Is your child with autism a picky eater? You’re certainly not alone. A healthy, varied diet is essential for development. However, many families face challenges at mealtime, where picky eating can become an ongoing struggle. These challenges make meals stressful and limit access to a balanced diet.
By understanding the connection between nutrition and development—and learning practical strategies to expand your child’s food choices—you can support their health and help create more positive mealtime experiences.
Nutrition plays a key role in many aspects of a child’s growth and development. A balanced diet can impact physical health, cognitive functioning, and behavior. Adequate nutrition provides vital nutrients that support a growing child’s brain development, learning, and emotional regulation–each of which is critical for reaching developmental milestones.
In a perfect world, to achieve optimal development, children would consume all essential nutrients, such as protein, fats, carbohydrates, vitamins, minerals, and micronutrients, like iron, zinc, folate, and choline (Roberts et al., 2022). The foods and beverages a child drinks can positively or negatively impact their day-to-day functioning. In behavioral terms, one’s diet can be a setting event for various challenges, such as difficulty focusing or behavioral issues. Conversely, a balanced diet may help improve mood, increase energy, and support one’s ability to engage and learn (Jacka et al., 2010).
While a healthy, well-balanced diet is important, families of children with autism often find this easier said than done. Research suggests over 70% of children with autism experience eating challenges, such as limited food preferences and hypersensitivity to food textures (Mayes & Zickgraf, 2019). This is a stark contrast to the general population, with only 4.8% of neurotypical children experiencing atypical eating habits.
Children with autism may struggle with eating for a number of potential reasons, such as a need for routine and predictability, sensory sensitivities, or even gastrointestinal (GI) issues. GI problems, including constipation, bloating, and abdominal pain, are more prevalent among children with autism than the general population (Lasheras et al., 2023). These discomforts can lead to food avoidance and reinforce sticking with “safe” foods.
A few of the most common eating challenges that children with autism experience include:
If your child engages in behaviors that limit their ability to consume a well-rounded diet, there are many approaches you can try to encourage more variation. Here are a few strategies to consider.
Rule out medical conditions–Before making changes, consider whether physical discomfort or medical conditions could cause or worsen your child’s picky eating. Treating GI problems and other medical conditions could potentially improve the child’s food selectivity (Zickgraf & Mayes, 2019).
Start small–Introduce new foods in small, manageable portions alongside familiar and preferred items. Offering a small portion to try without pressure may make the idea of tasting new foods less intimidating.
Add structure to mealtimes–Predictable mealtimes can help your child know what to expect, reducing anxiety and resistance. Try using a visual schedule to communicate your snack and meal routines and stick to them as closely as possible.
Offer foods that are similar to their preferred foods–While you may be eager to get some nutrient-dense foods in your child, a slow and systematic process is often needed to encourage variation in their diet. This may involve offering foods that have similar textures, colors, and smells as their preferred ones. It could even involve offering the same foods but a different variation or brand of them.
Gradually try new foods–Allow your child to acclimate to new foods at their own pace. Have them work on trying one new food at a time. If they’re not ready to immediately eat the food, that’s okay. Have them simply touch it and smell it. As they feel more comfortable, encourage them to bring it up to their lips. Next, have them lick the food. Eventually, as they progress through each of these baby steps, they’ll make it to the point of taking a bite.
Allow choices–Encourage your child to make choices to foster independence and offer a sense of control. Even choices that aren’t directly related to the food, like choosing which plate to use, can help reduce mealtime anxiety.
Keep trying–While it can be discouraging to see your child repeatedly refuse healthy and varied food options, it is important to avoid getting into the habit of only presenting their preferred options. Research has shown that repeated exposure to foods increases the likelihood of children accepting them. One research review found that children were more likely to consume fruits and vegetables when a single item was presented once per day for 8-10 days (Spill et al., 2019).
Steer clear of power struggles–Avoid mealtime power struggles. These could make your child’s selective eating worse and create new undesired behaviors.
Consult professionals–Eating challenges often require a multidisciplinary team of professionals to support, including OTs, SLPs, and sometimes BCBAs who are trained in feeding therapies. If your child engages in food behaviors that limit their nutrient intake, it’s best to consult professionals to provide individualized assessment and treatment.
Many kids are known to be picky eaters–but how picky is too picky? A good rule of thumb is if their eating habits are enough to cause you concern, it’s best to have it evaluated by a professional.
Here are a few signs that your child should have an assessment with an SLP and/or OT for their feeding and eating challenges:
The CompleatKidz team of multidisciplinary clinicians, including Speech Therapists and Occupational Therapists, are here to guide you and your child through mealtime challenges. Contact us today to schedule an initial evaluation.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Jacka, F. N., Kremer, P. J., Leslie, E. R., Berk, M., Patton, G. C., Toumbourou, J. W., & Williams, J. W. (2010). Associations between diet quality and depressed mood in adolescents: results from the Australian Healthy Neighbourhoods Study. The Australian and New Zealand journal of psychiatry, 44(5), 435–442. https://doi.org/10.3109/00048670903571598
Lasheras, I., Real-López, M., & Santabárbara, J. (2023). Prevalence of gastrointestinal symptoms in autism spectrum disorder: A meta-analysis. Anales de pediatria, 99(2), 102–110. https://doi.org/10.1016/j.anpede.2023.07.003
Mayes, S. D., & Zickgraf, H. (2019). Atypical eating behaviors in children and adolescents with autism, ADHD, other disorders, and typical development. Research in Autism Spectrum Disorders, 64, 76-83. https://doi.org/10.1016/j.rasd.2019.04.002
Roberts, M., Tolar-Peterson, T., Reynolds, A., Wall, C., Reeder, N., & Rico Mendez, G. (2022). The Effects of Nutritional Interventions on the Cognitive Development of Preschool-Age Children: A Systematic Review. Nutrients, 14(3), 532. https://doi.org/10.3390/nu14030532
Spill, M., Callahan, E., Johns, K., et al. (2019, April). Repeated exposure to foods and early food acceptance: A systematic review. USDA Nutrition Evidence Systematic Review. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK582166/
Zickgraf, H., & Mayes, S. D. (2019). Psychological, health, and demographic correlates of atypical eating behaviors in children with autism. Journal of Developmental and Physical Disabilities, 31(3), 399-418. doi:https://doi.org/10.1007/s10882-018-9645-6
If you have any questions about this Notice of Privacy Practices, please contact our Privacy Officer, by telephone at (704) 824-7800 or in writing at 2675 Court Drive, Gastonia, NC 28054.
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. Protected health information is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our Notice of Privacy Practices at any time. The new Notice of Privacy Practices will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. You may request a revised version by calling or writing our Privacy Officer and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment.
Your protected health information may be used and disclosed by our office staff others outside of our office who are involved in your care and treatment for the purpose of providing health care services to you.
Your protected health information may also be used and disclosed to pay your health care bills and to support the operation of our practice.
Following are examples of the types of uses and disclosures of your protected health information that we are permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office.
Others Involved in Your Health Care or Payment for our Care:
Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your protected health information that directly relates to that person's involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death. Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.we may collect information about your computer, including your IP address, operating system and browser type, for system administration and in order to create reports. This is statistical data about our users' browsing actions and patters, and does not identify any individual.
The only cookies in use on our site are for Google Analytics. Google Analytis is aweb analytics tool that helps website owners understand how visitors engage with their website. GoogleAnalytics customers can view a variety of reports about how visitors interact with their website so that they can improve it.
Like many services, Google Analytics users first-party cookies to track visitor interactions as in our case, where they are used to collect information about how visitors use our site. We then use the information to compile reports and to help use improve our site.
Cookies contain information that is transferred to your computer's hard drive. These cookies are used to store information, such as the time that the current visit occured, whether the visitor has been to the site before and what site referred the visitor to the web page.
Google Analyticsw collets information anonymously. It reports website trends without identifying individual visitors. you can opt out of Google Analytics without affecting how your visit our site- for more information on opting our of being tracked by Google Analytics across all websites you use, visit this Google page
We embrace diversity and equality in a serious way. We are committed to building a team with a variety of backgrounds, skills, and views. The more inclusive we are, the better our work will be. Creating a culture of Equality isn't just the right thing to do, it's also the smart thing.
Diversity at Compleat KiDZ is expressed through management commitment to equity and the treatment of all individuals with respect. We embrace and encourage our employees’ differences in age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique.
We take our commitment serious to promoting cross-cultural understanding and respect among its employees, patients, and the broader community. At Compleat KiDZ we have a commitment to recruiting and retaining a diverse and all-inclusive staff. We will always strive to maintain the highest standards in cultural inclusion and sensitivity, but we know that we will not always get it right.