Children everywhere have a well-earned reputation for picky eating: They can be selective and often strangely uniform in what they consume, perhaps eating only chicken nuggets or cereal for every meal.

Children with autism are even more notorious for their extreme eating habits. This can be a source of frustration and worry for parents, who find themselves prepping special meals. It also raises questions about whether picky eating is an indicator of other autism features, such as restricted interests, or contributes to the gastrointestinal distress seen in some children with the disorder.

A new study, published 18 May in Appetite, found no physical or behavioral differences between children with autism who are picky eaters and those who have more diverse diets. It did, however, uncover some interesting differences in the mindsets of their parents.

“Parents of children with food selectivity seem to perceive that their child has more difficulty with behavioral and emotional problems,” says Valentina Postorino, a postdoctoral fellow in neuroscience at Children’s Hospital Bambino Gesù in Rome, Italy.

Postorino and her colleagues studied 158 children with autism, half of whom are picky eaters. They assessed the children’s autism symptoms, intelligence quotients (IQ), behavioral problems, life skills such as being able to dress themselves, and physical well-being. The researchers also surveyed the children’s parents about their stress levels and perceptions of their children’s symptoms.

They found that picky and adventurous eaters have similar rates of behavioral problems and gastrointestinal issues. They’re also similar on measures of life skills and IQ.

But parents of picky eaters perceive their children to be significantly more impaired by their autism symptoms than do parents of more typical eaters. They also report higher levels of personal stress. “The differences that we found were all in the perceptions by parents,” Postorino says.

The findings reinforce the notion that picky eating takes an emotional toll on parents of children with autism. They jibe with those of another study, published 13 June in the Journal of Autism and Developmental Disorders, in which researchers compared the mealtime habits of 53 children who have autism with the habits of 58 typically developing children. Parents of the children with autism reported more behavioral problems around the table, such as tantrums and refusal to eat, and higher levels of stress.

Although the root cause of picky eating in autism remains unknown, the studies highlight the need for treatments that alleviate mealtime stress for children with autism and their families. Postorino and her colleagues are developing an intervention that they plan to test later this year. The hope, she says, is to improve the situation for everyone at the table.