Nearly every child exhibits food-related tantrums or some kind of picky eating habits during the first few years of life. Developmentally, children become highly selective eaters between 18 to 24 months. But with continued exposure to new foods, most kids outgrow picky eating by age 7, or at least they're not as selective.
"But children on the autism spectrum can take picky eating to an entirely new level," says Mariana Fraga, a board-certified behavior analyst at Henry Ford Health. "In fact, many children with autism usually don't outgrow picky eating without a formal intervention."
The Link Between Selective Eating And Autism
Children with autism — and the parents who feed them — often face significant distress around mealtime. In fact, between 50% and 89% of kids with autism have some food selectivity. The end result: They tend to eat far fewer dairy products, fruits, vegetables and whole grains than typical children.
A few common obstacles to achieving a more nourishing diet:
- Predictability: Kids with autism like things to be predictable, and that includes the foods they eat. "When we look at the dietary habits of children with autism, they're largely made up of processed foods," Fraga says. The reason: Fruits, vegetables and other whole foods don't feel and taste exactly the same every time you eat them.
- Sensory issues: Children with autism often have strong preferences for certain textures and temperatures. Some kids prefer soft, creamy foods like purees or even baby food. Others need the extra stimulation of crunchy foods. In every case, sensory preferences can limit what kids are willing to eat.
- Mealtime behaviors: It's not uncommon for kids to display challenging mealtime behaviors. Children with autism have much more difficulty sitting still and making it through a meal. "To make matters more complicated, allowing children to eat away from the table is a huge safety issue because they could choke while wandering around," Fraga says.
Broadening A Picky Palate
Parents who have children with autism are often trying to address competing needs simultaneously, including speech issues, toilet training and behavior. Unfortunately, that means feeding challenges often get placed on the back burner.
"Parents and professionals need to flip the equation and put feeding at the top of their priority list," Fraga says. "Otherwise, we are trying to teach a brain that does not have the proper nutrition. This will make learning even more challenging."
The good news: Eating a variety of foods is a skill that can be taught. The sooner you start working on your child's mealtime behaviors and food preferences with these seven strategies, the easier it is to change them.
- Create a schedule and stick to it. For children with autism, consistency is key. Routines help them thrive, so why not create a meal- and snack-time schedule and stick to it? Choose set times for breakfast, lunch and dinner each day and allow two snack times at regular intervals. "Don't allow your child to snack away from the table," Fraga says. "And only provide water between meals and snacks, so your child fills up on foods instead of sugary beverages or milk."
- Be persistent. All kids often need to be presented with a food again and again — up to a dozen times — before they’ll willingly eat it. Kids with autism may need even more exposures before they'll explore a new food or food group. Start with a pea-sized bite and work your way up. And choose foods that are similar in taste and texture to those your kid already likes. Then gradually increase the size of the bite.
- Take baby steps. Don't expect any child to eat a whole bowl of broccoli straight out of the gate. Instead, start by exposing your child to new foods in small doses. Put it on the table during mealtime, encourage your child to look at it, touch it, smell it, even play with it. Then practice the "no thank you" bite: Ask the child to take just one small bite. If they don't like it, they can decline eating more. "It's best to try one bite at a time," Fraga says. "Otherwise, children become so overwhelmed they shut down."
- Pay attention to texture. Kids with autism are often sensitive to textural changes. They may not like the way a food feels in their mouth. The texture is such a turnoff that they never even discover the flavor. In some cases, using a blender to make smoothies or pureeing foods does the trick and they're willing to try the food in a new format. This may help you sneak some vegetables in while trying new foods.
- Reward with intention. Children with autism often need extra motivation to try a different food. Stock your treasure chest with a variety of rewards for when your child accepts new foods. Good choices include things like a favorite movie, stuffed animal, or preferred video games.
- Focus on the positive. Praise the behaviors you want your child to repeat — and be specific. So instead of saying "good job," say things like "I love how you tried that new food" or "you did a great job of staying seated during dinner tonight." This type of labeled praise helps reinforce the behaviors you're trying to encourage. Always turn your attention toward positive behaviors and avoid addressing challenging behaviors. Your child will soon learn that they get praise for good behavior.
- Keep a log. Documenting what the child is eating helps you remember which foods you've tried, how much your kid ate of it and whether your child accepted the food without a fuss. This information can help you pinpoint which categories of foods your child is lacking and when to increase bite sizes.
Happier Eating For Kids With Autism
Eating is a skill and children with autism often need formal training to develop appropriate eating habits and develop a healthy range of food preferences.
"Eating a variety of foods, especially fruits and vegetables, not only supports growth and development, but it also helps stave off chronic diseases, such as heart disease and diabetes," Fraga says. A bonus: When kids with autism learn to eat new foods, they're also learning how to tolerate and even embrace change, which may help reduce anxiety in other areas.
While food selectivity is common among kids with autism, these issues can be addressed through targeted training programs. In many cases, children can progress to eating dozens of foods.
Still struggling? A board-certified behavior analyst (BCBA) can help identify and treat your child's feeding issues. They will develop a customized, targeted program to ensure your child gets the nutrients she needs while also developing a healthier relationship with the foods she eats.
To find a doctor or board-certified behavior analyst at Henry Ford, visit henryford.com or call 1-800-436-7936.
Mariana Fraga, M, Ed, BCBA, LBA, is a board-certified behavior analyst and manages the Henry Ford Center for Autism and Developmental Disabilities.
