Why Do So Many Children With Asd Suffer From Feeding Problems
There are many qualities of children with ASD that could cause feeding problems, including: sensory impairments; restricted interests and insistence on sameness; anxiety about changes to routines or novel situations; ritualized behavior; increased focus on details of food presentation; impulsivity and challenging behavior; challenges with social skills and decreased responsiveness to the social rewards of eating; oral-motor skill deficits, biologic food intolerances or history of gastrointestinal discomfort; disrupted eating patterns; responding to internal states of hunger; and/or aversive learning events paired with eating, such as gagging, choking or vomiting episodes.
My Experience Of Eating Disorders
While I have never had a particularly great diet, predominantly living off bacon and shepherds pie for most of my early life , the lowest point of my dietary battle came in 2007, whenmy restrictive eating resulted in me being hospitalised with an eating disorder.
This all started after the breakup of my family meant that I was forced to move out from the house I had grown up in; leaving behind all sense of control as well as the nest of a routine I had spent years creating there.
I was vomiting a lot at this time as, like some kind of gross lizard seen on the Discovery Channel, my reaction to the threat of anxiety has always been to chuck up my guts. This got so bad that, in my naive mind, I thought I could overcome this permanent nausea by stopping eating altogether.
Of course, this didnt go down well with my family and resulted in dramatic weight loss. However, when they had contacted a doctor for advice, they were initially told to just wait and when I was hungry enough I would come crawling back .
Inevitably, things got much worse on these orders and, just before I reached a size where I could wear a Cheerio as a bracelet, I was taken to the hospital, extremely underweight, malnourished and diagnosed with what my friends would later delicately describe as manorexia.
What Can You Do About Picky Eating
Do you often wonder how to get your autistic child to eat new foods? The key to success is to understand that the problem is mainly a fear of new foods or new food experiences. Therefore, what we do to help picky eaters become more flexible and to try new things tends to be similar, even though picky eaters can be that way for different reasons.
Here are some proven strategies for Picky Eaters:
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Managing Overeating In Autistic Children And Teenagers
The best strategies for autistic children and teenagers who overeat depend on whats causing the overeating.
Overeating out of habit
- Keep problem or snack foods out of reach. This can encourage 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.
- Have some of your childs favourite activities handy to keep your child busy until its time for a regular meal or snack. This can be good if your child snacks when theyre bored.
- Encourage your child to do some physical activity as part of a balanced, healthy lifestyle. You could try making this part of your childs daily routine, perhaps at a time of day when your child might otherwise want to snack.
Overeating because of compulsionsIf you think your childs overeating might be because of obsessions or compulsions, try to limit how much food you put on your childs plate, and how much food is in sight.
Overeating because of unpredictable mealtimes
- Aim for regular mealtimes. This can help your child adjust to eating certain quantities of food at certain times. While your child is getting used to the new mealtime routine, it can help to have some low-fat, low-energy snacks handy, so that your child is neither too hungry nor too full at the next meal.
- Make sure that your child drinks plenty of water throughout the day, especially between mealtimes. Sometimes children think theyre hungry when theyre really just thirsty.
Enjoy Your Meals Together
Do you question how to get your autistic child to eat vegetables and other healthy foods? Try to focus on the opportunity to be together and share an experience. Dont pressure anyone to eat, eat more, eat this but not that, etc., and dont make a big deal when he/she tries something new. Your children should eat because they are hungry and they like what they eat. They should like coming to the table, and they should do all eating and drinking at the table. Eating should not be more about what you want than what satisfies your child, so common strategies that use rewards, praise or deal-making can be counterproductive.
- Eventually, youll require your child to at least tolerate the presence of the new food on his or her plate.
- Because youve planned plenty of opportunities to eat and some general rules against between-meal grazing and eating or drinking anywhere other than the table, you can afford to say, No to whining and complaining about hunger at the wrong times.
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When To Seek Professional Help
If pica is suspected, the behavior should always be discussed with a medical professional as soon as possible. Children may be tested for nutritional deficiencies to rule out malnutrition as an underlying cause. If a child is ingesting or attempting to ingest poisonous, sharp or metal objects, seek help immediately to prevent serious injury or illness.
Treating pica will require collaboration between family members, therapists, school personnel and medical professionals.
Why Are Children Picky Eaters
When you are identifying strategies to deal with extreme food selectivity in autism, it is important first to identify the causes of food selectivity in autism. Picky eating is a useful survival strategy that kept us alive since we were all hunter-gatherers. For many thousands of years, we traveled in small tribes from one new place to another. If we ate every plant along the waywe wouldnt be here. Children that were too adventurous would poison themselves on any of those many plants that were trying to kill us. Their genes never made it this far.
Just as important is the parent, especially the mother. The mother that could be nonchalant about her child not eating probably didnt have many offspring that made it either. The genes of mothers unmoved by their childs refusal to eat tend not to survive generations. ;Most mothers report that they are anxious about their childrens picky eating habits. Indeed, changes in mothers brains following bonding with their children make them acutely sensitive to signs that a child is not eating. As a result, mothers can experience feelings that fathers and other people may not understand, but that matters a lot if a change plan is to work.
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Allow Hunger To Motivate Eating:
We generally recommend five opportunities to eat in 24 hours. This includes three regular meals and two snacks. ;There isnt a problem adding more opportunities, as long as they follow a regular pattern and some rules. What you want to avoid is eating whenever your child feels like it, especially if he/she has a constant grazing type pattern. If you have more meal/snack opportunities regularly expected in the routine, then your child wont have to wait too long for another opportunity.
Build Acceptance To New Foods Through Gradual Exposure
In my practice, Ive worked with kids who are truly fearful of certain foods placed in front of them. I find that many of these children have particularly strong reactions to a foods appearance. For example, several of the kids in my practice refuse foods of certain colors. Another has an extreme fear of touching apples because they look wet. Yet another child fears even being in the same room as an orange.
Its important to appreciate and understand that these fears are just as powerful as, say, a fear of snakes or big spiders. With this in mind, I begin to use the principles of gradual exposure to help them learn to control and eventually get rid of these fears.
Take for example, the boy who felt anxious around apples. First we worked on his getting comfortable with just looking at an apple in front of him for a few minutes. I assured him he didnt have to eat it and encouraged him with praise. We then moved on to touching the apple with a fork, then with a napkin, then with his fingers. We used play-based language like I challenge you to hold the apple to your cheek for 30 seconds. He even learned to use a food processor to chop up the apple all of these steps helping him overcome what had been a very real fear.
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Children With Autism May Need Help To Stay Hydrated
Summer is a time of outdoor activities, heat, and sunshine. There is great potential for fun, as long as we are careful about our fluid intake.
You might think that it is easy to make sure you drink enough: if you are thirsty, you drink. However, children generally need help to make sure that they stay hydrated when the temperature rises, and children with special needs require extra help.
Not enough water may lead to discomfort and even serious physical distress.7
We are going to share some recommendations in this article about helping children to stay hydrated and why they need your help.
Do Children With Feeding Problems Need To See A Specialist What Should Families Do If One Is Not Available
It is important that feeding issues in children with ASD are addressed by a specialist. These problems dont resolve on their own over time and may get worse. The recommendation to let them get hungry and wait until they eat does not work and can result in serious harm. Providers should refrain from this recommendation and instead get the children and family to the right intervention specialist.
Behavioral interventions provided by an interdisciplinary team are currently the only empirically supported treatment for pediatric feeding disorders in children with ASD. Unfortunately, few of these interdisciplinary programs exist, which results in a huge barrier to accessing care. We have one such program at Childrens Autism Center, however families often encounter long wait times because there are limited providers trained in working with this complex population.
While families are waiting, providers should help parents find resources and put together their own care team, including:
Together, this team can craft a plan addressing why a child might be refusing to eat.
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Mendability Water Games And Self
Although the challenges with self-awareness for children with autism mean that they might not drink enough, water is often a great element of play and discovery for children on the autism spectrum. Mendabilitys therapy program includes specific exercises that help children with autism and developmental delays to improve their self-awareness by focusing on body posture or tactile processing. One example of these exercises is called the Water Game.
Environmental Problems That Affect Feeding And Eating
Throughout the limited feeding and eating disorders literature , environmental factors primarily focus on sensory processing variables. Children with extreme food selectivity issues are frequently dealing with many environmental factors related to sensory modulation and regulation. Selective eating is defined as eating very small amounts of food and/or restricting foods eaten to an extremely narrow selection of sometimes only one or two items. Selective eating can have significant developmental and health consequences. Extreme selective eating problems are often seen paired with strong negative reactions to the introduction of new foods. Mild selective eating is common in all toddlers and young children according to a variety of studies. It cannot be emphasized enough that the issue of concern for a significant number of children on the autism spectrum is extreme food selectivity.
Extreme food selectivity, when related to environmental and sensory issues, can be addressed successfully in many cases. The place to start is to analyze eating habits and then sensory variables. Gathering information about what the child eats successfully, and about how, when and where the child eats best can provide clues for broadening the childs diet. The following questions should be answered: what foods, with whom, where, when and how does the child eat any foods even if it is just a few foods. Frequently, there is a pattern to what foods the child eats or where the child eats successfully.
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What Causes Food Problems In Autistic People
Although it might not seem so, autistic people are often the ultimate foodies. This is because, when we sit down to eat, our minds dont just register the flavour and presentation but also every other sense and stimuli in our surroundings from the sounds we hear to the sights we see.
This is something which has always affected me and while, in recent years, my tolerance to sensory disturbances has improved, it used to be the case that a variety of senses would affect my meals; such as restaurants with electronic bathroom driers or even waitresses with too much makeup.
But while sensory problems are the most common reason for fussy eating on the spectrum, they arent the only one as many autistic people can struggle to eat something due to the connotations we have made with that particular food.
One example of this is a boy who would only eat pink foods. This arose after he had conditioned himself to believe that only pink food was healthy, due to the link he had made between wellness and the U.K.s favourite childrens medicine: Calpol .
This is not the end of the challenges autistic people have when it comes to eating, however, as there are also many other autistic quirk related factors which play a role in unhealthy diets: including those who are susceptible to pica and those with obsessive personalities, who may calorie count.
Focus On The Foods Not Behaviors
Behaviors centered around mealtime may be a way for your child to escape the meal.
Instead of focusing on negative or disruptive behaviors, focus instead on trying to engage your child in conversations about the food. You might consider asking about the foods colors, texture, and taste to try to capture their attention.
If you want to talk about behaviors, aim to focus on good behaviors. Try praising your child for sitting nicely, trying a new food, or other positive behaviors you see them doing instead of focusing on negative behaviors.
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What Is The Relation Between Sensory Processing Disorder And Food
Sensory processing issues are common in individuals with autism. Due to the disorder, autistic individuals are impacted negatively in terms of their daily routines.
One of the major parts of a daily routine for an individual is naturally eating.
Eating is known to be frequently impaired in children with autism. Studies showed significant correlation between sensory processing disorders and eating problems for these children.
Since hyper- or hypo-sensitivity to stimuli such as textures, smells, temperatures or colors greatly impacts the decision of a child to eat or not, food aversion can occur.
Children with autism are really selective and strict with what they eat.
This picky eating behavior creates major problems in the childs diet.
A child with autism, who has sensory issues, does not process the sensory input in the same manner as a typically developing child.
Studies conducted with children with ASD showed that there is a strong correlation between eating problems and sensory issues.
Be Patient Yet Consistent
You may feel overwhelmed or frustrated when your child simply refuses to eat or has a tantrum. But remember that you are not alone; managing your expectations and being patient are critical.;
Take slow steps and celebrate little wins occasionally. There will be setbacks; try not to give up or be discouraged.
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With Such A Long Waitlist At The Seattle Childrens Autism Center Where Do You Recommend Pcps Send Their Patients
Providers can continue to refer to our program as we try to increase our access to care
The Autism Center also offers classes each month for parents on feeding issues. Once a provider has made a referral, parents can call the Autism Center at 987-8080 to schedule a class.
You may also view a video lecture
Autism And Eating: 8 Tips To Help A Picky Eater With Autism
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Autism and eating is a hot topic among parents with a child on the autism spectrum.
And with good reason.
While fussy eating is common among many children, having a picky eater with autism can be much more extreme. Some kids;with ASD have gastrointestinal issues they cant verbalize, others have strong food texture issues, some have sensory eating issues regarding certain tastes and smells, and still others have rituals around food that make it impossible for them to eat anything thats not a certain color, brand, food group, etc.
Whatever the reason for your childs picky eating, it can be extremely frustrating and challenging, not to mention worrying, but Im here to tell you theres hope.
There are things you can do to help a picky eater with autism.
Will these strategies work overnight?
Probably not.
But Im a big believer in the idea that good things come to those who work hard and persevere, and feel the long-term success far outweighs the short-term pains when it comes to figuring out the autism and eating puzzle as it relates to your individual child.
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