Feeding Challenges and Food Aversions: Helpful Hints for Parents of Autistic Children
Picky eating habits are one of the most common complaints from parents of autistic children. Challenges can range from a limited diet where a child will only eat from a few food groups (like only meat and grains), overeating or not eating enough, oral motor difficulties that prevent proper chewing and processing of food, to sensory issues around food such as texture or colour, and digestive issues. Many parents find mealtimes frustrating, and become concerned about their child’s nutrition, health and overall well-being due to feeding problems. Below is a list of some of the best tips I have learned during almost two decades of mealtimes with my two children on the spectrum:
1) Keep mealtimes calm and stress-free. Avoid eating in a hurry or on the go, or feeling frustrated by how meals “generally” seem to go. Try to budget enough time for a relaxed atmosphere. That is not always easy when you are a busy family!
2) Set a routine for mealtimes. Individuals with ASD thrive on routine so create a set plan around mealtimes that is consistent and predictable. Choose a regular time and place for eating as much as possible.
3) Create a visual plan around mealtime. Some children feel anxious about when an activity will end so show them the steps of eating a meal and let them know when they will be finished. If you can, involve your child in food preparation so they become part of the meal preparation process. This creates a predictable routine and involves the child in the meal process.
4) If your child prefers to eat alone, investigate the reason for this. I know one autistic adult who cannot tolerate the sound of other people chewing so she can only join her family for meals if she is wearing noise-cancelling headphones.
5) Teach rules around food serving sizes if you have a child who over-eats. For example, our son used to sneak a bag of his gluten-free cookies and eat them all in one sitting. We taught him a serving size was 6 cookies and he now follows that rule by counting them out and placing them in a bowl.
6) Look for signs of food intolerances. Things like a bloated stomach, diarrhea, changes in bowel movements (frequency, color or smell), headaches, constipation, sleep disturbances, or acid reflux are not normal parts of healthy digestion, and may be a sign of food sensitivity. There may be a physical cause for your child’s avoidance of certain foods.
7) If you do suspect there is food intolerances, keep a food journal so problem foods can be identified. It can be hard to track what foods are causing issues, and sometimes it’s not one food but combinations. Keep a journal and then take that with you to your doctor. Also, consider visiting a dietician if there are food intolerances, or you suspect food intolerances. In our case, it was a dietician who discovered our children needed to follow a gluten-free/casein-free diet. They have been on this diet since they were a year old, before they were diagnosed with autism.
8) Allow time to explore new foods. When introducing a new food, allow the child time to explore it and get used to it being on the plate. It takes approximately 20 exposures to a new food before a child will try that food.
9) Avoid feeding your child at least 2 hours before bedtime. Nighttime snacking can cause sleep disturbances and make it more difficult for the child to fall asleep.
10) If the child will only eat certain textures: consider having an assessment done by a speech pathologist or occupational therapist. There may be an oral motor problem that makes chewing and swallowing difficult or sensory issues that need to be identified.
11) If the child follows a limited diet: consult a physician about supplementation of vitamins and minerals. A person has to eat a wide variety of foods to get the required daily intake of nutrients and this does not always happen with people on the autism spectrum.
Finally, talk to other parents and ask what works for them or what they struggle with when it comes to eating. It will offer you support, and a group of parents putting their heads together come up with great solutions and sources of information!
Recommended Reading for Feeding Challenges
Just Take A Bite
Improving Speech and Eating Skills in Children with Autism Spectrum Disorders
Can’t Eat, Won’t Eat
Feeding Your Child with Autism: A Family-Centered Guide to Meeting the Challenges
Starting the GF/CF Diet
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