Does serving pizza, processed foods, or chips every day for lunch and dinner sound familiar? Meal time can be an important part of the day for families to talk to each other, relax, and bond. These are the perfect times for modeling proper manners and setting an example of healthy eating. Furthermore, research shows that children who eat dinner with families have a lower chance of engaging in high risk behaviors later on in life. It can be a difficult and anxious time for a child with autism which can create a stressful situation for parents.
When it comes to your child on the spectrum, making sure they get the right nutrition can be a battle. This can be very frustrating for parents and can sometimes leading to giving up or “giving in” and feeding the child only what they prefer. Think back to when you were a kid, did you enjoy eating fruits and vegetables? Most likely your answer is no. One important aspect of this for parents to understand is that this is not your fault, you did not create this problem. In certain cases, this can be very dangerous for the child’s wellbeing. Melissa Olive Ph.D., a psychologist with experience treating eating disorders, says “some of them limit what they eat, in some instances so severely that it results in nutritional deficiencies that lead to weight loss, malnutrition and inadequate growth”.
In the journal article: Food Selectivity in Children with Autism Spectrum Disorders and Typically Developing Children, the study concluded that food selectivity is more common in children with autism than in typically developing children, and limited diet may be associated with nutrient inadequacies. The article states that “children with ASDs exhibited more food refusal than typically developing children. A more limited food repertoire was reported for children with ASDs than typically developing children. Only four children with ASDs and one typically developing child were reported to demonstrate high frequency single food intake. Children with a more limited food repertoire had inadequate intakes of a greater number of nutrients”.
Often times a child’s diet will be diverse until one day they begin to be much pickier and only want to eat a few preferred foods. These foods tend to be unhealthy. This can be related to many different factors. The following is a list of some but not all of the possible reasons:
- Pain or discomfort when eating. This could be due to an underlying medical condition such as reflux
- Seeing familiar others dislike certain foods such as family members or classmates
- Children on the spectrum tend to stick to rituals and routines. This can include food and can cause a child to be cautious when trying new foods and sometimes they will even refuse to eat anything new. This can make it difficult to introduce nutritious foods and replace the normal foods the child is used to. They may want the same food, in the same color container, on the very same plate they ate on the day before.
- Sensory issues such as not liking the texture of certain foods
- Medications can change the taste of the food for the child
- Difficulty swallowing food
- Is the eating difficulty a social interaction issue? Does the child eat the same foods when around certain people?
In their book Food Chaining: The Proven 6-Step Plan to Stop Picky Eating, Solve Feeding Problems, and Expand Your Childs Diet Food Chaining: The Proven 6-Step Plan to Stop Picky Eating, Solve Feeding Problems, and Expand Your Child’s Diet, Cheri Fraker, Mark Fishbein MD, Sibyl Cox, and Laura Walbert offer a “common sense approach to dealing with problem eaters”. The authors analyze the different characteristics of the child’s preferred food. These characteristics include textures, flavors, and food groups. The foods that are similar to preferred foods but are also nutritious are then introduced.
An additional approach is the the Sequential Oral Sensory (SOS) feeding program created by Dr. Kay Toomey. This program “integrates sensory, motor, oral, behavioral/learning, medical and nutritional factors and approaches in order to comprehensively evaluate and manage children with feeding/growth problems. It is based on the normal developmental steps and skills of feeding”.