For many parents, managing fussy eating in children is a daily struggle.
However, for parents with children on the autism spectrum, fussy eating is significantly more challenging.
Autism spectrum disorders (ASD) are characterised by an impaired ability to engage in social interactions as well as a deficit of verbal and non-verbal communication, and restricted, repetitive and stereotyped patterns of behaviour and interests. This can significantly impact on diet, as children on the spectrum are more likely to have food sensitivities and aversions.
Children are constantly changing as they get older and adequate nutrition is vital to ensure proper growth and development. Children with ASD are more likely to be sensitive to taste, smell, texture and appearance of food as well as any distractions around them which means they are more likely to be fussy eaters and at greater risk of developing nutrient deficiencies.
8 Ways to Manage Fussy Eating Behaviours
Managing fussy eating can be hard and finding the best ways is usually a matter of trial and error. Here are 8 strategies to help improve fussy eating:
- Keep a food diary. Keep track of everything related to what your child is eating. What (type, amount, texture, taste), where (environment, were people around? Who was around?), when (time of day), and how they reacted (did they eat it quietly? Did they dismiss it without trying?). All these will help you to get a good idea of some of the main barriers you will need to overcome.
- Keep mealtimes regular. Having meals at the same (or similar) time every day will help to create a familiar routine.
- Ask. Your child will generally have a justification why they don’t like a certain food and this will help you to understand the reasons for the aversions and sensitivities.
- Make small changes. If you know foods or textures that your child already likes, try giving something similar. If your child likes bread and butter, try a different spread like smooth peanut butter.
- Give a new food with one of your child’s favourite foods. This might help your child relate the new food to something they like.
- With new foods, let your child experiment and build up to eating. Start by letting them touch, smell, and bring the food to their lips, before touching it with their tongue and then tasting the food. This may be done in a day, but could also take months to get to the final step, so be patient.
- Eat together. Kids look to their parents, so if they see you eating foods it will help them feel more comfortable with different foods.
- Rewards. If your child tries something new, even if they didn’t like it or eat it, give them a reward for trying. Whether it be love and praise, a hug, a toy, or their favourite food, this will encourage your child to try something new next time.
What about Adolescents and Young Adults?
When it comes to fussy eating and autism, we mainly focus on children.
But what about adolescents and young adults with ASD? There is an expansive amount of literature on children with autism, but the research on adults is much less significant in comparison.
Fussy eating is common between the ages of 2 and 6 and in most cases it will improve with age, but that doesn’t mean that it is always completely resolved by adolescence. Autism is a lifelong disorder that has potentially detrimental impacts on adult functioning, and as such, it has been suggested that symptoms of fussy eating may in fact continue to persist into adulthood.
Studies have shown that adolescents and young adults with ASD were more likely to be classified as being afraid of eating new/familiar foods, were more likely to report disliking textured foods, and less likely to enjoy strong tastes likes spices.
Nutritionally, fussy eating can increase the risk of deficiencies and obesity. Adults with ASD have increased risk of developing chronic conditions such as diabetes, heart disease and cancer.
In addition to this, more so in adolescents and young adults, fussy eating can result in negative social consequences. Being a fussy eater can limit outings with friends, and opportunities to advance daily living skills. Evidence has found that adolescents and young adults with ASD who report a fear of eating new or familiar foods had lower ratings of daily living skills.
While it may not be as severe, fussy eating can still be present in adolescents and young adults with ASD and can significantly impact on their lives. Similar to the strategies for younger children, exposure to foods is likely to be an effective intervention for fussy eating.
However, as the fussy eating has persisted into adolescence, an appropriate intervention may involve targeting the behaviours associated with the fear of trying new foods. This might involve managing things such as gastrointestinal problems, sensory processing impairments, anxiety or inflexible behaviours.
Working with a health professional can help you or your child overcome the challenges associated with fussy eating and autism. If you are concerned that important food groups or nutrients might be missing, you can make an appointment with me and I can conduct a nutritional assessment to determine if the fussy eating is causing any nutritional issues.
Author: Ashleigh Hamilton, BHlthSc (Nutr & Diet), MSc (Diet), APD.
Accredited Practicing Dietitian and Nutritionist, Ashleigh Hamilton, is passionate about a whole of body approach to health which encompasses both physical and mental aspects. She works with people to make lifestyle changes that will benefit their health for the future, using a range of counselling techniques including aspects of cognitive behavioural therapy, mindfulness and person-centred therapy.
To make an appointment with Brisbane Dietitian and Nutritionist, Ashleigh Hamilton, try Online Booking – Mt Gravatt or call Vision Psychology (Mt Gravatt) on (07) 3088 5422.
- Kuschner, Emily S., et al. “A preliminary study of self-reported food selectivity in adolescents and young adults with autism spectrum disorder.” Research in autism spectrum disorders 15 (2015): 53-59.
- Rastam, M. “Eating disturbances in autism spectrum disorders with focus on adolescent and adult years.” Clinical Neuropsychiatry 5.1 (2008): 31-42.
Sharp, William G., et al. “Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature.” Journal of Autism and Developmental Disorders 43.9 (2013): 2159-2173.
- Marí-Bauset, Salvador, et al. “Food Selectivity in Autism Spectrum Disorders A Systematic Review.” Journal of Child Neurology (2013): 0883073813498821.