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Writer's pictureKristin Carr (Owner)

Eating with Autism

Updated: Jun 30, 2023

Feeding and mealtime challenges are one of the most common characteristics of children with autism spectrum disorder (ASD) with prevalences estimates of as much as 84%-89%" (Marcus & Breton, 2022). Children with ASD tend to show problems with feeding as early as 6 months. Children with autism refuse more foods and have more problems with eating than neurotypical children. At 6 months, children with ASD are described as slow feeders, then 15-24 months they are described as difficult to feed leading to a later introduction to solids. 67-90% of children with autism have difficulty sitting at the table, trying new foods, and overall are considered “picky eaters.” Picky eaters tend to prefer certain textures, have a narrow food diet, eat with certain utensils, and have preferences on food groups and their presentation. Sometimes, children with autism do not always associate food with hunger, and as adults they often forget to eat. With the decreased interest in eating certain textured or smelling foods, the oral muscles will be weak, increasing the risk of gagging, aspiration, and choking.


Children with autism tend to struggle with transitioning, socializing, communicating, and interacting with others (Klein, 2019). Imagine having these challenges. Would you want to sit at the table with your entire family where transitioning, socializing, and communicating are expected? This fear of not knowing what to communicate, how to interact with others, and being in a room with new people can lead to negative associations with mealtime.


Children with autism like control, routine, and feeling safe; if they can make their mealtimes the same, they will (Morris & Klein, 2000). Mealtimes are usually their biggest challenge sensory-wise, transition-wise, and social-wise. Therefore it is important to start small and make gradual changes to make each experience positive.


What can Feeding Therapy do for clients with ASD?

  • Create sensory food experiences

    • Build a garden

    • Go on a field trip to the grocery store or farmer’s market

    • Messy play

  • Create a supportive eating environment

  • Create expectations that come with eating, manners, and sitting at the table

  • Provide sensory regulation strategies

  • Address oral-motor challenges

  • Decrease overstuffing tendencies

  • Teach the components of food without the pressure of eating the food

Resources to try at Home:



References

Emond, A., Emmett, P., Steer, C., & Golding, J. (2010). Feeding symptoms, dietary patterns,

and growth in young children with autism spectrum disorders. Pediatrics, 126(2),

e337-342

Fraker, C., Fishbein, M., Cox, S., Walbert, L. (2007, November 2). Food chaining: The proven

6-step plan to stop picky eating, solve feeding problems, and expand your child’s diet.

Hachette Books.

Friedman, J. (n.d.). Autism food rules: Practical solutions for expanding your child’s diet.

Jenny Friedman Nutrition.

Hunt, M. A. (2020). Occupational therapy for the treatment of selective eating. In R. Bédard &

L. Hecker (Eds.), A spectrum of solutions for clients with autism: Treatment for

adolescents and adults. (pp. 185–192). Routledge/Taylor & Francis Group.

https://doi.org/10.4324/9780429299391-24

Klein, M. D. (2019, November 8). Anxious eaters, anxious mealtimes: Practical and

compassionate strategies for mealtime peace. Archway Publishing.

Marcus, S., & Breton, S. (Eds.). (2022). Infant and child feeding and swallowing: Occupational

therapy assessment and intervention (2nd ed.) AOTA Press.

Morris, S. M., & Klein M. D. (2000, January 1). Pre-feeding skills: A comprehensive resource

for mealtime development. Pro-ed International Publisher.

Toomey, K. A. (2008a). Family meals [PDF]. Denver, Colorado: Toomey & Associates, Inc.

Toomey, K. A. (2008b). Therapy meals [PDF]. Denver, Colorado: Toomey & Associates, Inc.

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