Here at NourishRX, we know that it can be extremely challenging for a caregiver to know how to best support their child who has autism, or is suspected to have autism, with their feeding difficulties.
While feeding difficulties do not impact all children, it should be noted that it is estimated that children with autism and other developmental disabilities are up to 5x more likely than neurotypical children to have an eating concern.
These concerns may include allergies, food-related sensory aversions, or/and can be due to difficulties with movement such as seen in dyspraxia and apraxia (e.g., swallowing, chewing, using cutlery, sitting straight). Sometimes, children with autism go on to develop an eating disorder.
autism and avoidant restrictive food intake disorder (ARFID)
While they may develop any type of eating disorder, we want to highlight the connection between autism and Avoidant Restrictive Food Intake Disorder (ARFID).
ARFID is an officially recognized eating disorder that may involve food sensory aversions. It is estimated that up to 21% of those with autism may be at high risk for having ARFID. Just because someone has food aversions does not mean they automatically have ARFID. To learn about the ARFID diagnostic criteria, click here.
However, your child does not need to have an official eating disorder diagnosis or an official autism diagnosis for their eating challenges to be valid, and they do not need to have an official diagnosis to qualify for our nutrition support services.
If you and your child are struggling, support is valid. Bottom line.
Individualized professional care is best. Working with a treatment team who specializes in autism and eating challenges is recommended, because they can take a thorough assessment of your child and help give recommendations for interventions that are specifically tailored to your child.
For our families and future clients that are struggling, we have collected some tips below that may be helpful for supporting someone with autism in their eating challenges:
6 ways to support feeding difficulties in autistic chidren
Rule out medical problems
Individuals may demonstrate aversions to food that are caused by an underlying medical issue, such as a gastrointestinal condition. Articulation of discomfort can be very challenging for those with autism.
remember the importance of patience
It is normal for a child to have to taste something numerous times before they may tolerate it, especially for children with autism-related sensitivities. According to Autism Speaks, “If your child continues to reject a food even after a dozen-plus tries, perhaps he just doesn’t like it. Consider trying a different food. Above all, don’t let mealtime become a family battleground. Instead, get creative.”
gently invite them to use other senses
If your child is open to sitting with the food, but is hesitant or resisting eating it, you may think about using the senses to start.
Your child may be interested in engaging with the food with their senses, gently inviting them one time to explore the food by looking at it, observing the color and appearance, touching it and smelling it without pressure to eat it.
Many individuals with autism feel afraid to try new things. If they don’t want to do that or put it in their mouth don’t force them. While in the short term forcing them to eat it (by giving them an ultimatum or a fear based health claim) may work, in the long term this has been shown to lead to psychological harm and an unhealthy relationship with food.
respect texture aversions
Be willing to make texture accommodations for your child, if you are able. For example, if your child dislikes the squishy texture of tomatoes, try blending them into a sauce or salsa and adding them to the dish.
make eating fun
To help your child cope with anxiety that often comes from trying new foods, try making eating an adventure. Allowing your child to paint with pasta sauce or make fun shapes and faces on pizza or other foods with cookie cutters may help your child to be more receptive to the food and actually enjoy it.
offer choices and control
Autistic children have a need to feel control around eating. If you are able, it can be helpful to present your child with options for a meal or snack by showing them pictures or laying out the foods in front of them. It’s okay to not like some foods. Allow choices within food categories you care about.
For example, if you want your child to have one serving of grains and one serving of protein for dinner, present them with multiple options of foods in each of these groups.
more information on feeding difficulties in autistic children
When working towards understanding your child’s feeding difficulties we typically recommend
Helping Your Child with Extreme Picky Eating: A Step-by-Step Guide for Overcoming Selecting Eating, Food Aversion, and Feeding Disorders by Katja Rowell, MD and Jenny McGlothlin, MS, SLP
This book and corresponding website is meant to support caregivers with children who have autism-spectrum related picky eating challenges.
how NourishRX can support you
The virtual dietitians at NourishRX are skilled in creating treatment plans for feeding difficulties in collaboration with families and other providers. We invite you to reach out today to set up a clarity call to explore what services may be the best fit for your family. If you and your child are struggling, please seek professional support if you can. A registered dietitian is just one specialist who can offer you support!
References: Autism Speaks, linked here
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