Autism, feeding and eating challenges

Whilst feeding and eating can be tricky for many children, it is especially challenging for many autistic children and their families. It is reported that 89% of autistic children display some form of difficulty with feeding behaviours¹. Some of these issues include but are not limited to food selectivity, rumination, eating non-edible items, eating disorders and disordered eating. For more information on specific eating disorders visit our autism and eating section.

By ensuring your child is accessing all good groups, there is a reduced likelihood of nutritional deficiencies and, illness. Deficiencies in nutrients can impact upon a child’s performance at school leading to increased irritability, reduced energy or difficulties associated with memory, concentration and learning. This in turn can lead to withdrawal, fewer social interactions or subsequent increased absences.

When attempting to overcome some of the challenges associated with feeding and eating, it is important to consider the following:

• Flexibility of thinking
• Communication difficulties
• Social interactions
• Motor issues
• Medical issues
• Behavioural issues
• Sensory issues

By taking into consideration all the above, parents, caregivers and professionals can begin to implement strategies and interventions that support autistic children to eat a healthy and varied diet.

Take a look at some suggestions of interventions/strategies below. It is important to note that before beginning any interventions or modifying your child’s diet, you should consult your GP or dietician. This can also help with identifying any underlying medical issues such as gastrointestinal problems.

1. Create a routine.

Parents and caregivers can create structure such that mealtimes are regular, spaced apart, not lengthy in duration and always occur in the same location e.g., at the dining table and not in front of the TV. By creating a routine of sitting together, your child can observe an adult whom they can imitate positive eating and feeding behaviours from. Through imitation, your child can learn the mechanics of eating as well as be introduced to developmentally appropriate foods. Establishing routines also helps to avoid ‘grazing’, where your child may be snacking throughout the day and reducing their appetite.

2. Make adaptations to address sensory issues.

It is important to consider your child’s sensory needs. This may be related to the eating environment or to the food specifically. In such cases, parents and caregivers may need to adjust the lighting, alter the seating, or reduce the noise in the room during mealtimes. Additionally, parents and caregivers may present food on partitioned plates if your child is averse to different food types touching. If hyposensitive (a lot feels like a little), you may offer your child spicier, stronger, crunchier or hotter foods and if hypersensitive (a little feels like a lot), you may offer your child more bland or soft foods to meet their sensory needs.

3. Reduce emotions around food allowing for the opportunity to try again next time.

There are a number of ways you can try new things with your child or young adult. Graduated exposure is where you reinforce your child for attempting different stages. For example, this may start by just looking at new food. Then trying to touch it, pick it up, smell it and eventually taking a bite. Rather than trying to go straight to eating, taking small steps can help reduce any anxieties around the new food. Alternatively, you can try food chaining, where you alter some aspect of their familiar food. This might be trying out similar tastes or textures to ending up at different tastes and textures.

You want to make the experience a positive one, do not react negatively when food is spat out or refused. Try again next time!

For more information take a look at our food modifications page.

4. Take food outside of meal times.

Simply exposing your child to the food including how it looks, smells, feels or sounds can be a way to reduce eating and feeding challenges for autistic children. Remove the expectation for your child to eat the food – they might first engage in food art (painting with vegetables), food games (teddy bear picnics) or messy play activities. Other ways to make food fun can include introducing functional and meaningful activities such as getting your child involved with shopping for food or cooking and preparing food. (link to resource around making food fun).

5. Develop social skills to reduce anxieties that may be associated with dining with others.

Feeding and eating challenges may be centred on the fact that mealtimes are usually social situations. For many autistic children, mealtimes can result in added pressure to behave in specific ways. This can lead to escape behaviours where they do not want to be at the table and therefore do not eat. By working on social skills outside of mealtimes, such as responding to conversations or identifying social cues, you may be helping your autistic child to sit comfortably at a table with peers and engage in positive eating and feeding behaviours.

Have a look at our Tips for Healthy Eating.

Remember that resolving your child’s feeding and eating challenges requires small, subtle, and consistent changes. Be patient with the progress, no matter how slow. Do not be discouraged by the downs and ensure you celebrate the wins! For a more detailed look at the subject, look at our recent lunch and learn on the same topic.

1. Ledford, J. R., & Gast, D. L. (2006). Feeding Problems in Children With Autism Spectrum Disorders: A Review. Focus on Autism and Other Developmental Disabilities, 21(3), 153–166.