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Feeding Children With Autism Spectrum / Sensory Defensiveness Disorders

Many of us can relate to the challenges of trying to feed picky eaters. Yet, this is not uncommon and is often resolved with time. Children on the autism spectrum, however, may be more restrictive in their food choices thanwhat is typical. This selectivity may extend beyond the early childhood years, presenting challenges for families including distressing mealtimes.

Food selectivity in children with autism spectrum disorders can be affected by both behavioral and environmental problems, and one of the consistent themes relates to food textures. How foods look, feel, or smell are commonsensory factors for individuals with autism. The temperature or texture needs to be “just right” or have “perfect” uniformity. Needless to say, this can be taxing. Yet, children with autism can be reasonably healthy eaters and enjoy a wide range of foods. In this Note, we’ll explore some of strategies that can be done at home to address eating and feeding problems, to lead to more pleasant mealtime routines.

WHAT DOESN’T WORK?

Before we talk about what may work, it’s helpful to talk about what we know doesn’t work…

• It is best not to try to “trick” your child into trying new foods, (i.e., hiding vegetables in sauce). While this can sometimes work, it can also backfire if your child detects the addition, and subsequently learns to be become suspicious of all foods.
• Both force-feeding and withholding food are not recommended. Force-feeding may increase your child’s resistance to trying new foods, and withholding food may cause your child to lose height and weight.
• “Insisting” that your child eat only healthy foods.
• Expecting your child to imitate other children.

WHAT MAY WORK?

• Gradually introduce new foods, so your child may become desensitized to the smell, look, and feel of unfamiliar items.
• Offer new foods on a daily basis, one or two times per day, in an effort to desensitize your child. Do not attach expectations to your child to try or eat it -– this is all about repeated exposure.
• Choose foods that have the best “sensory fit.” For example, if your child likes crunchy foods, then introduce raw carrots, celery, and apples. Or, try new foods similar to a favorite food, such as a different brand of the same food in the same flavor, or a different flavored yogurt (if your child enjoys yogurt).
• Try naturally occurring pureed or smooth foods (such as applesauce) in very small amounts. The reason for this is, when your child accepts a bite of pureed food, swallowing is almost guaranteed. Increase the bite-size gradually.
• Another strategy is to alternate offering small bites of the new food with small bites of a highly desirable food.
• Stick to a daily, predictable schedule of meals and snacks, and eliminate grazing between meals.
• Kids often fill up on liquids between meals, making them less likely to feel hungry at meal time. You might consider limiting access to liquids (particularly high-sugar, high-calorie liquids) between meals, and sticking with water to support hydration based on activity level and weather.

Since struggles over eating often make matters worse, gradual exposure to new foods is very important, and it’s important to be both calm and not controlling. The most successful experiences are when the child feels a sense of control. The idea is to make trying new foods both pleasant and successful.

If your child has a difficult time sitting at the table overt he course of an entire meal, there are a few ideas you could consider. One idea would be to allow a designated time for physical activity beforehand, so he or she comes to the table both hungry and prepared to sit and rest for a period of time.  You might also try setting a timer, beginning with just a few minutes and gradually lengthening the time so success can be built.

There is no doubt that eating and feeding challenges can be overwhelming for families, especially given that meal times occur three times per day.  As you take steps for more positive outcomes, patience is a key to success. Take small steps (even if they feel painfully small) to structure meal times and calmly offer new foods in a non-controlling way.

Finally, stay positive and stay at it!

Anne Marie Kuchera, our Kids Plus Nutrition Consultant, is a Licensed Professional Counselor and Registered Dietitian.