Why do children with Autism Spectrum Disorder have feeding problems? 

It can look like bad pickiness or stubbornness, but there is more in Autism Spectrum Disorder usually. 

​​Feeding difficulty in Autism Spectrum Disorder is very common because of two main factors:

• A child’s nervous system is over sensitive (i.e., a sensory processing feature) to food textures, taste, temperature

• The autism feature of "insistence on sameness" i.e., insistence on "same" presentation of same foods and rejecting food if it is not "just right" 

​It doesn't really matter how much is "sensory" and how much is "sameness" though. There's no test for this. The treatment is the same!

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How can pickiness get worse over time?

Parents want their kids to eat, this feeling is normal. If you know your child will more likely eat a food that is “just right”, you might give them that food more often (or make it for them if they reject the regular meal). In this way, increasing pickiness happens because of avoiding different sensory experiences or foods that are different in some way. In other words, a concerned parent makes the food "more perfect" or provides the more desired same food out of concern that otherwise the child will not eat, and things get worse. This can lead to an insistence on McDonalds (only) fries at 40-45º or only liquified/pureed foods, for example. 

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​​What is the treatment?

We do want to make sure the child does not have any physical source of discomfort that might be affecting appetite. The three most common medical problems are constipation, constipation and constipation, but there may be other reasons and a doctor’s assessment may be needed. 

• Have schedule for meals and snacks (roughly the same time, and in a routine) with only water in between

• Parent decided what is available (choose things your child has eaten at least sometimes in recent memory)

• If the child does not eat the food you put out, DO NOT GIVE THEM SOMETHING ELSE. You may have do deal with some big emotions, but over time, they get used to it

• Do not allow your child to snack whenever they want (you may need to lock up the desired foods)

• Over time, slowly expand the foods you give (even changing the shape, texture or temperature slightly is a big deal at first)- this is a long term project!

• Children may need to get used to just having the “unsafe” food on the table for weeks  to months for each of the steps: having it near them, on their plate, touching it with hand, touch it to mouth, chew, swallow, and eat substantial amounts. That’s a long time!

• An occupational therapist, speech language pathologist or applied behavioural analysis (ABA) therapist with experience in feeding problem in Autism Spectrum Disorder can be helpful