Why Is My Child With Autism a Picky Eater?
Prevalence of Autism and Picky Eating
An often-cited statistic is that 90% of children with autism have feeding difficulties. When you hear something like this, it’s easy to think that your child with autism is a picky eater because they have autism, end of story. You might think this is just another thing that their child has to face because of their diagnosis. And yet, even though lots of children with autism struggle with picky eating, these challenges are highly individual and the reason why YOUR child might refuse to eat new foods could be very different than another child on the spectrum. So, knowing that lots of kids with autism have picky eating isn’t the end of the story. As a feeding therapist, I need to know more about your child and their history with eating in order to truly understand what is making them picky. …and to know how to treat their picky eating.
So, why is my child with autism a picky eater?
Let’s put on our detective hats and start to think critically about how to answer that question. There are a lot of systems at work in the body when we talk about eating. I made you this picture to give you an idea of just some of the systems I’m talking about. The systems are the white bubbles and branching out from those are factors to consider:
It’s important to dig deep and think about your child and what might be going on for him or her in each of these, and any other, systems.
Take mental health for example.
If your child is anxious about or fearful of trying new things, this is something that could definitely be contributing to their food refusal at mealtimes when you are presenting new foods. Their fear of trying new things is going to rear its ugly head right on top of that plate of broccoli.
If your child, like most kiddos with autism, tends to be someone who relies on routines and is inflexible about schedule changes, then they might really like to have predictable foods available at the table. They are going to struggle when you change their regular breakfast of cinnamon oatmeal to apple-flavored oatmeal.
Let’s shift to fine motor skills.
If your child struggles to pick up small food items or has difficulty coordinating to pick up a cup with one, or even two hands, then the effort required for them to eat is much greater than it is for a child who doesn't have those fine motor deficits. When you ask them to try raisins for the first time, not only is this a new food, but it’s really hard to even pick that raisin up. This could definitely contribute to their food refusal or tantrums at the table.
Now let’s look at an example from the GI tract.
If your child is constipated, they are going to be less interested in food or eating than if they are not constipated. Constipation gives our bodies a feeling of fullness we don’t otherwise have that can sabotage our interest in meals. So, when your child sits down to your new casserole recipe feeling full, not only are they going to see a new food, but they are also going to have little room in their belly for a meal.
Putting it Together
Are these examples helping? Are you starting to see how concerns in any of these areas can really contribute to problems at mealtimes? If so, you can start to fill in the blank around why your child with autism struggles with picky eating. Use this information to start writing a list of reasons why your child is picky. Your list is going to be highly individual to your child and, hopefully, it’s going to start guiding your thinking around what supports your child might need. By that, I mean, if constipation is on your list, then you’re going to want to see your pediatrician to get recommendations on how to get more regular stooling. If fine motor skill deficits are on your list, then you might consider working with an occupational therapist to improve your child’s skills in this area.
It Takes a Village
Earlier, I described the importance of having a feeding team to assess your child before starting any ongoing feeding therapy. This ensures that your child’s whole person is taken into account, that is, all of the systems from that picture above. This includes your child’s medical history, their feeding skills (such as their ability to use a cup and spoon or their ability to chew and swallow), their nutritional intake and finally, their development, mental health and feeding environment. All of this insight can help you to determine 1) what to do and 2) the order of things to do for your child with autism and picky eating. This is also how you and your child’s feeding therapy team can individualize treatment based on your child’s unique reasons for being a picky eater that go way beyond the reason: because they have autism.
What are some of the systems or factors that are influencing your child with autism’s picky eating the most? Tell me below!
