Journal des troubles de la communication, des études sur les sourds et des aides auditives
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"Changes in Food Selectivity": Evolution towards Self-Induced Vomiting in a Boy with Autism Spectrum Disorder

Pia Bernardo, Maria Pia Riccioa, Maria Marinoa, Marco Poetab, Messina Antonioa, Annamaria Staianob and Carmela Bravaccioa

Introduction: Food selectivity (FS) is a common problem in Autism Spectrum Disorders (ASD) for its negative impact on nutrient adequacy, mealtime behavior problems, spousal stress, and food choices for all family. The majority of research on FS in ASD is focused on early childhood. However, the symptoms may persist into adulthood.

Methods: Here, we describe the history of 17 years old boy with ASD, early onset of FS, gastrointestinal dysfunction and recent onset of self-induced vomiting. We report the clinical, instrumental and therapeutic approach in a boy with ASD. We reviewed the literature; the keywords were “food selectivity”, “eating disorders”, “feeding problems” in ASD. Inclusion criteria were studies written in English and in which children were the subjects of the study.

Results: The patient showed a peculiar evolution of FS, towards an eating disorder characterized by self-induced vomiting. During the clinical course presented weight loss, cachexia, dehydration and electrolytes alterations. A rehydration was necessary. Pharmacologic treatment with aripiprazole and intensive behavioural intervention helped the resolution of self-induced vomiting, but not the complete resolution of the FS.

Conclusion: The case of our patient suggests further scenarios of FS evolution, up to strong complex and difficult to treat food behaviour: the self-induced vomiting.