Getting Help For Overeating In Autistic Children And Teenagers
How These Behaviors Escalate
Often parents who have children with autism are focused on a number of different needs at the same time and many of those speech issues, toileting, school placement, overall compliance take precedence over the variety of foods a child is accepting. Feeding issues get back-burnered until either they become untenable or parents are able to focus on them.
If the child eats 10 foods and those 10 foods are keeping them alive and safe and fine, then parents will default to those foods, says Dr. Lee. But ignoring these issues tends to make them tougher to solve. The longer these negative mealtime behaviors go on, the more ingrained they become and the longer they take to treat successfully. That doesnt mean parents should give up, just that the process is probably going to take longer and require more persistence and patience on everyones part.
Impact Of A Limited Diet
Eating only a handful of specific foods or not eating enough overall can have health consequences for any child. Research shows some of these are especially likely in those with ASD.
Nutritional deficiencies is a common concern. Research has found kids with autism often get too little of certain micronutrients. In particular, vitamins A, B1, B6, B12, and D. There’s also evidence children with ASD often don’t get enough calciumwhich when paired with low levels of vitamin D can affect the health of growing bones.
Obesity is another concern. Many children with ASD tend to prefer foods that are high in fat and calories, such as chicken nuggets, hot dogs, cake, fries, pizza, ice cream, and soda, which puts them at risk of being overweight or even obese.
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Behavioral Problems That Affect Feeding And Eating
Eating disorders are complex and continue to be studied among various populations. Eating disorders such as failure to thrive, rumination, pica, obesity and anorexia nervosa can affect children with autism spectrum disorders. Children experiencing these problems are at risk for serious health and growth problems that can lead to life threatening consequences. It is frequently mentioned in the literature that individuals with disabilities may be at a greater risk for these types of behavioral eating disorders.
Pica, the ingesting of non-nutritious substances, is a behavior that can start at any point in life under various circumstances. If a child is persistently eating non-edible items such as paper, dirt, or craft items and/or chewing on plaster or wood, an evaluation should be done to try and determine the cause. Obviously the child should be closely supervised and kept away from substances related to this pica behavior. There are multiple causes and treatments for pica. A knowledgeable professional can assess and address pica. Nutritional deficiencies, sensory stimulation, lack of ability to discriminate non-edible items, and relief of anxiety are all possible factors that can lead to pica. If the pica is not seriously health or life threatening, sometimes substituting edible and/or sensory stimulating alternatives can take care of the problem.
Top 5 Methods To Help Your Autistic Child Overcome Picky Eating
Here are some ways you can help your child if they struggle with specific issues:
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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.
How Can Pediatricians Appease Families Anguish When Their Children Dont Eat Well
Families can, occasionally, overestimate food allergies or intolerances as contributors to feeding problems or a reason to restrict their childs diet. In these cases, we suggest pediatricians pursue high quality testing and discuss objective data with the family. Providers might also consider screening for celiac and nutritional deficiencies. If nothing else, these actions can be reassuring to families who are stressed by their childs diet.
Providers should assess for constipation and treat it aggressively. In our clinic, approximately 88% of our children are chronically constipated and may not have regular treatment. Children with ASD may require more intensive treatment than the typical child.
We recommend pediatricians engage in conversations with parents who are pursuing elimination diets as a treatment for ASD. They should provide education to the families about the insufficient empirical support for these interventions and the potential harmful consequences of pursuing these diets in children with significant nutritionally deficits.
Families should be encouraged to continue serving a variety of foods as much as possible, even if their child doesnt accept them. Families can approach this by offering their child a choice around food types versus insisting they eat the one you are offering. If the child wont tolerate the new food on his plate, find an acceptable middle ground .
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Moving Your Childs Diet Forward
In short, even though the research outlined above shows some promise for cruciferous vegetables reducing inflammation and oxidation in the body, much more research needs to be done. As a parent or caregiver, its essential to evaluate whats known about the benefits and evaluate that for your own childs needs. While more research on taking sulforaphane supplements for ASD needs to occur, parents can still be confident in the benefits of eating cruciferous vegetables as part of a healthy diet.
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.
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Pay Attention To Textures
In many cases, children with autism are hypersensitive to textures, so keep in mind that it might be how the food feels in his mouth, not its flavor, that results in an aversion to that particular food. For example, he may cringe from the squishiness of a tomato. Try blending or chopping these types of foods to help smooth out the texture. For instance, that tomato can be blended and cooked into pasta sauce or chopped and turned into salsa.
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.
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Resolving Food Problems In Autistic People
So, youre probably now wondering, how to stop an autistic person from replicating the mistakes I made, which left me walking the streets of Stockport with a cannula in one arm and a gown which almost certainly guaranteed that the city experienced a full moon that night.
Well firstly, if you are concerned about an autistic persons diet, step one is to start a diary. Like seriously, start a diary now! Make a note of every meal that a person has had in a day and jot down everything:
- The food given
- Where did it take place?
- What time did it take place?
- What could be seen?
- What was going to happen after?
Even if you only slightly suspect an autistic person is having food problems, its so important to have everything recorded, because it allows you to spot patterns and narrow down which sense could be causing the problem. Furthermore, if things progress, it allows you to be able to trace back where the complication may have originated.
Once this has been recorded you can then look at ways to reduce the problem e.g. if a child is only eating bacon, try mixing the bacon in with other foods or try using bacon flavouring in meals which feature the nutrition the child is missing out on. Whilst the dont feed someone until they beg for it technique didnt work on me, it may still might work on others.
From Picky To Possible: How To Get Your Autistic Child To Eat New Foods
Getting your child with autism to try different foods can be challenging and stressful. Typically, children with ASD are more selective eaters than neuro-typical children which makes ensuring the proper intake of vitamins and nutrients a daily struggle for parents. These picky eating patterns often lead to nutritional deficiencies that can have lasting effects on ASD symptoms and overall health.
While this task may seem daunting given the potential effects of your childs eating habits, it is important to remain calm. There is an ever-increasing pool of knowledge from scientists and ASD parents that can help navigate dinner table tantrums and picky eating. Below are four tips for introducing new foods and links to other resources and information:
Helpful Links for Your Food Journey:
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Autism & Dietary Struggles
Why is autism often tied to dietary struggles? People on the autism spectrum have a developmental condition that manifests in a range of behavioral differences and struggles. These behavioral struggles can sometimes become evident as feeding problems. An autistic persons issues with food may manifest as:
- Rituals around eating.
- Pocketing food in their cheeks or sucking on food instead of chewing it.
- Strongly preferring certain foods.
- Avoiding certain foods.
People with autism are also at higher risk for gastrointestinal problems. Autistic children may avoid certain foods or develop strong texture or temperature aversions because of the physical discomfort they associate with those sensations. In frustration, parents of autistic children may limit their childs foods to only those they know will be accepted. However, this is not a sustainable model to develop healthy eating and nutrition habits. It is important to work with your pediatrician and potentially a nutritionist to expand your childs diet. Over time, you and your childs treatment team can develop a list of optimal foods that your child enjoys as well as a list of foods to avoid that often result in digestive issues.
Increase Omega 3 Fats
Deficiencies in essential fats are common in people with autism. Research by Dr Gordon Bell at Stirling University has shown that some autistic children have an enzymatic defect that removes essential fats from brain cell membranes more quickly than it should10. This means that autistic individuals are likely to need a higher intake of essential fats. It has been found that supplementing EPA, which can slow the activity of the defective enzyme, has clinically improved behaviour, mood, imagination, spontaneous speech, sleep patterns and focus in autistic children. There have since been clinical trials testing omega-3 supplementation, which have found that when children with autism were given omega-3 supplements, improvements in symptoms such as hyperactivity, social ability, concentration, irritability and aggression were reported 11,12.
Side effects? Causes loose stools in sensitive individuals if they are started on too high a dose.
Contraindications with medication? Essential fats may have a blood-thinning effect and should not be mixed with blood thinning medication, such as warfarin or heparin. Always consult your doctor before commencing a new supplement.
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Ruling Out Gi Problems
When a child on the autism spectrum is dealing with eating issues, the first stop for a parent should be a pediatric gastroenterologist who can rule out organic causes. Autistic kids may suffer from many of the same childhood GI disorders as other kids, notes Joseph Levy, MD, a pediatric gastroenterologist at NYU Langone Hospital who works with autistic children, but kids on the spectrum may not be able to localize or verbalize their pain. As a result, parents need to be proactive about trying to find the source of their childs discomfort. Below are some of the more common GI issues kids may experience.
Other Reasons For Picky Eating
Another common issue in refusing food is stress. If your child is being bullied or feels out of control in their life, they might be unable to eat. Fight or flight stress states suppress digestion and feelings of hunger. Some even report being unable to swallow, as if their bodies are rejecting food.
Sometimes, being a picky eater is about needing routines. Trying new foods is outside of an established routine and therefore uncomfortable or overwhelming. Likewise, routine foods can be a huge source of comfort.
Autistic kids cant always read signals from their bodies, either. So, theyll miss physical cues that theyre hungry.
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Carry On The Conversation
Todays article was requested by Magela over on the . If theres anything you would like to see discussed on the site, please leave a comment below and I will see about adding it to the schedule. Also, if you want to hear more about the challenges my anxiety has caused and how it impact me then please follow this link to my: World Mental Health Day post.
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