Autism and Picky Eating: What Can You Do As A Parent?
When you live with Autism it seems like you live with an endless supply of whatever food your child has chosen as their preferred “go to food.” Stereotypically, it is chicken nuggets and French fries. In my home we add burgers to that short list. No matter how severe your child’s eating issue is, many parents of children on the Autism Spectrum struggle with their child’s severe eating problems with little or no professional help. I
n part, this is simply due to the limited number of specialists dealing with eating and feeding disorders. Another issue is lack of research on the topic. A frequently suggested strategy for many children with eating and feeding disorders involves withholding food until the child is hungry enough to eat. This approach has been shown to be “dangerous and not appropriate for a child on the Autism Spectrum.” So, what are we supposed to do?
If your child has a nutritional deficiency that is a problem that cannot be ignored. It is also a problem that many Autistic children face- that is not their parents fault. They simply will not eat certain foods; however, per autism.com, “poor eating creates nutritional imbalances, which further reduce appetite or increase carbohydrates cravings [French fries.]” It has also been found that “deficiencies in zinc and vitamin B-1 contribute to anorexia.” An immediate and specific nutrient deficiency need not be present for a parent to worry about their child’s nutrition though. General malnutrition can contribute to “disinterest in food, leading to further malnutrition, reducing appetite increasingly over time.”
So, what are some possible Solutions for Nutritional Deficiencies in Autistic children?
It is noted that “children cannot be forced to eat the necessary diet to correct malnutrition. Once they become malnourished, diet alone may not correct the deficiencies, particularly if children have poor absorption or delivery of nutrients.” It is best to use “nutrient supplements with moderate levels of a broad range of vitamins (C, E, and B-6) and minerals (magnesium, molybdenum, chromium and selenium) that are most deficient in an overly processed diet.”
If your child won’t take pills, liquid nutrients are available. You can also ground up vitamins in a mortar and pastel and mix them with frozen grape juice concentrate, applesauce, or, in desperate cases, chocolate syrup.
Medical Assessments and Issues
Once you have gotten to the point of being concerned enough about your child’s diet to be researching it online, it may be time for some medical assessments. These can include “evaluations of oral motor function including swallowing studies, assessments of food sensitivities and allergies, medications and their effect on eating, and a profile of the child’s diet and resulting nutritional issues.” In addition, an eating history should be taken if your child’s picky eating is severe enough to impact their nutrition.
The eating history should include gathering the following information:
-Details of extensive choking, coughing or gagging when eating;
-Loss of oxygen (turning blue/purple) while eating;
-Pattern of liquids or foods that emerge through the child’s nostrils when eating; and
-Reoccurring respiratory difficulties and/or pneumonia.
An occupational therapist, speech and language pathologist, and nutritionist or dietician along with a doctor and a nurse are all involved when a team approach is used for a feeding assessment. “Frequently a social worker or child psychologist is also part of a feeding team.” It is important to keep in mind that medical conditions can affect a child’s eating habits and eating habits impact health. It is important to assess and address medically related feeding problems first so that the child’s health needs can be recognized and managed.
“After medical problems have been examined, and plans are in place to address these problems, then the behavioral problems, if any remain, are important to address and treat.” Occasionally behavioral issues are so severe that medical intervention is needed for these issues. Per Indiana University, “eating disorders are complex and continue to be studied among various populations. Eating disorders such as failure to thrive, rumination, pica, obesity and anorexia nervosa can affect children with Autism Spectrum Disorders. Children experiencing these problems are at risk for serious health and growth problems that can lead to life threatening consequences.” Environmental issues including sensory difficulties can be considered after medical and behavioral issues have been treated.
Sensory misreading in the mouth or poor oral-motor skills is a common issue among Autistic children and can often be the cause of their picky eating. A child with “tactile defensiveness often exhibits hypersensitivity in the mouth and/or craves oral stimulation, such as chewing on his/her clothes.” Low muscle tone in both mouth and face often coexists with deeper oral-motor issues. It’s important to note that passing a medical swallow study “does not guarantee that a child can chew and swallow consistently and has the stamina to consume an entire meal.”
Possible Solutions for problems in the mouth can be addressed by a speech or occupational therapist with oral-motor training. It is suggested that teaching your child to use an electric toothbrush to massage (desensitize) the mouth or having them drink from a straw can strengthen oral-motor skills and greatly reduce eating anxiety.
When Nobody Understands
Unfortunately, in some cases, professionals as well as concerned family members and friends mistakenly blame parents of children with Autism Spectrum Disorders for their child’s poor eating habits. Sometimes parents’ concerns are ignored, and they are told not to worry since most children go through stages of picky eating and food fads. Though no reliable statistics are available on feeding and eating disorders of children on the Autism Spectrum, it does appear to be relatively common.
Families of these children may end up struggling on their own with little understanding from family, friends and the professional community. Truth be told- “medical, behavioral, and environmental factors, including sensory difficulties, must be considered when feeding and eating problems occur.” If your family members cannot understand that than let it roll off of your back. If the professionals that you are seeing can’t be on the same page as you, then ask for a second opinion. It is rarely just one thing that is causing it. Medical issues, and behavioral issues need to be assessed and addressed by working with the appropriate professionals. If it is environmental and sensory related problems that are causing the issues than often families can often adjust on their own once they better understand their child’s needs with a little guidance.
Whatever the issue ends up being, whether it is medical, behavioral, sensory or a combination of the three; it is obviously important to address your child’s nutritional needs as soon as possible. Don’t let it go for too long, it can lead to devasting results. There is help out there. Utilize it to it’s fullest!