Feeding challenges in children with ASD: why is my child a picky eater?
Depending on how it is defined, 45-90% of parents of children with autism spectrum disorder (ASD) report their child has feeding/eating difficulties. The most common feeding challenge associated with ASD is selective eating.
What is selective eating?
Selective eating, also commonly referred to as ‘picky eating’ or ‘fussy eating’, is characterised by acceptance of a very narrow range and number of foods. Almost two thirds of children with ASD will eat fewer than 20 foods. Food is often accepted or refused based on their characteristics such as flavour, texture, temperature, colour, or based on their placement i.e. on a particular plate or touching another food.
Why is my child a picky eater?
This is a difficult question to answer as it is typically multifactorial. First of all, we need to consider if there is a medical cause for your child’s selective eating e.g. reflux, tummy pain, or constipation. Sometimes children with ASD are unable to express that they are in pain or discomfort which makes identifying these issues more difficult. Selective eating can also be an extension of ‘insistence on sameness’ and fear or dislike of uncertainty. Heightened senses that cause the sensory activity of eating to be overwhelming or unenjoyable for the child can also be a factor.
Why is selective eating a concern?
Selective eating difficulties can include;
1. The child not eating enough for adequate growth and development.
2. The child only accepting food that is energy dense which can lead to excessive weight gain.
3. The child only accepting food of low nutritional value which can lead to nutrient deficiencies.
4. The child not eating enough volume or variety to support gut function, leading to constipation.
5. Stress/concern for parents and other family members
6. Anxiety for the child
Often two or three of the above difficulties will co-exist or appear at different times throughout childhood.
What next?
Acorn Autism uses a multidisciplinary approach to help reduce your child’s anxiety around trying new foods, aiming to increase food variety and flexibility. Our dietitian can assess the adequacy of your child’s current diet and therefore help to prioritise which foods to explore first. As a team, we collaborate with each other and with you as parents to determine the best approach for your child. We involve parents in our feeding therapy sessions to empower you to continue increasing your child’s food variety at home. Please contact Acorn Autism for more information.