Despite longstanding clinical experience of unusual feeding difficulties in children with autism, there is no published literature describing their association with early onset FTT. This paper examines literature that may link feeding problems and abnormal growth with developmental and psychiatric conditions and describes seven cases of children with autism, who showed growth failure caused by severe feeding problems starting in the first year of life. Inadequacies in existing classifications systems are highlighted. The presence of severe or atypical feeding problems and FTT in infancy should alert professionals to possible underlying ASD. The aetiology of feeding disorders in autism appears to involve an unusually complex interactional model with biological vulnerabilities due to dysfunction in sensory, cognitive and emotional response interacting with dysfunctional attachment and learnt behaviours to produce a severe and intractable problem. Effective treatment therefore requires a novel multifaceted approach that can address each of these areas.