Parents and caregivers of children with autism frequently report that feeding issues are of great concern on an ongoing basis. Research has confirmed that the eating behaviors of children with autism vary markedly from their typical peers.[i] Those with autism experience significantly more feeding problems and eat a significantly narrower range of foods than children who do not have autism. Addressing these feeding problems-and the core issues behind them-is of critical importance to ensure that children with autism are able to thrive. Before parents embark on an aggressive approach to improve their child’s dietary intake, any underlying medical conditions must first be either identified and treated, or ruled out.
Other symptoms often associated with autism include sensory processing challenges which may in part provide treatment options for feeding problems. According to a report from 2008, “Given these distortions in sensory processing, and depending on the number and type of sensory stressors in the environment, the impact on feeding can be pervasive.”[ii] An evaluation for sensory processing dysregulation by an occupational therapist will reveal whether your child can benefit from therapies to improve sensory issues which may then have a positive impact on problems with eating behaviors related to texture and other sensory factors.
The same paper confirms what a growing number of other researchers and parents have been reporting for years regarding children diagnosed with autism and gastrointestinal dysfunction, “GI disorders encompass a constellation of problems,including gastroesophageal reflux disease (GERD) and constipation,diarrhea, or other symptoms resulting from food allergies.” [iii] Obtaining appropriate clinical investigation of and treatment for gastrointestinal dysfunction and food allergies can therefore be crucial for many individuals with autism and feeding problems.
In addition to sensory and GI issues, several other underlying medical conditions often found in children with autism can have a bearing on eating behaviors. These include other allergies and chemical sensitivities, nutritional deficiencies, impaired detoxification, and viral infections.[iv] Once any additional underlying medical conditions have been either ruled out or accurately diagnosed with appropriate treatments in place, parents can begin to implement strategies and protocols at home that can greatly improve feeding issues in their children with autism.
Where can you start if your child has problems with eating behaviors? Being a “picky eater” comes with the territory so broadening the range of foods that your child will accept is a good place from which to launch a plan. Consult with a nutritionist to help you devise a program customized to most effectively target your child’s nutritional deficits.
One of the most important things to keep in mind when starting any nutritional program is that the effort ideally will involve the support and commitment of the entire family. Make sure siblings and others living in the home have an understanding of the seriousness of feeding issues and the health benefits of improving your child’s eating behaviors. The approach to widen your child’s meal time repertoire must be intensive as it will be in operation for every meal, every day.
Here are some guiding principles that may be effective as you implement your at-home nutritional-enhancement plan:
- Schedule specific meal times. Stick to pre-set times as routine is key.
- No grazing. Eliminate snacks and grazing to encourage a feeling of hunger at meal times.
- Introduce new foods slowly. Even touching a new food to his lips is an important step for your child.
- Offer praise for each small gain. Verbal reinforcement will encourage your child to move forward as new foods are introduced.
- Wait it out. Be prepared for your child to tantrum or engage in other negative behaviors as new foods are introduced. Initial resistance may be strong but stick with the plan.
For additional practical strategies to make the most of your child’s nutritional intake, see the Autism File article “Help for Picky Eaters” by Missy Olive, PhD, BCBA-D (Issue 40).
[i] Schreck, Kimberly A., Williams, Keith; Smith, Angela F. A Comparison of Eating Behaviors Between Children with and Without Autism. Journal of Autism and Developmental Disorders Volume 34, Number 4, 433-438, DOI: 10.1023/B:JADD.0000037419.78531.86
[ii] Twachtman-Reilly, Jennifer; Amaral, Sheryl C., Zebrowski, Patrecia P. Addressing Feeding Disorders in Children on the Autism Spectrum in School-Based Settings: Physiological and Behavioral Issues. Language, Speech, and Hearing Services in Schools Vol.39 261-272 April 2020. doi:10.1044/0161-1461(2008/025)
[iii] Twachtman-Reilly, Amaral, Zebrowski (2008)
[iv] Cubała-Kucharska, Magdalena. The review of most frequently occurring medical disorders related to aetiology of autism and the methods of treatment. Acta Neurobioliae Experimentalis. Exp 2010, 70: 141–146.