Children with Autism Are More Likely to Experience Feeding Problems

Date: March 13, 2017

Children with Autism Are More Likely to Experience Feeding Problems

Four Tips to Help Parents Manage This Common Issue

By Emily Kate Rubio, M. A., BCBA

Did you know up to 90 percent of children with autism and developmental disabilities experience feeding challenges, according to a study in the Journal of Pediatric Psychology (Kerwin, 1999). Children with autism often struggle with food and taste sensitivities. This can result in developing preferences and aversions to certain textures and the refusal to try new foods. For example, some children may prefer starchy, crunchy foods; whereas, other children may only choose more basic textures like applesauce and yogurt or cakes and breads.

Feeding problems can range from mild to significant. Mild feeding difficulties exist when a child has some food selectivity and/or refusal to try new foods, but the foods in his/her diet still meet basic nutritional needs (i.e., will eat some fruits or vegetables, some healthy proteins and starches). Feeding problems are considered more moderate when a child refuses a whole food group, like all fruits or vegetables, and only incorporates a few foods in his/her diet. Feeding problems are more significant when a child only eats one or two foods, relies on formula or other drinks to supplement his/her diet, and normal growth and development becomes a concern.

Inappropriate mealtime behavior is often the first sign of feeding problems. Parents might start to notice their child is pushing food away, gagging, leaving the table, throwing food or utensils from the table, crying, whining, complaining and arguing.

If your child is a poor or picky eater, or engages in inappropriate mealtime behavior, consider the following tips:

  1. Start small. If you are trying to introduce new foods into your child’s diet, make things easier and less overwhelming by only presenting one small bite of the new food on their plate (e.g., one pea or a half of a mandarin orange). A whole bowl or plate of food can be overwhelming and lead to problem behavior.

 

  1. Be consistent and firm. Keep meals on a schedule. Children with autism commonly snack on preferred foods throughout the day. This can decrease hunger and make it more difficult to entice them to sit down and eat an actual meal. Restricting snacks may be difficult at first, especially if they are used to snacking between meals. However, over time, they will adjust to the new routine. Try to avoid allowing them to snack 30 minutes to an hour before or after your designated meal time. You don’t want them starting a meal full, and you don’t want them refusing dinner and being allowed a snack soon after.

 

  1. Set your menu. Allowing your child to choose what he/she wants to eat might seem like a good idea, but if your child has feeding issues, it can be a slippery slope. They may learn to refuse every option you provide or request the same food repeatedly. Try to only present two meal options. If they refuse to choose one, you can pick for them.

 

  1. Monitor your attention. As in other applications of behavior analysis, we can shift our attention to the good behavior we hope to achieve. For example, tasting a small bite of a new food or eating a whole meal and restricting our attention following inappropriate behavior we do not want to see, like crying, complaining, or pushing away food.

It is always important to first rule out and/or treat any medical reasons for food refusal (e.g., reflux, food allergies, swallowing concerns, etc.) before beginning a program to treat food refusal. If you are concerned about your child’s eating, please contact your EAP program supervisor for individualized guidance or a recommendation on a local feeding clinic.

Reference: Kerwin, M. E. (1999). Empirically supported treatments in pediatric psychology: Severe feeding problems. Journal of Pediatric Psychology, 24(3), 193-214.

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