Food Issues and Children with Autism
By The May Institute

Q: My 5-year-old son has autism. He has always been a picky eater, but his eating habits seem to be getting worse. How can I get him to eat better?

A: "Eating disorders are common in all children," says Colleen O’Leary Zonarich, M.A., BCBA, Senior Educational Consultant for School Consultation and Family Support Services at May Institute. "Nearly half of all typically developing children experience eating problems at some point during their childhood. While experts in the field are trying to better determine the number of children with feeding issues, and what causes those issues, researchers have suggested that up to 90 percent of children with developmental disabilities such as autism have issues with food."

According to Zonarich, typically developing children with feeding issues often outgrow them, while children with disabilities do not. For these children, systematic intervention and collaborative efforts are the best ways to promote better eating habits and improved their overall health.

"Well-meaning friends may suggest that if you let your child get hungry enough, he or she will eventually eat. Unfortunately, this is not always the case," Zonarich warns. "Children with special needs require special intervention."

Children with autism have many different types of feeding issues including over-eating, food selectivity (eating only certain foods), food refusal, and pica (eating non-edible items). In addition, they often have problems sucking, chewing, and swallowing, and may be unable to feed themselves. Disruptive behavior such as tantrums, spitting, and pushing or throwing food away also contributes to feeding and eating problems.

"Proper nutrition is the primary concern for all children," says Zonarich. "Children with developmental disabilities may need a ‘food intervention team’ to help ensure they get adequate nutrition. This team often includes parents, physicians, a nutritionist, school nurse, teachers/paraprofessionals, physical, occupational, and speech therapists, and a behavior analyst."

Before implementing an intervention program that is tailored for the individual child, the team will first rule out any medical issues. They will come to consensus about long-term goals, supports needed for families and school teams (i.e., materials, staff, environmental/food preparation) when to begin intervention, and how to collect and share information. The team also takes responsibility for providing a structured environment and functional mealtime routine, and any necessary adaptive equipment (i.e., seating arrangements, special utensils or bowls; suggested by therapist).

After deciding which foods to target, and how much of them to offer to the child, the team determines the best approach for ensuring increased acceptance of foods and drinks. Different strategies include systematic sampling of new foods, rewarding children for accepting new foods, and providing assistance with eating. The team may also try repeated presentations of new foods, blending new foods with already accepted foods and textures, and/or peer modeling of others eating the new foods.

"Once a new food is accepted, it’s important to put a maintenance program in place to ensure continuing progress," Zonarich explains. "With an effective plan in place, a consistent approach, and a lot of patience, mealtime can become a more enjoyable experience for children with autism and their families."

May Institute is a national nonprofit organization that provides educational, rehabilitative, and behavioral healthcare services to individuals with autism and other developmental disabilities, brain injury, mental illness, and behavioral healthcare needs. May Institute operates six schools for children and adolescents with autism and other developmental disabilities in Chatham, Randolph, West Springfield, and Woburn, Mass., Freeport, Maine, and Santa Cruz, Calif. For more information, call 800-778-7601, or visit www.mayinstitute.org.

The information presented on this site is intended solely as a general educational aid, and is neither medical nor healthcare advice for any individual problem, nor a substitute for medical or other professional advice and services from a qualified healthcare provider familiar with your unique circumstances. Always seek the advice of your physician or other qualified healthcare professional regarding any medical condition and before starting any new treatment.