Associations Between Behavioral Inflexibility, Sensory Sensitivity, and Feeding Problems in a Clinical Sample

Keith E. Williams, Whitney Adams, Kristin Sanchez, Helen Hendy

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Past research suggests that children, particularly those with autism spectrum disorder, with general behavioral inflexibility to objects, persons, and environments may be at risk for feeding problems. However, questions remain about whether feeding problems are better predicted by behavioral inflexibility or sensory sensitivity, and whether general or food-specific measures are stronger predictors. The present study compared two types of behavioral inflexibility (general, food-specific) and two types of sensory sensitivity (food touch, temperature) for their association with children’s feeding problems. Participants were 372 children and their parents who completed surveys on their children’s demographics, as well as measures of behavioral inflexibility, sensory sensitivity, and feeding problems. The children, all referred to a feeding clinic were 71.8% male and had a mean age of 71.53 months. For this sample, 33. 7% had autism spectrum disorder (ASD), 28.7% had special needs other than ASD, and 37.5% had no special needs. ANCOVAs examined child demographics (age, weight status, medical problems, gender, special needs status) for their associations with each measure of inflexibility and sensitivity, finding that ASD was associated with more general and food-specific inflexibility, and younger age was associated with more food touch sensitivity. Hierarchical multiple regressions, which controlled for demographics, including ASD diagnosis, compared the four measures of inflexibility and sensitivity as predictors for each feeding problem. These analyses found food-specific behavioral inflexibility was the only significant predictor of all three feeding problems. Results suggest reducing the severity of children’s feeding problems, clinicians focus on increasing behavioral flexibility as it relates to food.

Original languageEnglish (US)
Pages (from-to)589-605
Number of pages17
JournalJournal of Developmental and Physical Disabilities
Issue number4
StatePublished - Aug 2023

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Developmental and Educational Psychology


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