The Chewing Challenge: Linking Oral Motor and Oral Sensory Skills to Feeding Difficulties in Autism

Introduction: Nearly 60% of children with autism exhibit chewing difficulties, yet the specific nature and the contributing factors remain underexplored. Understanding these factors is vital for effective management. The present study aimed to compare chewing skills between children with autism and typically developing peers and to examine its relationship with the age of acquisition of early feeding milestones, oral sensory and oral motor skills, food neophobia, and food selectivity. Methods: Sixty children (30 autism and 30 neurotypical), aged 4–10 years, were assessed for chewing skills using the Mastication Observation and Evaluation instrument . Parent interviews provided data on feeding milestones. Oral sensory and oral motor skills were assessed via the Child Sensory Profile 2 and the Com DEALL Oro-Motor Assessment , while food neophobia and food selectivity were evaluated using the Modified Child Neophobia Scale and a food inventory. Results: Children with autism exhibited significantly reduced chewing skills compared to typically developing children. Chewing difficulties were associated with delayed transition to textured, finger and regular foods, atypical oral sensory processing, immature oral motor skills, food neophobia, and food selectivity. Conclusion: Findings underscore chewing dysfunction in autism, linked to delays in feeding milestones, sensory integration challenges, oral motor immaturity, and dietary restrictions. These results highlight the need for comprehensive management addressing sensory, motor, and dietary factors to improve chewing abilities.