Selective eating in autism

Feeding disorders in toddlers and preschool children

According to the guideline, there is no evidence for the use of specific therapy methods to treat feeding disorders in autism in toddlers. For treating feeding disorders in children of this age group, the recommendations of the DGKJP’s S2k guideline “Mental disorders in infancy, toddlerhood and preschool age” should be implemented (consensus-based recommendation, strong consensus). ^{[1, Rec. 97]} The guideline described this as “under revision”.

Parent training

Parents of children with autism can be offered participation in a disorder-specific, behaviour-based parent training if the child has a feeding disorder. The recommendation has grade of recommendation 0 (open) and rests on evidence level 3, that is, on a weak body of studies. ^{[1, Rec. 98]} This means: it can be an offer, but it is not a well-established standard solution.

Eating disorders in children, adolescents and adults

For treating additional eating disorders, according to the guideline the recommendations of the AWMF S3 guideline “Diagnosis and treatment of eating disorders” should be implemented, taking into account fundamental aspects of the therapeutic approach to people with autism. Early (part-)inpatient therapy should be considered if no success is seen within two to three months of outpatient treatment. ^{[1, Rec. 99]}

What else you should know

• Have it medically assessed if it becomes serious. For example in the case of weight loss, deficiency symptoms or great distress around eating: talk to the paediatric or GP practice. This is a recommendation for action by the editorial team, not derived from the guideline.
• Connection with perception. How taste, smell and texture are experienced can play a role; more on this: Sensory processing and perception.
• Concrete tips and diets (for example supplements or special forms of diet) are not covered here, because the guideline recommended nothing on them.
• Sleep and co-occurring conditions are also part of the overall picture: Sleep problems in autism, Common co-occurring conditions.

Sources and literature

1. DGKJP, DGPPN et al. Autismus-Spektrum-Störungen im Kindes-, Jugend- und Erwachsenenalter. Teil 2: Therapie. S3-Leitlinie, AWMF-Reg.-Nr. 028-047, Stand Text 02.05.2021 (Kap. C.7.8; Empf. 97, 98, 99). – Guideline (in German); expired on 23 March 2026 (see no. 2)
2. DGKJP. Aktuelle Leitlinien (Eintrag 028-047: „Gültig bis 23.03.2026“). https://www.dgkjp.de/wissen/aktuelle-leitlinien/ – Professional society (website in German)