Children with autism often develop very specific struggles with food and mealtimes. These behavioral, emotional, and physical problems go beyond simply disliking particular foods.
Children with autism may reject more food than they eat, preferring very specific textures or flavors, eating only foods that are familiar, or even failing to eat more than five different food items.
One research study found that 70% of children with autism displayed “atypical eating behaviors,” which was about 15 times the rate of neurotypical children in their age group. Children with autism were also more likely to have two or more atypical eating behaviors, while children with other developmental disorders tended not to have as many struggles with food.
Picky Eating vs. Food Rejection: Autistic Children Struggle More With Food Preferences
Many children become picky eaters as they enter toddlerhood, refusing certain foods because of taste, smell, texture, and other reasons. For parents, it may seem like your child is being obstinate for no reason, and that can be very frustrating, especially as you try to move them from baby food to regular food, encourage them to eat fruits and vegetables, and experience new food that may not be like the food they enjoy the most.
Problems with eating in children on the autism spectrum are significantly different from the colloquial “picky eating.” While most children become picky eaters at some point, they grow out of it.
Children with autism retain this hyper-focus on certain types of food unless they receive behavior therapy. Nutritional therapy can also help to ensure your child is getting a balanced diet.
Reasons Behind Picky Eating
Children with autism should work with a behavior therapist as early as possible. This will help them adjust symptoms of autism that become maladaptive behaviors, like socially isolating, developing repetitive or ritualistic behaviors, or rejecting all but a few foods.
There may be gastrointestinal issues associated with some food rejection. People with autism often struggle with digestive discomfort, constipation, diarrhea, and related issues. If a child feels that a specific food triggers that pain, they may refuse it, become suspicious of mealtimes in general, or throw tantrums around food.
Finally, motor issues may be a cause of food rejection. Children with autism often have less muscle tone and motor coordination than their peers. This might manifest in rejecting tougher, crunchier, or fibrous food that requires more chewing in favor of softer foods with uniform textures.
Top 5 Methods to Help Your Autistic Child Overcome Picky Eating
Here are some ways you can help your child if they struggle with specific issues:
- Offer small tastes. Keep track of the foods your child likes, and slowly introduce very small tastes of other foods alongside what they already like. For example, if they like chicken nuggets, you can introduce crumb-sized pieces of broccoli, so they get used to the presence, appearance, feel, taste, and texture of the food. They may not eat it the first day, but as you continue to introduce very small amounts of this food on their plate, they will get used to it and start eating it. As they get used to eating small bites of broccoli, you can add larger pieces. You may want to start by adding foods that are similar textures and/or flavors to what your child already likes.
- Try stimulus fading. This works well with offering small tastes. For eating issues, stimulus fading is the process of gradually increasing the size of foods that are presented. This is specific to foods that your child may have rejected in the past or that have textures, smells, and flavors that are very different from what your child currently prefers. When your child has accepted three consecutive bites of this food within 30 seconds, without gagging or screaming, you can increase the size of the bites of that food at the next meal.
- Pair foods. Combine foods that you know your child loves with foods that are new or that they previously rejected. This allows for positive reinforcement. For every small bite your child takes of the disliked food, you can give them a bite of the food they enjoy. You can also use other token systems for positive reinforcement. For example, if your child eats a snack of a food they do not enjoy, they can get extra time doing something they do enjoy, like watching a movie.
- Try desensitization practices. If your child has soundly rejected a certain food, but you need it to be in their diet, you can reintroduce it more slowly. For example, if your child hates oranges, you can start by putting an orange in the same room with them during playtime. They will get used to the presence of the food without having to interact with it in any way. Once they are used to the food’s presence around them, you can move it to the table during meals, but your child still does not have to eat it or touch it. Then, you can introduce the food to their plate, while they still do not have to eat it. Finally, you can get them to try the food once their original feelings of rejection around the food have been resolved.
- Adjust textures. If your child refuses to eat foods of certain textures, you can also prepare a wider range of foods that match the textures they prefer. For example, if they only like semisoft food, you can add cooked fruits and vegetables to their diet, which match the textures of the grains and proteins they prefer.
Support Your Child With Many Approaches to Fix Picky Eating
You can also rephrase how you present food to your child. For example, instead of asking what your child wants to eat, tell them what options are available. You can offer several nutritional foods, so they still get to choose but all the options are healthy.
Get your child involved in preparing food, which is another way to help them get used to it. You can try masking the smell of certain foods by combining them with other foods. You may also try to offer your child something delicious to drink after they’ve tried a food they rejected previously.
You may need to work with your pediatrician and behavior therapist to manage your child’s physical health, in case there is an underlying cause for their rejection and discomfort. Behavior approaches to eating work best for most children with autism. Over time, you’ll notice less picky eating and more openness to trying new foods.
- Unusual Eating Behaviors May Be a New Diagnostic Indicator for Autism. (July 2019). Penn State.
- Autism and Food Aversions: Seven Ways to Help a Picky Eater. Autism Speaks.
- Improving Food Selectivity in Children With Autism. Association for Science in Autism Treatment (ASAT).
- Practical Strategies for Feeding Aversions in Children With Autism. Center for Autism & Related Disabilities at the University of South Florida.
- A Behavior-Analytic Approach to the Assessment and Treatment of Pediatric Feeding Disorders. (2015). Clinical and Organizational Applications of Applied Behavior Analysis.
- How to Help Your Child With Autism Overcome Picky Eating. Autism Parenting Magazine.