Neuropsychological profiles of children and adolescents with selective eating in the presence or absence of elevated autistic traits

Selective eating (SE) refers to an individual narrowing their range of preferred foods, resulting in a restricted food intake, high levels of rigidity and food refusal (Bryant-Waugh, 2000). SE is encompassed in the new Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V) (American Psychiatric Association, 2013) category avoidant restrictive food intake disorder (ARFID). Such difficulties are common in children with an autism spectrum disorder (ASD) (Raiten & Massaro, 1986) and neuropsychological differences have been found in children with ASD (Hill, 2004). This research aimed to be the first to investigate whether a distinct neuropsychological profile exists in children and adolescents with SE and furthermore, whether aspects of the profile vary depending on whether the child or adolescent displays elevated autistic traits. A case series of 10 children between the ages of 8 to 13 years old were recruited. A well-established neuropsychological test battery, the Ravello Profile (Rose, Frampton & Lask, 2012), was modified and administered to assess visuospatial processing, central coherence, executive functions (including cognitive flexibility, inhibition and planning) and theory of mind abilities. The results demonstrated a high degree of variability across the group in terms of visuospatial processing and theory of mind, weak central coherence across all participants and otherwise relatively intact abilities in executive function domains. There were no substantive findings in relation to those children with elevated autistic traits although a trend toward visuospatial processing differences did emerge. This exploratory case series was the first attempt to describe a neuropsychological profile in SE, however the small sample size and high variability in the data meant that a distinct neuropsychological profile did not emerge. The results did however provide an initial indication of possible trends in strengths and weaknesses across neuropsychological domains in SE. These findings have implications for the assessment and treatment of SE difficulties.