Parents of children with autism know eating issues all too well. From mealtime tantrums to picky food preferences, dealing with the eating issues that may come with autism can be a major stressor. However, be assured that these issues can be solved by seeking support, establishing routine, and practicing a lot of patience.
Eating Issues Related to Autism
Food selectivity
Children with autism often have selective food preferences. According to our Vice President of Clinical Operations, Jennifer Thomas, Ph.D., BCBA-D, LBA, these preferences can occur due to learning, tactile, and/or olfactory sensitivities. Children might prefer soft foods like yogurt or soup, or crunchy textures like snack crackers. Another common preference of children on the spectrum is foods with high starch and sugar content such as snack foods. “Sometimes, the way a food tastes or feels in the mouth, or the way it smells, is aversive to kids and therefore physically challenging to try new things,” Dr. Thomas explains.
Not eating enough
Sitting through a meal and finishing food can be a challenge for kids with autism. As a result, kids may not receive the calories and nutrients they need to maintain their health. Chronic malnutrition can lead to physical, emotional and cognitive decline.
Inflexibility in trying new foods
Autistic children may avoid entire food groups such as fruits and vegetables. When parents attempt to introduce non-preferred foods, challenging behaviors often occur. This can make mealtimes difficult for the whole family and eating out undesirable.
From these eating issues come behavioral and health issues, such as:
Challenging behaviors
Parents often experience behaviors at mealtimes, such as their child consistently getting up from the table, crying, or throwing food or utensils.
Nutrient deficiencies
Lack of nutrients can cause several health issues, such as difficulties in cognition, protein, vitamin and mineral deficiencies, constricted physical growth, an increased probability of obesity, or a suppressed immune system and chronic illness. Dr. Thomas notes that children with autism may have a weaker immune systems due to poor nutrition, making them more prone to illness and slower to recover.
GI issues such as constipation
The struggle to help your child eat well is a reality for many parents. Parents often find it easier to simply give their child preferred foods rather than battling behaviors to change eating habits. But if a child has a limited number of foods they will eat, the lack of variety of things like fruits and vegetables can lead to digestive issues. Constipation can then contribute to other issues. It’s important to know that the longer these issues become ingrained, the harder they are to address in the long term.
5 Tips to Address Eating Issues
1. Make mealtimes routine
Kids with autism often thrive with routine. Help them know what to expect by serving meals at the same time every day. You could give your child reminders 30 minutes to 5 minutes before meals to prepare for the transition. It’s great to involve your child in meal preparation, such as having them set the table or help cook, if they enjoy it. Give your child choices during mealtimes by letting them select a food item to serve or choose where they sit at the table.
2. Keep introducing non-preferred foods
Continue to offer non-preferred foods in small amounts. It’s tempting to simply remove them altogether in order to avoid certain behavioral challenges. But it’s important to continually give your child opportunities to try new foods.
Shape behaviors by starting small. For example, provide a small portion of food that is similar to a food they are currently eating. If they eat Goldfish crackers, provide bunny crackers. If they eat one brand of macaroni and cheese, provide another variety. Give lots of praise for their effort of trying, and remember it’s okay if they don’t like it the first time. “It’s also okay if they don’t eat the new food right away,” Dr. Thomas explains. “Even if they touch the food, or smell it, it’s a step closer to the goal. It’s important to be gentle about the process so food avoidance doesn’t increase.” Consider placing novel food on a separate plate near your child throughout mealtime without requiring them to eat it. Having a special reward for your child for trying something new, or even just tolerating something new nearby, can help move things along faster.
In regard to introducing non-preferred foods, parents may try to accommodate their child’s eating issues by packing preferred food during restaurant outings or gatherings. However, doing so may cause increased stress and relationship strain in parents. Additionally, it limits opportunities to expose your child to novel and non-preferred foods.
3. Keep reasonable expectations for mealtime
Changing behaviors and your child’s food preferences will take time and patience. Try not to expect big changes all at once. In the meantime, model your expectations for your child. Perhaps you’d like them to sit at the table for a minimum length of time and gradually increase that time. Keep phones and toys away from the table to increase the association between eating and being at the table. Screentime may be a good idea to include after a meal or snack, as a special reward. Ignore non-desired behaviors as long as they are safe.
4. Give LOTS of specific praise!
Praise your child consistently for anything they are doing (or not doing) to increase desired behavior. Give specific praise such as “I love how you are sitting so calmly at the table”, “Way to go trying that bite of food!”, or “I’m proud of you for eating those two more bites.” There is almost always something for which to praise your child!
5. Consult your child’s pediatrician
Eating issues and autism aren’t always preference based. Medical issues are often a culprit, such as acid reflux or allergies. Be sure to consult your child’s pediatrician if you suspect health issues. Additionally, if your child is receiving Applied Behavior Analysis, Occupational or Speech Therapy services, seek the input of each provider and, if possible, coordinate and advocate for an interdisciplinary approach.
Though navigating eating issues in children with autism can be tricky, you are not alone in the journey. And it doesn’t have to be so difficult—the trajectory can change! Seek out resources and support for not only your child, but for yourself as well.
Does your child with autism have struggles related to food and eating? Our interdisciplinary team of ABA, OT and Speech Therapists work together to address eating challenges. To learn more, please reach out to us.