Parents of children with autism know eating issues all too well. From mealtime tantrums to picky food preferences, dealing with the eating issues that come with ASD can be a major stressor. However, rest assured that these issues can be addressed by seeking support, establishing routine, and lots of patience.
Eating Issues Related to Autism
Food selectivity
Children with autism often have selective food preferences. According to our Director of Clinical Standards, 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 are 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 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, iron deficiency, constricted physical growth, and an increased probability of obesity and heart disease. Dr. Thomas also points out that kids are more likely to get sick and take longer to recover because the immune system isn’t as strong without nutrients.
GI issues such as constipation
The struggle to help your child eat well is hard enough. In addition, parents may try to accommodate to their child’s eating issues, such as packing preferred food during restaurant outings or gatherings. Accommodating to eating issues may cause increased stress and relationship strain in parents.
Parents often find it easier to simply give their child preferred foods rather than battling behaviors to change eating habits. But 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 daily time. 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 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 behaviors. But it’s important to continually give your child opportunities to try the new foods. Shape behaviors by starting small. For example, have your child try one grape or half a carrot. Give lots of praise for their effort of trying and remember it’s ok if they don’t like it right away. “It’s also okay if they don’t eat the new food right away,” Dr. Thomas adds. “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.” For example, the novel food can be placed on a separate plate near your child throughout the meal, though they do not need to eat it. Having a special reward for trying something new, or even just tolerating something new nearby, can help move things along faster.
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 demonstrate focus at mealtimes. 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 most likely 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.
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.