Picky Eating and Autism

Picky eating is often considered to be a typical, albeit temporary, part of child development. But what happens when they don’t just “grow out of it” and your child’s picky eating becomes cause for concern? This is often the case for parents of children diagnosed with autism spectrum disorder (ASD), with research showing that people with ASD are five times more likely than their peers to develop an eating, or feeding, problem.

Feeding problems in children can look very different. For some children, this may mean that they stick to one food group (carbs, for example), or they may prefer very specific brands of food. Other children may experience food jags, which is when they consume only one or a small group of foods over and over again for every meal. Specifically, in children with ASD, we often see sensitivities to certain textures or temperatures and increased rates of problem behaviors, such as crying or leaving the table during meals. If left untreated, these picky eating behaviors can continue to escalate, resulting in a variety of concerns.

Negative outcomes associated with feeding problems

• Low body weight
• Sleep disturbance
• Immune system compromise
• Fatigue
• Increased caregiver and familial stress

When addressing picky eating in children with ASD, it is important that we are first ruling out any possible medical or skill concern that may be contributing to this problem. In addition to being at an increased risk for feeding problems, individuals with ASD are also at an increased risk for having gastrointestinal issues, such as acid reflux or constipation. Additionally, individuals with ASD may experience oral motor delays, or difficulties controlling the mouth and tongue, that can affect their ability to chew certain textures of food.

Once caregivers have taken the proper steps to rule out any contributing medical concerns, it is time to tackle feeding using the steps provided below. Remember, your child’s picky eating will not be fixed overnight. Caregivers should prioritize what aspect of their child’s eating is most important to them and start there. For example, if your child is unable to tolerate sitting at the table, you may want to first start with addressing this specific behavior.

Simple steps to prevent picky eating

1. Be consistent, persistent and patient: Picky eating will likely not improve overnight. It may take several exposures to a new food before you are successful.
2. Avoid power struggles: Give your child the opportunity to participate in making choices before meals. Once a choice has been made, it should not be changed. If your child does say they want to change their mind, tell them they can make a new choice tomorrow!
3. Set clear expectations: It is important for your child to know what to expect during meals. For example, “We are going to sit at the table during dinner today,” or “You don’t have to eat everything on your plate, but we are going to try at least one bite.”
4. Model a balanced diet: If a caregiver is avoiding certain foods, their child is likely to mimic them. Do your best to model the behaviors you want your child to do. For example, if you want your child to eat broccoli, you might need to eat broccoli too!
5. Focus on the positive: Caregivers should do their best to avoid giving attention to problem behaviors. Instead, provide praise and high-quality attention for the behaviors you want to see. This can include sitting in the chair, participating in the meal and trying new foods!
6. Make mealtimes fun!

For more in-depth information on addressing your child’s picky eating, please check out our blog post titled “Managing Mealtime: A Parent’s Guide to Successful Mealtime”. If you feel like your child may benefit from services targeting limited variety or food refusal, please contact the Pediatric Feeding and Swallowing Disorders Team at the Michael R. Boh Center for Child Development at (504) 493-2019 or email at feedingclinic@ochsner.org.