This is one of the most common problems parents face when they come and see us for the first time. The most common issues tend to be eating a limited food selection, showing anxiety or tantrums when presented with new foods, and/or having ritualistic eating behaviours, such as not wanting different types of food to touch one another.
In fact, research has shown children with autism are five times more likely to have such mealtime challenges.
The term ‘picky’ or ‘fussy’ eaters are usually defined as children who consume an inadequate variety of foods through rejection of a substantial amount of foods that are familiar (as well as unfamiliar) to them. For a child with autism or behavioural and learning difficulties, there may be sensory sensitivities or oral motor challenges, nutrient deficiencies, anxiety or food addictions/cravings.
As well as sensory, texture, and environmental control factors, children with autism often suffer from issues with digestion and absorption, food and chemical sensitivities, oxidative stress, compromised immune function, mitochondrial disorders, impaired detoxification systems and higher than normal bacterial, viral and parasitic load. But as a parent or caregiver, you want to gently expand a narrow diet with sustainable, practical and achievable methods.
Try these ideas so that, over time, your child becomes more confident with his/her eating skills:
Gastrointestinal distress is common among children with autism and the fear that food may cause pain may make your child refuse to eat. Other nutritional causes for food addiction (such as the desire just to eat carbs), and narrow food choices, could include the creation of opioids from certain foods (such as those containing gluten and dairy), which can lead to cravings and addictions and contribute to yeast overgrowth and microbial imbalance of the digestive tract.
A nutritionist can help identify allergies, sensitivities and deficiencies that may be affecting the food choices your child makes – and suggest a suitable diet to ease symptoms and pain.
This is easier said than done of course, but parents of children with autism are generally used to taking things slowly and recognising small achievements.
Avoid turning mealtimes (three times a day!) into stressful battles by setting realistic (small) goals and celebrating the smaller steps towards an eventual larger target. All children will need to taste some new items many times over before developing a taste for it.
For a child with autism or other additional needs, new foods can be alarming – so don’t expect a child to progress straight to eating a food without first looking, touching and smelling it. In this instance ‘playing with your food’ is to be encouraged – so the item becomes less intimidating and more familiar.
Children that struggle physically to eat – such as those with poor muscle tone in their gums – may also like to warm up to eating by preparing the mouth with blowing bubbles, sucking a drink through a curly straw, or using an electric toothbrush.
Many children with autism like routine and to have control over what is happening to them. At mealtimes this means that they could benefit from wanting to be included in the planning, shopping for, choice and arrangement of food.
Familiar timings and utensils and cutlery will also bring reassurance to the situation – and mentioning food an hour before eating can help a child be ready to accept a meal. Offering a choice of newer foods will allow your child to pick a favourite food to eat. If you need to change the meal time try and give your child an advance warning.
Hypersensitivity to textures and sensory issues are common among children on the spectrum. This can affect the type of foods they like to eat – to the point that crunchy foods are considered too loud when consumed or softer foods like a tomato are unbearable in the mouth.
Work around this by cooking, chopping or blending food – or adding it to a sauce. If crispy or crunchy food is preferred then look to replace unhealthy options with those that offer maximum nutrition, but have the right texture for your child (please look at our recipes for ideas).
You can do all this alongside the longer-term work of expanding food choices, allowing you to become more relaxed about meeting your child’s nutritional needs.
Helping your child to expand the range of food they accept, and to learn to try new and unfamiliar foods, may be a lengthy process. However, it is an important one if you want your child to be healthy in the short and long-term. Congratulate yourself and your child each step of the way of this vital journey.