Navigating Picky Eating in Children with Autism

Picky eating can be a significant challenge for families raising a child with autism. Mealtime experiences can be filled with stress and frustration for these children, as their heightened sensory sensitivity and entrenched dietary habits come into play. However, there are ways to effectively manage picky eating and ensure that your child maintains a balanced and nutritious diet with the help of suitable resources and support.

The Connection Between Picky Eating and Autism

Picky eating is highly prevalent among children with autism, with research suggesting that approximately 70-90% of them display selective eating behaviors. This tendency can be attributed to sensory sensitivities, including taste, texture, smell, and visual aspects of food. These sensitivities contribute to the development of strong aversions towards certain foods, which may stem from negative experiences or sensory issues.

As a result, children with autism often have limited food repertoires and gravitate towards familiar and safe food choices. However, this can give rise to nutritional concerns, as their restricted diets may lack essential nutrients. Furthermore, these children frequently establish food rituals and adhere to strict routines, making any disruptions during mealtimes a potential source of distress.

Addressing picky eating in children with autism requires thoughtful intervention strategies. Gradual exposure to new foods, desensitizing sensory sensitivities, and creating a positive mealtime environment are some of the approaches employed to encourage a broader range of food choices. It is important to recognize that each child with autism is unique, and picky eating behaviors can vary. While some children may outgrow their selective eating habits, others may continue to exhibit these behaviors well into adulthood.

Common Root Causes of Picky Eating

Sensory Processing Disorder: Some kids may have more sensitive taste, touch, smell, or visual perceptions of food. These sensory sensitivities can lead to selective eating behaviors, where children only consume a limited range of foods that they find comfortable.

Nutritional Deficiency: A deficiency in iron, zinc, vitamin B12, magnesium, and vitamin D can lead to a decrease in appetite and/or an altered sense of smell and taste.

Gastrointestinal Issues: Gastrointestinal discomfort may discourage your child from trying new foods, or food preferences may be affected.

Hypotonia or Oral Dysphagia: Children with oral dysphagia, characterized by difficulties in chewing and swallowing, or those with low muscle tone, may experience challenges with picky eating.

Medications: Certain medications, such as stimulants, may cause a lack of appetite and/or an increase in metabolic rate.

Tips to Improve Picky Eating Habit

1. Consistent mealtime routine: Structure 3 meals and 2 snacks daily

   1. A good rule of thumb is to have 30% of calories at mealtime and 10% at snack time.

2. Take gradual steps: Encourage your child to examine food with their hands, noses, and eyes without pressuring them to consume it right away. Through sensory exploration, they can gradually become less sensitive to new meals and feel more at ease.

3. Serving food: Don't serve more than 3 different foods on your child's plate at a time

   1. Put no more than one non-preferred food on the plate

   2. Manage the amount, start small!

   3. Be creative, use fun divided plates, and use letters/shapes/numbers cutter to make the meal fun!

4. Food rotation: Avoid burnout by rotating the food item every other one or two days.

   1. May change the shape/flavor/texture each time when repeating the food

5. Mealtime habits: Reduce distractions like loud noises and overstimulating visuals eg. TV, to prevent sensory overload

6. Seeking help from a licensed feeding therapist, dietician, or naturopathic doctor, with expertise working with autistic children with picky eating habits. They can offer unique directions and approaches to deal with certain difficulties.

Reference:

Adams S. N. (2022). Feeding and Swallowing Issues in Autism Spectrum Disorders. Neuropsychiatric disease and treatment, 18, 2311–2321

Baraskewich, J., von Ranson, K. M., McCrimmon, A., & McMorris, C. A. (2021). Feeding and eating problems in children and adolescents with autism: A scoping review. Autism : the international journal of research and practice, 25(6), 1505–1519.

Martins, Y., Young, R. L., & Robson, D. C. (2008). Feeding and eating behaviors in children with autism and typically developing children. Journal of autism and developmental disorders, 38(10), 1878–1887.