Eating disorders in children with autism spectrum disorder (ASD) are multifactorial and complex, and impair their quality of life. The link between eating difficulties and ASD is still controversial, and few studies have focused on very young children with ASD.

Our objectives were: 1) to characterize the eating disorders of ASD children under 4 years; 2) to study the links between these eating disorders and the characteristics of the child (symptoms and severity of ASD, level of development).

33 ASD children (18 months to 4 years) were included. Their developmental level was assessed by the Brunet-Lézine Revised test (BL-R) and characteristics of ASD by the Autism Diagnosis Interview-Revised (ADI-R). We used a new questionnaire on eating disorders of children between 9 months and 6 years of age that covered 4 dimensions: eating behavior, oro-motor skills, oral and bodily sensory characteristics, and parental impacts and strategies.

70 % of parents declared eating disorders in their child, with an early frequent onset beyond 12 months of age. These disorders caused significant parental suffering and worries about the future in two-thirds of parents, and more than half of the parents implemented strategies to handle them. We found two striking results: 1) No statistical link was observed between the severity of an eating disorder and the severity of ASD symptoms or the child's developmental level; 2) Children with better communication and socialization levels had more eating disorders.

These results show that eating disorders in our population are probably linked with the relational nature of the act of eating.