Sensory feeding problems, pica-related behaviors, and sleep habits among children with autism spectrum disorder in palestine: a parent-reported cross-sectional study
Abstract
Background: Autism Spectrum Disorder (ASD) is commonly associated with feeding difficulties and sleep disturbances, yet their co-occurrence remains understudied in Arab and Palestinian contexts. Pica and broader pica-related sensory feeding behaviors are among the most clinically significant feeding problems in children with ASD, carrying serious health risks. This study examined the level of parent-reported sensory feeding problems, pica-related behaviors, and sleep habit disturbances in children with ASD attending care centers in the West Bank, Palestine, and explored their association.
Methods: A cross-sectional descriptive-correlational survey was conducted. A convenience sample of 105 parents of children with ASD was recruited from care centers in the West Bank during August 2025. Two instruments were used: a 20-item literature-informed Sensory Feeding/Pica-Related Behaviors Scale developed for this study, and a 21-item Sleep Habits Scale adapted from the Arabic scale developed and validated by Al-Merdasi. The feeding scale underwent expert content review and pilot testing, while internal consistency was assessed for both instruments in the present sample. The feeding scale was designed to describe caregiver-reported sensory feeding difficulties and pica-related behaviors rather than to establish a DSM-5-TR or ICD-11 diagnosis of pica. All sleep items were coded so that higher scores indicated greater sleep disturbance; sleep adequacy items were reverse-scored. Data…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 105 participants or records.
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