Could this be a feeding disorder?

[jillsn]

My daughter has Autism and, as a result of her sensory issues, only eats an extremely limited number of foods.  She will not eat in unfamiliar or "smelly" places (many food smells bother her).  She will not eat foods that are broken (crackers, french fries), the "wrong" temperature, or the "wrong" color.  She will actually go very long periods of time without eating before she will eat something that she deems "wrong."  For years she stayed at the bottom end of a normal weight range, so I didn't worry much about the food issues beyond keeping a good supply of her preferred foods around.  She took Risperdal for just over two years and went off of it in early March, 2009 (due to sedating side effects).  She has taken 25 mg daily of Strattera for a year and a half, and still takes it.  Since she went off the Risperdal, her weight has dropped steadily (from 54 lbs to 51 lbs).  Her "stimming" consists of running in short little bursts, so she's constantly expending energy.  Incidentally, despite all of her movement, she has very low muscle tone.  I've  voiced my concerns to her neurologist and pediatrician, but both tell me that she's thin, but not underweight (but they always weigh her fully clothed, with sneakers on).  I've been looking up eating and feeding disorders online, and she doesn't seem (to me) to fit the bill for either one.  However, she is definitely underweight.  I'm starting to worry, as she's been getting leg cramps, she has dark circles under her eyes, her skin is always cold to the touch, and she recently started taking daytime naps.  Her height hasn't increased at all since the last time I measured (2 months ago), but this may be normal.  Should I be seeking out some kind of treatment for her food issues?  Would a private occupational therapist offer treatment for this kind of thing?  Her school district canceled their Autism summer program this year, so I don't have access to her school therapists until the fall.

[Renee Radenberg]

She is still a child and growth charts should be used to determine her growth patterns. If she has not grown or gained weight for a certain length of time, that is important regardless if she is within the growth chart. If you are concerned about the issues you described, suggest having blood work done. All the best to you.

[jillsn]

I was under the impression that she is underweight based on her BMI.  (http://apps.nccd.cdc.gov/dnpabmi/)  Should I not worry about that and go by growth charts instead?  It's kind of confusing to me how one says normal and one says underweight!  In any event, we have an appointment with her pediatrician on Thursday.  If we can't get O.T., at the very least I'll make sure that she's getting the nutrients she needs.  Thank you for your time and thoughts.

[Renee Radenberg]

Her weight is just below the 10th percentile and her height is just below the 50th percentile for her age. She is still in the growth chart which is considered normal for her age. Suggest getting blood work on her levels of her vitamins and minerals. In the meantime, suggest giving her a chewable daily children's multi-vitamin, if she will accept it, due to her eating habits.