BackgroundAutistic children experience disproportionately high rates of malnutrition compared to non-autistic (NA) peers. Sensorimotor integration differences (SMD), prevalent in 69–95% of autistic individuals, are hypothesized to drive this disparity. SMD contributes to core autistic traits that exacerbate feeding difficulties (e.g., food selectivity), potentially leading to malnutrition and gut dysbiosis. Current caregiver-reported SMD assessments lack validity in autistic populations and are