Early neurodevelopmental problems and risk for avoidant/restrictive food intake disorder (ARFID) in 4‐7‐year‐old children: A Japanese birth cohort study

JCPP Advances · 10 authors, 9 centres

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TL;DR

Early feeding problems were common but rarely predicted ARFID, whereas broader neurodevelopmental problems were more predictive.

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This prospective birth cohort study used data from a sub-sample of the Japan Environment and Children's Study (JECS) to examine whether early neurodevelopmental problems (NDPs) predict suspected ARFID in 4–7-year-old children. ARFID was identified cross-sectionally at age 4–7 years using a newly developed screening tool. Children in the highest risk decile of the composite NDP risk score had an absolute ARFID risk of 3.1% compared to 1.1% below that threshold, representing roughly three times higher odds. Early NDPs excluding feeding problems were more predictive of later ARFID than early feeding problems, though the total explained variance was small at 3.2%. Specific predictive NDPs included problems with general development, communication/language, attention/concentration, social interaction, and sleep. Neurodevelopmental trajectories diverged after age 1 year. Key limitations include reliance on a newly developed, not yet fully validated screening tool for ARFID, a small ARFID subsample limiting statistical power, parent-report-only data on NDPs, and a 56.6% response rate with potential healthier-responder bias.

STUDY TYPE

cohort

SPECIALTY

pediatrics

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ORIGINAL PAPER

PMC10242837

Early neurodevelopmental problems and risk for avoidant/restrictive food intake disorder (ARFID) in 4‐7‐year‐old children: A Japanese birth cohort study

JCPP Advances

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ABSTRACT

Abstract Background An overrepresentation of neurodevelopmental problems (NDPs) has been observed in individuals with avoidant/restrictive food intake disorder (ARFID). Previous studies on the association between ARFID and NDPs have been limited by cross‐sectional data from clinical samples of small size. This study aimed to extend previous research by using prospectively collected data in a non‐clinical child cohort. We examined the occurrence of early NDPs in 4–7‐year‐old children with suspected ARFID and how predictive early NDPs are of ARFID. Methods Data were collected via parent‐report a sub‐sample of the Japan Environment and Children's Study (JECS) including 3728 children born 2011–2014 in Kochi prefecture. NDPs were assessed biannually between 0.5 and 3 years of age with the Ages and Stages Questionnaire‐3, at age 2.5 years with the ESSENCE‐Q, and at age 1 and 3 years via parent‐reported clinical diagnoses. ARFID was identified cross‐sectionally (at age 4–7 years) using a newly developed screening tool. Logistic regressions were used to test association of (1) a composite early NDP risk score, (2) specific early NDPs, and (3) neurodevelopmental trajectories over time with ARFID. Results Children in the highest risk percentiles of the NDP risk score had roughly three times higher odds of having suspected ARFID; the absolute risk of later ARFID for children above the 90th percentile was 3.1%. Early NDPs (excluding early feeding problems) were more predictive of later ARFID than were early feeding problems. Specific NDPs predictive of ARFID were problems with general development, communication/language, attention/concentration, social interaction, and sleep. Neurodevelopmental trajectories of children with and without suspected ARFID started to divert after age 1 year. Conclusions The results mirror the previously observed overrepresentation of NDPs in ARFID populations. In this non‐clinical child cohort, early feeding problems were common and rarely developed into ARFID; however, our findings imply that they should be monitored closely in children with high NDP risk to prevent ARFID. Keywords: attention‐deficit/hyperactivity disorder, autism spectrum disorder, eating disorder, Japan Environment and Children's Study (JECS), neurodevelopmental disorders

CITATION EXPORT

Lisa Dinkler, Kahoko Yasumitsu‐Lovell, Masamitsu Eitoku et al.. Early neurodevelopmental problems and risk for avoidant/restrictive food intake disorder (ARFID) in 4‐7‐year‐old children: A Japanese birth cohort study. JCPP Advances. (2022). https://doi.org/10.1002/jcv2.12094

AUTHORS

10 · 9 CENTRES

Lisa Dinkler, Kahoko Yasumitsu‐Lovell, Masamitsu Eitoku, Mikiya Fujieda, Narufumi Suganuma, Yuhei Hatakenaka, Nouchine Hadjikhani, Rachel Bryant‐Waugh, Maria Råstam, Christopher Gillberg

1 Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
2 Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
3 Department of Pediatrics, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
4 Faculty of Humanities and Social Sciences, University of the Ryukyus, Nishihara, Okinawa, Japan
5 Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
6 Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
7 Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
8 Department of Clinical Sciences Lund, Lund University, Lund, Sweden
9 Department of Psychiatry, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan