Families For Life | Eating Habits: Children and Teenagers with Autism Spectrum Disorder
Some children with autism spectrum disorder (ASD) are fussy eaters. Other children overeat, undereat or eat non-food items like soap, rubbish or toy parts. These tips will help you manage your child’s eating behaviour.
Fussy eating habits and autism spectrum disorder
Some children and teenagers with autism spectrum disorder (ASD) are fussy eaters and will eat only a limited range of food.
If your child’s diet is severely limited – for example, he eats only mushy foods – he might not be getting all the nutrients he needs. It’s a good idea to talk to your GP or a dietitian about supplementing your child’s diet.
Understanding your child’s fussy eating habits
The first step in managing your child’s eating habits is working out why your child is fussy about food.
See your GP or paediatrician to start with, to rule out any gastrointestinal problems like food intolerances.
If tummy problems aren’t the cause, the fussy eating might be because your child:
has sensory sensitivities and prefers food with particular textures
likes routines and wants the same food at the same time every day
finds it hard to try new experiences, including eating new food
has become preoccupied with a particular type of food
Encouraging a varied diet
Try using foods with textures your child likes. For example, if your child doesn’t like soft foods and will eat only crunchy foods, offer raw vegetables like carrots, rather than cooked vegetables.
Offering a choice between two foods can give your child a sense of control. This can be helpful for children who find change difficult.
At the supermarket, let your child choose some food. She might pick a food you wouldn’t have expected – perhaps it looks interesting to her, or smells good. You could try cooking it in different ways together.
In the short term, disguising foods can help your child eat a more varied diet. You could try chopping new food into tiny pieces and mixing it into something your child loves, like pasta or pizza. But this won’t change your child’s eating behaviour, so it’s also important to keep offering the foods your child has refused. When you do this, your child has the chance to get familiar with and learn to like different tastes and textures.
If your child finds change difficult, he might take a while to get familiar and comfortable with a new food. Try offering a new food, or a food your child has refused, with another healthy food that your child likes. You can also let your child sniff or lick a new food to get used to the look, feel and smell of it. You might need to let him do this over several meals before he’s willing to take a bite. If sniffing and licking a food is too much for your child, you could start just by getting your child used to having the food on his plate.
If you show your child how much you or a sibling enjoy a particular food, over time she might be willing to give it a try too. This method works particularly well for younger children who have an older sibling they look up to or copy naturally.
Praise your child when he tries a new food – for example, ‘It’s great that you tried those carrots’. You could reward him with a favourite activity, but be mindful that in the longer term you’re aiming to get your child eating a variety of food because he wants to, not just because he’ll get a reward. A reward chart might help in the short term.
Strategies to avoid
There are some things that don’t work with fussy eating habits:
Making your child eat a new food can make things worse, and your child might refuse to eat altogether.
Making a separate meal for your child will teach her that she’ll get a special meal for herself if she carries on being fussy.
Ignoring your child’s fussy eating doesn’t work and your child is likely to keep being fussy.
Punishing your child – for example, by taking away something he likes – generally doesn’t work. It’s better to reward the eating behaviour you want to see – for example, by giving your child a reward for tasting a new food. This might be a sticker or extra time doing a favourite activity.
An experienced therapist can help you understand and manage your child’s eating behaviour. This might be particularly helpful if your child also has other difficult behaviour at mealtimes, like throwing food around, gagging or refusing to sit down. Your GP can help you find a therapist.
Overeating habits and autism spectrum disorder
Overeating is less common in children and teenagers with ASD than fussy eating, but some children with ASD might graze all day, or just eat too much at mealtimes.
Understanding your child’s overeating
Working out why your child is overeating can help you manage her eating behaviour.
See your GP or paediatrician to start with, to rule out underlying medical conditions.
If there are no medical reasons, your child might be overeating for one or more of the following reasons:
Habit: Keeping a diary for a few days will help you see if there’s a pattern to your child’s snacking. Is he snacking at particular times of the day? While he’s watching TV? On the computer? When he doesn’t have anything in particular to do?
Obsessive compulsive behaviour: Is your child’s overeating more than just a habit? She might have an obsession with a particular food, which she can’t control. If your child overeats at mealtimes and wants an excessive amount of food, she might be showing signs of compulsive behaviour.
Medication side effects: Some behaviour medications can make children eat more and gain weight. This is because the medications change the hormones that control appetite and how the body processes food.
Unpredictable mealtimes: If your child doesn’t have set mealtimes, he might be more likely to snack throughout the day.
Sensory sensitivities: For example, if your child likes soft textures, she might regularly seek out soft foods.
Managing your child’s overeating
If you think the overeating might be because of obsessions or compulsions, try to limit how much food you put on your child’s plate, and how much food is in sight.
If you think your child’s medication might be the problem, talk to your paediatrician about prescribing another medication. It can take a bit of trial and error to work out which medication works best with your child’s body.
Regular mealtimes can help your child adjust to eating certain quantities of food at certain times. While your child is getting used to the new routine, it can help to have some low-fat, low-energy snacks handy, so that he’s not too full by the next mealtime.
Try teaching your child what ‘hungry’ and ‘full’ feel like. If she doesn’t feel ‘hungry’, she should wait a little longer to eat. If she still feels hungry after a meal, encourage her to wait a few minutes. More often than not, she’ll feel full then.
Sometimes children think they’re hungry when they’re really just thirsty. Make sure that your child drinks plenty of water throughout the day, between mealtimes.
If your child snacks when he’s bored, try to have some back-up activities handy to keep him busy until it’s time to eat.
Keeping ‘problem’ or snack foods out of reach can help your child to snack less. If your child is older, or particularly good at reaching hidden spaces, you might need to keep these foods out of your house.
Encourage your child to do some physical activity as part of a balanced, healthy lifestyle.
If your child seeks out particular sensory sensations, try to replace one sensory object (food) for another (non-food). For example, if your child likes the feeling of soft substances in her mouth, you could make time each day for her to play with playdough. If she seeks out soft food, try giving her the playdough to feel with her hands instead.
Our dietary guidelines can help you work out whether your child is getting the right portion sizes for his age: food for children 2-3 years and food for children 4-8 years.
Non-food eating habits and autism spectrum disorder
Some children with ASD will mouth or eat non-food items, like dirt, hair, coins, soap or fabric.
This is called pica. It can be quite dangerous. If left untreated, it can lead to infections, increased levels of toxins or malnutrition.
Like fussy eating or overeating, pica can be the result of sensory issues. It can also come from obsessive compulsive behaviour, stress, anxiety or malnutrition.
You could try replacing non-food items with snacks, and praise your child whenever she chooses a food item over a non-food item.
If you’re struggling to manage your child’s habit of eating non-food items, it’s best to speak to a professional, like your child’s paediatrician.
Diet as a treatment for autism spectrum disorder
There are claims that special diets can ‘cure’ or help treat ASD, but these claims are not backed up by scientific evidence. The most popular diet is the gluten-free and casein-free (GFCF) or elimination diet.
Some diets can be unhealthy or can lead to a child not getting a good balance of foods.
A few children with ASD have gluten and casein sensitivities and intolerances. These children can benefit from a GFCF diet. But research shows that a GFCF diet won’t do any good for other children with ASD who don’t have these intolerances.
The best treatment for ASD is early behaviour intervention.
© raisingchildren.net.au, translated and adapted with permission
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