Autism and food sensitivities

Getting our kids to eat the same cooked meal sat nicely at the table seems almost impossible, unless we go to Pizza Express! My boys both have fairly limited diets and typically they like & dislike different things.  As a parent it is really stressful when you have a child with food sensitivities, feeding our kids healthy food is an important part of our job. 

You often get people saying ‘he will eat when he is hungry’ I promise you this is not the case for every child. Yes some kids eat really well with very little input from anyone, others respond well to strict parenting but many don’t. I have two kids that certainly don’t respond to most parenting techniques, trust me I have tried a lot of different things.

Food sensitivities are not exclusive to autism and every autistic child will have different sensitivities or reasons behind their issues with food. In this post I will explore some more common food issues an autistic child may have.  I will also share some ideas on how to support them.

Stressful mealtimes

Mealtimes can be difficult and stressful often when we place unreasonable expectations on our kids.  If you have a child that has a developmental delay it is very likely they will take longer to be able to sit nicely at the table.  Our kids appetite likely varies from day to day- are we putting unrealistic expectations on how much they should be eating.

There are so many reasons that meals can be stressful –

• Reluctance to try new foods
• Food / eating rituals
• Eating too few foods
• Eating too much

I think we often put a lot of pressure on ourselves to try and make mealtimes perfect and it just isn’t necessary. Once I started to focus on having a balanced but still limited diet and nothing else things have improved. It’s always important to pick your battles.

Sensory food sensitivities

It’s no surprise that those with sensory processing issues find eating a challenge, it is a highly sensory experience.

Think about how our senses interact with food:

• Texture
• Appearance (colour / shape)
• Taste (flavours)
• Smell
• Temperature
• Auditory – noisy chewing, crunching and sucking

Individuals can be over or under sensitive but they can also be both.  Some smells, tastes, textures can be overpowering and/or intolerable to different people.  My youngest hates chocolate which I find hard to understand but it really is different for everyone.

Our jaw contains a high level of proprioceptors and sensory seekers can benefit from sensory input in their mouth with chewing, biting and crunching being great ways to get this input.  When eating try really chewy foods like bagels, raisins, fruit yo-yo’s and ice. Sensory seeking can contribute to overeating so Chewlry is a great way to provide the sensory feedback when not wanting to eat, we love the options from Chewigem. 

Those with poor proprioception may have difficulty with co-ordinating movements, cutlery, hand to mouth, chewing, swallowing.

Interoception is our sense of signals inside our body like feeling full / hungry  or pain, some autistic individuals find it very hard to read these particular signals. If this is the case it can really help to have set routines around eating.

Find out more about sensory processing in my post on the sensory side to autism.

Autism and eating

There are many other issues relating to food that are not sensory related.

Social interaction can be challenging, some will like to eat with others and learn from modelled behaviour. Others may want / need to eat alone or with distractions like the TV.  I think balance is important for everyone here. We might do sit down family meals at the weekend and dinner in front of the telly after school.  Remember to consider what your child is able to cope with and adjust your expectations according to their ability. 

Routine around mealtimes is beneficial for many, some will struggle with feeling hunger and having a set mealtime helps to remind them to eat.  It is also great for those who need structure to their day.  Some will have a need for structure to minimise anxiety. Try to have clear expectations around mealtimes.  With food rituals try and pick your battles, if a child needs to sit in the same spot, with the same plate etc try and accommodate this.  Ideally we want to remove as much anxiety around eating as possible.

The need for sameness can also be an issue with food brands / types.  Some children are very sensitive to flavours and can tell instantly when a recipe has been changed.  Also branding changes can be an problem as it will be an unexpected change.  Being sensitive to your child’s experience even when it is strange to you will assist them to adjust to the changes / issue.

Many children feel the need for control and independence especially around what they eat.  Family style eating with everything shared in the middle can help with this.  Providing choices and also getting your children involved in the cooking process are all good ways to support children who need control.

Make sure choices are appropriate and provided in a way a child can understand such as visual aids.

Adapted seating can help with children who struggle to sit at the table such as wobble cushions and or footrests.

PICA is eating or mouthing inedible objects such as stones, dirt, metal see this PICA Factsheet for more information.

What should my child be eating?

Ideally your child will be eating 3 small meals a day with a 2 snacks one in the morning the other in the afternoon.  For a balanced diet we want kids to be eating something from each of the main food groups:

• Protein –  meat, fish, eggs, beans
• Fruit  – apples, melons, pear, strawberries 
• Veggies – carrot, tomatoes, cucumber
• Carbohydrates – bread, rice, potato, pasta
• Milk & Dairy – cheese, yoghurt

Also foods high in fat / sugar like small biscuits / cake are good in moderation. When our kids have restricted diets it can be very hard to cover all these groups but keep trying because if you can find just one item from each of these groups it will make a difference. My eldest really struggles with vegetables and the only way I can get them in him is with smoothies but that’s still going in so a win as far as I am concerned.

Also try to think of the food intake over a week rather than a day, appetite can vary day to day so it can be better to look weekly. For those with limited foods, write out what they will eat and see what you can try that is similar. So if they eat bread try all sorts of breads like pitta bread, flatbread, rolls, bagels, crumpets and so on.

Give smaller portion sizes and then offer more if they finish what they have, often we give children larger portions than they need.

As long as a child has some dietary variety and is eating foods from each of the main food groups and growing well then there is not necessarily any need for concern.

When to be concerned:

• weight loss
• lack of growth
• excessive weight gain
• limited variety / vitamin intake.

If you are concerned then the following professionals can help:

• Occupational Therapists for sensory assessments
• Dieticians for dietary and health issues
• Paediatrician / GP for health issues
• Speech and Language Therapists can help with swallowing or feeding issues

Vitamins

Giving your child a daily multivitamin is a good idea, having said that finding the right one for them can be a challenge.  The ones I would recommend trying are:

• Abidec drops
• Haliborange softies
• Nutrigen Vitamixin sprinkles

More ideas you can try:

Gradually introduce new food items and try to introduce them first without an expectation that they are eaten.  For some like my eldest this will need to be in really small steps over a long period of time:

1. Just looking
2. Then touch
3. Now on the plate
4. Smell it
5. Put it to the moth
6. Lick it
7. Hold it in the mouth
8. Bite
9. Chew
10. Swallow

It can take a long time but many of our kids need gradual change.

Always include something your child will eat at a meal for example bread and butter. Don’t withhold preferred foods.

Try family style eating, all the bowls of food are in the centre and everyone can help themselves.  This can help for individuals that like to be in control. Seasoning and sauces should be separate also.

Let children help prepare meals, this way they can see what is in it and explore the food before any pressure to eat it. Try foods they love combined with something good for them like cake made with butternut squash or brownies made with beetroot.

Kids always get a pudding – a little bit of everything is good for you! Pudding can be a yogurt, biscuit or fruit and it shouldn’t be the reward for eating your main meal.

If the volume of food eaten is an issue try changing the size of the plate to help with anxiety

If it helps a child to eat a new food then let them cover it in sauce – broccoli covered in tomato ketchup is better than no broccoli at all. 

Replace inappropriate inedible items with safe alternatives such as crunchy food like breadsticks, raw carrots or use chewlry. If a child often goes for specific inedible items look for alternatives with similar textures

If a child is undersensitve they may like spicy, sour and salty foods.  Try things with strong oral input like ice, chewy and or hot foods

Model behaviour exposure over time will help. Don’t pressurise or force children to eat it  just increases stress and refusal.

Give new food in new / different contexts like at someone else’s house or when out on a picnic,  it can make it easier to accept something new when not in regular routine.  Also ask friends  / family members to offer new foods as they may be better accepted from other people.

Try to play with food so they can become desensitised to them without any pressure, messy play is a great way to explore foods.

If your child has a special interest can you introduce food that relates to it.  My youngest has tried and likes many foods because of his favourite characters eating them.  He loves spinach leaves thanks to the Highway Rat.

You may need to offer permission to eat for prompt reliant kids, this can even be putting the food in their hands. 

The best advice is to be patient, careful how you react the main goal is to reduce any food related anxiety.

Do you have any top tips around eating drop them into the comments below.