61 0.32–1.19 .148 1.04 0.45–2.43 .927 1.13 0.56–2.29 .725
Iodine 1.61 1.12–2.31 .010 1.42 0.73–2.74 .303 1.76 0.76–4.11 .189 2.42 1.28–4.56 .006
Iron 0.93 0.61–1.42 .733 0.79 0.37–1.71 .553 1.44 0.56–3.67 .449 0.78 0.33–1.82 .566
Magnesium 1.20 0.81–1.77 .358 1.23 0.62–2.46 .551 1.55 0.64–3.74 .326 0.95 0.43–2.06 .889
Monounsaturated fat 0.95 0.52–1.76 .880 1.01 0.34–2.98 .983 1.36 0.34–5.43 .665 0.97 0.30–3.18 .964
Niacin 0.81 0.53–1.23 .319 0.68 0.32–1.44 .317 1.25 0.49–3.15 .643 0.97 0.44–2.16 .943
Non–milk-extrinsic sugar 1.01 0.70–1.45 .961 0.88 0.44–1.78 .727 0.97 0.43–2.21 .946 0.62 0.28–1.39 .246
Fiber 1.12 0.81–1.54 .490 1.20 0.69–2.10 .522 1.70 0.86–3.37 .129 0.84 0.44–1.62 .606
Phosphorus 1.12 0.69–1.84 .640 1.23 0.51–2.93 .647 1.10 0.35–3.44 .871 1.04 0.40–2.69 .941
Polyunsaturated fat 0.87 0.64–1.20 .399 0.56 0.31–1.02 .059 1.28 0.65–2.54 .476 0.82 0.44–1.51 .519
Potassium 0.95 0.59–1.52 .819 0.95 0.41–2.20 .909 1.10 0.37–3.29 .869 0.91 0.36–2.27 .833
Retinol 1.02 0.75–1.37 .922 0.80 0.41–1.59 .530 1.46 1.09–1.96 .012 0.92 0.47–1.79 .800
Riboflavin 1.07 0.74–1.56 .709 1.12 0.58–2.16 .746 0.89 0.37–2.16 .792 1.00 0.48–2.08 .944
Saturated fat 1.34 0.85–2.11 .203 1.87 0.87–4.01 .110 1.15 0.39–3.37 .803 1.32 0.55–3.17 .538
Selenium 1.17 0.85–1.61 .349 1.13 0.63–2.03 .677 1.49 0.74–3.02 .263 1.35 0.74–2.48 .333
Sodium 1.02 0.63–1.66 .930 0.61 0.26–1.46 .267 2.51 0.85–7.48 .097 1.63 0.64–4.14 .308
Starch 1.05 0.68–1.63 .811 0.98 0.43–2.20 .957 1.04 0.39–2.75 .941 1.53 0.68–3.45 .305
Sugar 0.92 0.59–1.43 .698 0.92 0.40–2.10 .847 0.67 0.24–1.89 .452 0.51 0.20–1.27 .148
Thiamin 0.77 0.51–1.15 .206 0.83 0.41–1.70 .619 0.79 0.31–2.01 .618 0.70 0.32–1.55 .378
Vitamin C 0.65 0.47–0.89 .007 0.69 0.41–1.18 .176 0.87 0.45–1.69 .679 0.48 0.23–0.98 .043
Vitamin B6 0.58 0.38–0.89 .012 0.50 0.24–1.05 .069 0.65 0.24–1.73 .386 0.85 0.38–1.92 .702
Vitamin B12 0.90 0.65–1.25 .536 0.84 0.47–1.51 .557 1.22 0.62–2.40 .565 1.19 0.67–2.13 .548
Vitamin D 0.63 0.46–0.86 .004 0.48 0.27–0.84 .011 0.63 0.30–1.33 .229 0.95 0.53–1.70 .866
Vitamin E 0.85 0.63–1.14 .279 0.55 0.30–0.98 .044 1.13 0.59–2.18 .713 0.75 0.41–1.36 .339
Zinc 1.02 0.67–1.58 .911 1.07 0.50–2.30 .863 1.22 0.45–3.33 .695 0.92 0.40–2.13 .844
The variety score is derived from 56 food-frequency questionnaire questions and reflects the number of times that “never” was reported. Logistic regression analyses were adjusted for
gender (and energy, except for energy, total fat, protein, and variety). ORs are for a 1-SD increase. Controls: n ⫽ 9796.

e342 EMOND et al
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 Feeding Symptoms, Dietary Patterns, and Growth in Young Children With
Autism Spectrum Disorders
Alan Emond, Pauline Emmett, Colin Steer and Jean Golding
Pediatrics; originally published online July 19, 2010;
DOI: 10.1542/peds.2009-2391
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Feeding Symptoms, Dietary Patterns, and Growth in Young Children With
Autism Spectrum Disorders
Alan Emond, Pauline Emmett, Colin Steer and Jean Golding
Pediatrics; originally published online July 19, 2010;
DOI: 10.1542/peds.2009-2391

The online version of this article, along with updated information and services, is
located on the World Wide Web at:
http://pediatrics.aappublications.org/content/early/2010/07/19/peds.2009-2391

PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly

publication, it has been published continuously since 1948. PEDIATRICS is owned,
published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point
Boulevard, Elk Grove Village, Illinois, 60007. Copyright © 2010 by the American Academy
of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.

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