Discovering the link between eating disorders and autism

Becoming a researcher was no surprise to her parents, Pauline explains. "I always asked many questions. Even at school, I always wanted to better understand how things work. As a people’s person, I find it interesting to discover why people behave the way they do."

Generation R

Pauline researches the origins of mental health problems in childhood. What are the risk factors for autism, depression or eating disorders? And can we predict mental health problems in adolescents? She uses data from a study that started in 2001 and is still ongoing: Generation R. It is a study on the growth, development and health of children growing up in Rotterdam. "We follow them since early pregnancy and continue to do so until they are adults. And we try to answer the question why one child develops optimally while another child does not or develops problems," Pauline explains.

ARFID

Using the data, for instance, she discovered a correlation between eating behaviour and common mental health problems in childhood. Pauline: "Half of all children go through a phase in which they find show selective eating behaviour. This is normal. Often, before they are six, this fades naturally. But some children continue to have difficulties with eating even after the age of six, sometimes resulting in an eating disorder." One example is the Avoidant Restrictive Food Intake Disorder (ARFID). People with ARFID have a very selective eating pattern which may even affect their health. If your food intake is not enough or notvaried enough, you have an increased risk of becoming underweight and are more likely to, for example, suffer from constipation symptoms. ARFID can also make you dread eating out. Christmas dinner with the family? Rather not. However, a lot of this discomfort may actually be preventable. It helps if you notice it in time, says Pauline. "By handling eating problems early on, we can help children and their caretakers before it becomes an ingrained, often stressful pattern. The great benefit of this research is that we can help people earlier with the (eating) problems they encounter in their lives."

Eating behaviour and autism

In addition, Pauline discovered that ARFID-like problems often occur in children with autism. The sensory sensitiveness and need for predictability that individuals with autism relatively often have may also be expressed in eating habits. "So eating behaviour can also be a signal of autism, a characteristic we might use to recognize autism more easily. Particularly women with autism may benefit from this, because, in women, the classical, social autism traits are often less visible, while they often do experience difficulties with eating," Pauline says. "Knowing you have autism can help to better understand additional problems. Also, eating problems. It helps you learn to cope with it."

Enjoying the interests of students

Pauline also recognizes her interest in people and their behaviours among her students in the Master program of Clinical Child and Adolescent Psychology. And she can genuinely enjoy that. "If you want to work as a child psychologist, this Master is an excellent preparation. What I really like is when students take the initiative themselves. For example, when they come up to me with a research question for their Master thesis that they want to investigate with the data from Generation R.  I can see that they want to know more, that they are curious. And then a world opens up for them because there is so much data available in this study!"