Autism And Picky Eating

Understanding Picky Eating in Autism

When it comes to autism and picky eating, it's crucial to understand the unique challenges that children with autism face during mealtime. It's also equally important to familiarize oneself with the latest research on this topic to gain a comprehensive understanding and devise effective strategies.

Mealtime Challenges in Children with Autism

Children with autism are five times more likely to have mealtime challenges, according to Autism Speaks. These challenges can include extremely narrow food selections, ritualistic eating behaviors, and meal-related tantrums. Additionally, kids on the autism spectrum often express a strong preference for foods that feel a certain way in their mouths, such as soft or crunchy foods. This can significantly limit the variety of foods they are willing to eat.

Moreover, children with autism spectrum disorders (ASDs) are often described as picky or selective eaters, with very restricted repertoires of food acceptance. In some cases, this can be limited to as few as five foods. Management of food selectivity and concerns about dietary adequacy have been found to be a major reason for referral of children for nutrition services [2].

Research on Picky Eating in Autism

When it comes to research on autism and picky eating, Autism Speaks is currently funding a project focused on expanding food choices for individuals with autism. This includes addressing underlying anxiety, inflexibility, and sensory issues. The lead researcher of this project is psychologist Emily Kuschner, PhD, of the Children’s Hospital of Philadelphia (CHOP).

Furthermore, it has been noted that children with autism spectrum disorder (ASD) often have very restricted diets, with a preference for only a few food items. Symptoms like insistence on sameness, rigidity, and sensory issues can interfere with food choices and eating habits [4].

In conclusion, understanding the challenges and ongoing research related to picky eating in autism can provide valuable insight for parents, caregivers, and professionals working with children on the autism spectrum. It can also guide the development of effective strategies for managing mealtime challenges and expanding the dietary preferences of children with autism.

Strategies for Addressing Picky Eating

Dealing with picky eating in children with autism can be a significant challenge for parents and caregivers. However, there are several strategies and techniques that can help manage this issue and gently expand a child's diet.

Recommendations from Psychologist Emily Kuschner, PhD

Renowned psychologist Emily Kuschner, PhD, offers several strategies for gently expanding the diet of picky eaters with autism. These include:

1. Ruling out any medical problems that could be contributing to picky eating.
2. Staying calm during mealtimes to create a relaxed and positive environment.
3. Encouraging children to take small steps toward tasting new foods.
4. Paying attention to the texture of foods, as this can often be a significant factor in food aversion.
5. Allowing children to play with new foods to help familiarize them with different textures and tastes.
6. Offering choices and giving children some control over what they eat.
7. Being careful with rewards, as they can sometimes reinforce picky eating behaviors [3].

Techniques for Gently Expanding Diet

In addition to the strategies recommended by Dr. Kuschner, there are several other techniques that can help address mealtime issues in children with autism:

• Start with small, manageable steps and gradually increase expectations.
• Set clear expectations for mealtimes.
• Provide consistent praise and positive reinforcement for trying new foods.
• Practice "planned ignoring" to address temper tantrums during mealtimes.
• Avoid power struggles at the dinner table and focus on enjoying meals together.
• Rely on time, repetition, and familiarity when introducing new foods.
• Allow hunger to motivate eating.
• Consider using supplements designed for children with autism to address any nutrient deficiencies.
• Keep a food journal and a poop journal to track progress and identify challenges.
• Remember that parents can model good mealtime behavior. What parents model often influences children more than what they say. Modeling good eating habits, enjoying mealtime without distractions, and trying new foods can positively impact a child's eating habits.

These strategies come from both the Child Mind Institute and the Autism Parenting Magazine.

By implementing these strategies and techniques, parents and caregivers can help children with autism overcome picky eating habits and enjoy a wider variety of foods. It's important to remember that every child is unique, and what works for one child may not work for another. Patience, persistence, and flexibility are key in managing autism and picky eating.

Factors Influencing Food Preferences

Various factors influence food preferences in individuals with autism, leading to the common association between autism and picky eating. Two significant factors include sensory sensitivity, often associated with Autism Spectrum Disorders (ASDs), and the impact of oral motor musculature.

Sensory Sensitivity in Autism

Sensory sensitivity is a common trait in individuals with ASDs, and it significantly affects their food preferences. This sensitivity can manifest as tactile defensiveness, where an individual may feel overwhelmed by certain food textures, smells, or tastes. This can lead to food selectivity, where the individual restricts their intake to foods with preferred, tolerable, and manageable textures [2].

For example, a child with ASD might reject a food because it feels too rough on their tongue or because its smell is too strong. This insistence on sameness and rigidity can interfere with food choices and eating, often leading to a very restricted diet consisting of only a few food items.

Impact of Oral Motor Musculature

The development of oral motor musculature also plays a role in food preferences in children with autism. If a child predominantly eats soft foods, this could lead to underdeveloped oral motor musculature, causing difficulties in chewing harder foods like steak or hamburger. This difficulty can further limit the variety of foods the child is comfortable eating, contributing to the perception of picky eating [1].

In conclusion, both sensory sensitivity and oral motor musculature development significantly influence food preferences in individuals with autism, often resulting in picky eating habits. Understanding these factors can provide a foundation for developing strategies to gently expand diet variety and improve nutritional intake in children with autism.

Behavioral Aspects of Picky Eating

When it comes to autism and picky eating, understanding the behavioral aspects can provide valuable insights into the challenges faced at mealtimes and offer effective strategies to handle these behaviors.

Challenges at Mealtimes

Children with autism can often struggle with sitting still and behaving safely at mealtimes. This can present a significant challenge for both the children and their families. They may also have specific preferences for foods that feel a certain way in their mouth, such as crunchy or soft foods. In some cases, children who favor soft foods may have weak jaw muscles that make eating chewier food unpleasant.

Approaches to Handling Mealtime Behaviors

Despite these challenges, there are several techniques that can be used to tackle mealtime issues in children with autism. Key among these are starting with small steps, setting clear expectations, and providing consistent praise. Parents can also practice "planned ignoring" to address temper tantrums, a method that involves not giving attention to the unwanted behavior.

Keeping a food journal and a poop journal can also be helpful in tracking progress and identifying challenges. These records can provide valuable insights into the child's eating habits and digestive health, and can be used as a reference during consultations with healthcare providers.

Moreover, parents should model good mealtime behavior, as what they model often influences children more than what they say. By demonstrating good eating habits, enjoying mealtime without distractions, and showing willingness to try new foods, parents can set a positive example for their children to follow.

Understanding and addressing the behavioral aspects of picky eating in children with autism can make mealtimes more enjoyable and less stressful for everyone involved. With patience, consistency, and the right strategies, it is possible to expand the child's diet and improve their mealtime behaviors.

Nutritional Concerns and Effects

The impact of picky eating, particularly in children with autism, extends beyond mealtime challenges. It can lead to nutritional deficiencies and impact growth and development.

Nutritional Deficiencies in Picky Eaters

Children with autism spectrum disorder (ASD) often have very restricted diets, with a preference for only a few food items. This is due to symptoms like insistence on sameness, rigidity, and sensory issues, which can interfere with food choices and eating. As a result, they may consume fewer fruits and vegetables and may have lower levels of calcium and protein compared to typically developing peers [5].

Picky eating behavior can also lead to a reduction in overall food intake, distortion of nutrient intake, and poor dietary variety. While energy intakes in picky children may vary across studies, there is a consensus on low intakes of essential minerals like zinc and iron in picky eaters.

Impact on Growth and Development

Children with autism are more prone to gastrointestinal (GI) issues, such as diarrhea or constipation, and may have specific food allergies, which can contribute to their picky eating habits [4]. These dietary restrictions and preferences can lead to unhealthy eating habits, mealtime-related behavioral problems, and an increased risk of developmental delays, stunting, and nutritional inadequacies related to malnutrition and obesity.

Research has shown that approximately 62% of children with ASD experience feeding difficulties, which are pervasive, heterogeneous, and complex in nature. These difficulties can contribute to a child's inability to meet their nutritional needs, potentially impacting their physical growth and cognitive development [5].

To ensure children with autism meet their nutritional needs, despite their picky eating habits, it's crucial to consult healthcare providers and work with occupational therapists. They can provide strategies and interventions tailored to each child's unique needs and preferences, helping them to expand their diet in a way that is comfortable and sustainable for them.

Seeking Support and Intervention

Managing autism and picky eating can be a complex task. It often requires the input and expertise of various healthcare providers and therapists. Engaging these professionals can help develop strategies to cope with mealtime challenges and ensure the child receives adequate nutrition.

Consulting Healthcare Providers

Parents or caregivers concerned about their child's diet or eating habits due to autism-related picky eating should consider seeking help from healthcare providers. They can offer guidance on managing feeding difficulties and provide necessary resources for nutritional support. Healthcare providers can also refer parents to a nutritionist who can help develop a balanced diet plan considering the child's food preferences and nutritional needs. This professional guidance is essential as children with autism spectrum disorder (ASD) often experience significantly more feeding difficulties compared to typically developing children [5].

Additionally, healthcare providers can help parents understand and navigate the relationship between ASD and specific feeding and eating disorders, such as avoidant/restrictive food intake disorder (AFRID) and anorexia nervosa (AN). Studies have shown a higher prevalence of diagnosed ASD in individuals with these disorders, emphasizing the need for adapted interventions and management strategies [5].

Working with Occupational Therapists

Occupational therapists (OTs) play a crucial role in managing autism and picky eating. OTs specialize in helping children with ASD develop skills necessary for everyday activities, including eating. They can work with the child and family to develop a feeding program tailored to the child's specific needs.

An OT can introduce strategies to gradually expand the child's diet, addressing sensory sensitivities and building tolerance to different food textures, tastes, and colors. They can also provide strategies to manage mealtime-related behavioral problems, create a positive mealtime environment, and promote independent feeding skills.

In conclusion, the challenges associated with autism and picky eating are significant, but with the right support and intervention, they can be effectively managed. The collaboration of healthcare providers and occupational therapists can help ensure that children with ASD have a balanced diet and a positive mealtime experience, contributing to their overall growth, development, and well-being.

References

[1]: https://childmind.org/article/autism-and-picky-eating/

‍[2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601920/

‍[3]: https://www.autismspeaks.org/expert-opinion/autism-and-food-aversions

‍[4]: https://www.uhhospitals.org/blog/articles/2024/01/food-and-autism-is-your-child-a-picky-eater

‍[5]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9579053/

‍[6]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398579/