Many children can be picky eaters, but for autistic children, the challenges can be even greater. Sensory sensitivities, routine preferences, and anxieties around new things can all contribute to a limited diet. This can lead to nutritional deficiencies and make mealtimes stressful for everyone.
Why Autistic Children Are Fussy Eaters
Mealtimes can be a battleground for parents of picky eaters, and for those with autistic children, the challenges can be even greater. Picky eating in autistic children goes beyond simple dislike – it can be rooted in sensory sensitivities, a desire for routine, and even underlying health issues.
Sensory Overload
The world can be a very overwhelming place for children with autism. Imagine the sights, sounds, smells, and textures of a busy dinner table – the clinking of silverware, the chatter of conversation, the bright lights overhead. For a child with sensory sensitivities, this can be overwhelming and lead to a strong aversion to eating altogether. Additionally, certain foods themselves can trigger sensory overload. The smell of broccoli, the texture of mashed potatoes, or the bright color of a bell pepper might be unpleasant or even painful for an autistic child.
Routine and Predictability
Children with autism often thrive on routine and predictability. Mealtimes are a source of comfort when they know what to expect – the same foods served in the same way at the same time. Introducing a new food disrupts this routine and can cause anxiety. They might be unsure of the taste, texture, or even color of the unfamiliar food, leading them to refuse it outright.
Interoception and Appetite
Interoception refers to the body’s ability to sense its internal needs. Some autistic children struggle with interoception, making it difficult for them to recognize hunger cues. Their bellies might be empty, but they don’t feel the physical sensation of hunger. This can contribute to a lack of interest in eating, even for familiar foods.
Behavioral Traits and Eating Disorders
Certain behaviors common in autism spectrum disorder (ASD) can also make mealtimes challenging. Children with ASD might have rigid rules about how food is arranged on their plate or become upset if something disrupts their routine. This inflexibility can lead to tantrums or meltdowns if they’re forced to try something new.
Physical Development Delays
Oral motor skills, which involve the muscles used for chewing and swallowing, can be underdeveloped in some autistic children. This can make it difficult for them to manage certain textures or foods that require a lot of chewing. They might take a long time to eat, gag or choke easily, or drool excessively. These difficulties can create a negative association with eating and lead them to avoid certain foods altogether.
Underlying Health Issues
Several health conditions common in autistic children can make eating uncomfortable or even painful. These include acid reflux, constipation, and eosinophilic esophagitis (EoE), all of which can cause stomach pain, heartburn, or difficulty swallowing. Addressing these underlying conditions can significantly improve a child’s eating habits.
Why It’s Important to Address Picky Eating Issue
While it might seem like a minor concern, allowing your autistic child to stick solely to their favorite foods can have significant consequences for their long-term health. How autistic individuals experience sensory input can significantly impact their relationship with food.
Dr. Sandhyaa S. Iyengar, M.D., M.P.H., attending physician at the Children’s Hospital of Philadelphia, explains that sensory sensitivities can lead to a narrower range of accepted foods. This selectivity often translates into unhealthy choices, like processed foods high in calories and low in nutrients, or a lack of variety in fruits, vegetables, and whole grains.
Imagine your child who only willingly eats chicken nuggets. For them, a piece of broccoli represents a completely new and potentially overwhelming sensory experience. The texture, color, and even smell can be unfamiliar and frightening. This is why introducing new, healthier options requires a slow, patient approach with plenty of support.
The consequences of limited food choices extend far beyond just a dislike for vegetables. Research indicates that children who eat a restricted range of foods or lack sufficient overall intake are at risk for various health problems, with some issues being especially prevalent in autistic individuals.
Nutritional deficiencies are a significant concern. Studies have shown that autistic children are more likely to lack essential micronutrients, particularly vitamins A, B1, B6, B12, and D. Additionally, evidence suggests they may not get enough calcium, which, coupled with low vitamin D levels, can negatively impact bone health during growth.
Obesity is another potential consequence of picky eating. Many autistic children gravitate towards high-fat, high-calorie foods like chicken nuggets, hot dogs, sugary treats, and processed snacks. This puts them at increased risk of becoming overweight or even obese.
Because autistic children are particularly vulnerable to weight gain due to medication, limited mobility, and feeding difficulties, prioritizing healthy nutrition is more important than ever. By working with a healthcare professional experienced in autism, you can develop strategies to help your child explore new foods and build a foundation for a healthy, balanced diet.
How to Introduce New Food Items to Autistic Children
Encouraging your autistic child to explore new foods can be a journey, and it’s important to be patient and celebrate small victories. Here are some strategies to gradually expand their dietary horizons:
- Slow and Steady Wins the Race: Don’t overwhelm your child by introducing multiple new foods at once. Instead, focus on one food at a time, presenting it consistently over several days or even weeks. Repeated exposure can make the unfamiliar seem less foreign, making them more likely to eventually try it.
- Strategic Selection: Think about what your child already enjoys and choose new foods with similar characteristics. For example, if they love crunchy snacks, try offering them raw vegetables with a dip or baked sweet potato fries. Similarly, if chicken nuggets are a favorite, introduce grilled or roasted chicken pieces as a familiar protein with a slightly different texture.
- The Power of Choice: Frame tasting new foods as an option, not a requirement. Let your child know the food is available if they’d like to try it, but don’t force them. Again, be patient, as it might take them days or even weeks to feel comfortable enough to take a bite.
- Positive Reinforcement: Some children might be more willing to experiment if they have a familiar favorite alongside the new food. For instance, suggest they alternate bites of their favorite mac and cheese with a sprinkle of green peas. This creates a sense of security while also exposing them to a new taste.
- Family Feast: Mealtimes become more enticing when everyone enjoys the food. Encourage the whole family to eat and express their enjoyment of the new dish. Seeing others relish the unfamiliar can motivate your child to give it a try themselves.
- Storytelling and Imagination: Weave a fun narrative around the new food. You could create a story about how eating a certain vegetable makes them strong like their favorite superhero, or talk about a character in a beloved book or TV show who loves that particular food.
- Celebrate Every Bite: When your child finally takes that first bite, acknowledge and celebrate their achievement! Positive reinforcement, whether it’s a simple “Good job!” or a more specific compliment like “I love how you’re trying those strawberries,” can encourage them to continue exploring new tastes.
Keeping Sensory Preferences in Mind
When choosing new foods, consider your child’s sensory sensitivities. Dr. Iyengar suggests prioritizing options that align with their existing preferences: “Similar texture, color, and flavor to what they already enjoy are key.” This means introducing changes gradually, respecting their sensory needs while nudging them towards healthier options.
For instance, a child who loves crunchy snacks might be more receptive to thinly sliced carrots if they’re paired with a familiar cheese sauce. Similarly, a grilled cheese enthusiast may be open to adding a slice of tomato if it complements their preferred texture and flavor profile. The goal is to meet their sensory needs while taking small, positive steps towards dietary diversity.
Another tactic is to expand the scope of a familiar food. For example, if they only eat one type of yogurt, introduce a different flavor or brand within the same category. This incremental approach builds flexibility and can pave the way for introducing new food groups in the future.
Getting Professional Help
If you’re struggling to expand your child’s diet, consider seeking professional help. In-home ABA therapy can provide valuable guidance and support. Board-certified behavior analysts (BCBAs) can develop a personalized plan to address your child’s specific needs and help them overcome their resistance to new foods.
Rainbow ABA offers in-home ABA therapy services to families in New Jersey, Oklahoma, Texas, and Georgia. Our experienced and compassionate therapists can help your child develop a healthy relationship with food. Contact us today to schedule a free consultation and learn how we can help your child thrive!
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