Autism spectrum disorder (ASD) is a developmental condition that affects how individuals think and interact with others. Depending on the severity of sensory experiences (smells, tastes, textures, noises, and body sensations) may be perceived as harmful. Children with autism are far more likely to select what they will and will not eat, often resulting in feeding concerns. This can pose serious health-related issues but can also be very challenging in a social setting.
Identifying a feeding problem, although common among young children, can be:
Autistic children often have more chronic feeding problems that go beyond “picky eating.” Children with ASD may avoid an entire food group, such as proteins or vegetables.
Common autism feeding problems indicate that the child exhibits a preference for starches and snack foods and often rejects fruits and vegetables. These behaviors may increase the child’s propensity for obesity, diabetes, and cardiovascular disease. However, more immediate consequences may include low bone growth, constipation, vitamin and mineral deficiencies. Autist children often engage in problem behaviors such as crying, disruptions, and leaving the table.
When ASD individuals consistently avoid negative sensory experiences, they may consume a limited variety of foods. Consequently, resulting in low energy, malnutrition, arrested growth, or weight loss. An eating disorder called avoidant/restrictive food intake disorder (ARFID) may occur.
Set a Feeding Schedule and Routine. Have your child eat at the same place and follow the same mealtime schedule and routine. Schedules and practices are essential for ASD children and help them know what will happen during mealtimes and what they want them to do during meals.
Avoid All Day Eating. Do not allow snacking all day or have food/drink available for your child all day. Their appetite will decrease and become unwilling to try new foods. Set aside five or six scheduled meals/snacks a day and limit how much your child eats at other times. Other family members should not snack all day, either.
Provide Comfortable and Supportive Seating. Place your child in a high-chair, booster, or at a child-size table so that he or she is able to sit upright without leaning, swaying, or dangling his or her feet. This physical stability promotes good feeding behaviors and reduces distracting behaviors by allowing them to feel “grounded” and safe.
Limit Mealtime. Even picky eaters do most of their eating in the first 30 minutes. Limit mealtimes and snacks to 15-30 minutes. At the end of the mealtime, remove all food and allow your child to move on to other activities.
Minimize Distractions. Distractions such as the TV can take the focus off the food. Feed your child only when he or she is alert and attentive.
Get Your Child Involved. Allow your child to help with the selection and creation of meals. Involving your child allows them to explore and play with different foods.
Practice Pleasant and Healthy Eating Behaviors. Children learn by observing. During family mealtimes, parents and other children can model good eating behavior. Make mealtime fun, and don’t over-focus on your child’s eating. Avoid repeatedly prompting, coaxing, and begging.
Reward Positive Behaviors. Offer praise when your child approaches or tries new foods. Immediate rewards can be helpful to encourage new feeding behaviors. Rewarding good mealtime behaviors will increase the likelihood that they will happen again.
Ignore Negative Behaviors. When possible, ignore your child when they are doing things such as spitting, throwing, or refusing food. It is essential to offer foods your child already likes and foods your child does not yet enjoy. A good example might be only to offer three foods at a time. Include one to two foods your child already likes and one food your child does not.
Presentation. Present new foods in small bites and in fun or familiar ways to make it more likely that your child will eat them (autismspeaks.com).
While your child is at the table, engage in “table talk about food” (examples):
Is the food wet/dry?
Does it have a big/little smell?
How is this spaghetti different from that spaghetti?
What sound does it make when you chew it?
What other foods do we eat that have the same color?
Becoming aware and following the outlined mealtime tips, your child’s eating habits may change – and so will your family’s behaviors. That could be good news for all of us!
Written by PJ Larsen, Ed. D., Veteran classroom teacher, college professor, and adventure traveler.
The child who is ‘left behind’ most is the one who leaves school without transition readiness.
Dr. James Stanfield, Ed.D.