Autism: Nutrition challenges and tips from a Dietitian
For children and teens with Autism Spectrum Disorder (ASD), a nutritious, balanced diet can make a world of difference in their ability to learn, how they manage emotions and how they process information. Because children with Autism often avoid certain foods or have restrictions on what they eat, as well as difficulty sitting through mealtimes, they may not be getting all the nutrients they need. If you have a picky eater with autism, know that you are not alone.
4 common challenges that hinder nutrition in people with Autism
Children with autism are more likely to face mealtime challenges, such as extremely limited food selections, ritualistic eating behaviours and meal-related tantrums. As every Autistic person is different to every other, some of these common challenges may not apply to your child or teen.
Limited food choices and strong food dislikes
Individuals with Autism can experience sensory issues (for example, increased sensitivity to light, touch, sound and taste). Hence, some will find it difficult to eat certain foods and result in consuming a very limited diet. Common dislikes include strongly flavoured foods, fruits and vegetables. They may refuse or even completely avoid some foods and even whole food groups.
Some examples of this include:
Having strong preferences for certain textures e.g. crunchy foods
Preference for a particular brand of food
Preference for ‘brown’ or ‘beige’ foods e.g. nuggets, white bread, biscuits
Preference for food prepared in a certain way e.g. bread cut in triangles instead of squares
Refusing certain foods to touch on a plate
Always wanting consistent and predictable foods
Insufficient food intake
Those with autism may have difficulty focusing on one task for an extended period of time, this may make it hard for them to sit down and finish a meal from start to finish. This can lead to not consuming enough energy and nutrition to meet their needs for healthy growth and development.
Gastrointestinal problems may be caused by several factors, including restricted food choices, low physical activity levels or side effect of medications. Gut problems such as constipation, diarrhoea and a bloated stomach are often seen in autistic people. Any gastrointestinal symptoms should be managed in the same way as in those who are not autistic. Reach out to your Doctor and Dietitian.
Some stimulant medications used with autism can lower appetite. This can reduce the amount of food a child eats, which may affect growth. However, other medications may increase appetite or affect the absorption of certain vitamins and minerals. If your child takes medication, consult your healthcare provider about possible side effects.
How to improve nutrition in autistic children
Be prepared for fussy eating
Try not to be discouraged if you don’t see improvements in your child’s fussy eating habits or diet at first. Finding new foods that work for your child will take time. Your child’s preferences may change and they might be more willing to try different foods as they get older.
Many children need to taste a food more than a dozen times before they’re willing to eat it without a fuss, although children with ASD can take longer. Be patient as your child explores and tries new food.
Most importantly, avoid turning mealtimes into a family battleground, as this will negatively impact a child’s relationship with food.
Get comfortable with food outside of mealtimes
One of the easiest ways to approach sensory issues is to tackle them outside of the kitchen.
Some ideas include:
Visiting the supermarket together and choose a new food
Research it together on the Internet to learn about where it grows
Looking at pictures of different food together
Prepare it a new food together, without putting pressure for them to eat it
Simply becoming familiar with new foods in a low-pressure, positive way eventually can help your child become a more flexible eater.
Stick to regular, routine mealtimes
A child with ASD may find it harder at mealtimes, as a busy kitchen with bright lights and strong smells all act as potential stressors. Making meals as predictable and routine as possible can help.
Some ideas include:
Serving meals and snacks at the same time every day
Dimming lights, using lamps with adjustable lighting instead of a bright overhead light
Allowing your child pick a favourite food to include at every meal
Let your child choose a favourite seat at the table.
Slow, gradual changes at a time
If your child finds change difficult, your child might take a while to get comfortable with new foods. Some ideas include:
Introducing foods that have a similar texture, colour or smell to other foods that you know your child enjoys
Try putting the new food near the food that they like. E.g. if your child won’t try broccoli, you could try putting the broccoli near some cauliflower
Allow your child sniff or lick a food to get used to the look, feel and smell of it
You might have to do this over several meals before your child is willing to even take a bite of the new food.
Make food fun!
Playing with a new food is another way to build familiarity and decrease mealtime anxiety. While you’re playing, let your child see that you also taste and enjoy the food.
Some ideas include:
Painting with pasta sauce on a plate
Using vegetables to make faces on a pizza
Using cookie cutters to cut sandwiches into fun shapes
Stacking burgers together
Putting foods on a plate with the child’s favourite cartoon character
How can a Dietitian help people with Autism?
Consulting with a Dietitian before making drastic changes to your child's diet is crucial, as there can be side effects and potential nutrient deficiencies when a restricted diet is self-prescribed, including weight loss and stunted growth. Restrictive diets (such as the gluten or casein free diet) require careful planning to make sure your child's nutrition needs are being met.
An Accredited Practising Dietitian can:
Assess if your diet is providing adequate nutrition to meet your needs
Identify nutritional risks based on your current diet
Provide advice on the use of nutrition supplements
Give practical tips and tricks to help reduce anxiety and stress at meal times
Provide advice and guidance on ways to introduce new foods
It is important to seek guidance from a health professional before starting and special diets.
More help and support
Having an autistic child or sibling can be a challenging experience at times. However, there are support services available. Receiving appropriate support will allow those with ASD to enjoy equal opportunity, and a full and effective participation in society. The organisations listed below can help you find support groups and resources: