Autism & Eating Disorders Advise

Eating disorders in children with autism can present unique challenges, often rooted in sensory sensitivities, rigid food preferences, or anxiety around eating. Here’s a guide with practical advice and strategies recommended by specialists to support healthier eating habits for these children:

1. Work with a Multidisciplinary Team

• Registered Dietitian: A dietitian experienced with autism can create a nutritional plan that balances the child’s sensory preferences with essential nutrients.

• Occupational Therapist: They can help with desensitizing sensory aversions and improving motor skills related to eating.

• Behavioral Therapist or Psychologist: Behavioral interventions, like gradually increasing food exposure, can help reduce anxiety around new foods and eating routines.

2. Sensory-Friendly Food Exploration

• Texture and Temperature Adjustments: Some children may have strong aversions to certain textures or temperatures. Experiment with soft, smooth, or crunchy foods that are acceptable to the child.

• Slow Introductions: Introduce new foods gradually and alongside familiar ones. Avoid overwhelming them by starting with small portions of the new food and using positive reinforcement.

• Plate and Utensil Preferences: Certain utensils, plates, or even seating arrangements can make mealtime more enjoyable. For example, some children prefer using a familiar spoon or having a plate with dividers to keep foods separate.

3. Use Visual Supports and Social Stories

• Visual schedules that outline meal times, portions, or the type of foods can provide predictability, which many children with autism find comforting.

• Social Stories: These are short narratives that explain the process and benefits of trying new foods. Social stories can reduce anxiety by providing context for the unfamiliar experience of trying a new food.

4. Behavioral Strategies for Food Exposure

• Reward-Based System: Encourage the child to interact with food in small steps, such as touching, smelling, or licking it, before trying a bite. Reward each step with praise or a preferred activity.

• Food Chaining: This involves slowly introducing new foods that are similar to what the child already likes. For instance, if the child eats only French fries, you might introduce roasted potatoes next, then move toward other types of vegetables with similar textures.

5. Incorporate Nutrition Smoothly

• Pureed or Blended Options: Many children with autism may tolerate smoothies or soups, allowing caregivers to blend in vegetables, fruits, and proteins without the child noticing changes in texture.

• Supplements: If a child’s diet is limited, a pediatrician or dietitian might recommend vitamin and mineral supplements to ensure they’re meeting their nutritional needs.

6. Create a Predictable Mealtime Routine

• Structured Timing and Environment: Eating at consistent times and in a calm, sensory-friendly environment can help the child feel more comfortable.

• Positive Mealtime Associations: Limit distractions and avoid pressuring the child. Offering calm, positive reinforcement and gentle encouragement can help make mealtime less stressful.

7. Address Underlying Anxiety and GI Discomfort

• Anxiety Management: Children with autism may experience anxiety around mealtime, especially if past experiences were unpleasant. Techniques such as deep breathing, using fidget toys, or practicing relaxation exercises before meals may help.

• GI Issues: Many children with autism experience gastrointestinal issues, which can worsen aversions to food. If there are signs of discomfort (e.g., bloating, constipation), a healthcare provider can help manage these symptoms.

8. Modeling and Peer Influence

• Model Eating: Caregivers or siblings can model trying new foods in a fun, non-pressuring way, which might encourage the child to explore foods in a similar way.

• Peer Eating Experiences: In a safe setting, observing peers or siblings who enjoy a variety of foods can sometimes inspire more openness to trying new foods.

Specific approaches in more detail to support children with autism who experience eating disorders:

1. Desensitization through Sensory Integration Therapy

• How It Works: This technique is often guided by an occupational therapist. It involves gradually exposing the child to different sensory experiences, beginning with non-food items and working toward food.

• Example Practice: If a child has an aversion to wet or slimy textures, they might first play with items that mimic these textures, like slime or putty, to gradually build tolerance. Afterward, similar foods (like fruits or soft veggies) can be introduced in a relaxed, non-meal setting.

2. The ‘Tiny Taste’ or ‘Food Bravery’ Method

• How It Works: This approach uses a step-by-step model for introducing new foods. The child starts by looking at the food, then touching it, smelling it, and eventually taking a “tiny taste” or lick.

• Why It Helps: This slow, pressure-free progression helps reduce anxiety and gives the child control over their interactions with food. Positive reinforcement, like a sticker or extra playtime, can be used to reward each step.

3. Food Texture and Temperature Hierarchy

• How It Works: For children with strong texture or temperature preferences, this approach introduces new foods in ways that closely match their preferred textures. For example, if a child prefers crispy foods, you could start with lightly roasted veggies or other crunchy options.

• Sample Progression: Start with a texture they like (e.g., crunchy), then gradually introduce similar textures with slight variations (e.g., baked rather than fried). Experimenting with temperature can also be beneficial, such as serving food slightly warmer or colder to test for comfort.

4. Incorporating Nutritional Smoothies or Shakes

• How It Works: For children who struggle with consuming a variety of textures or who have limited diets, smoothies can be an effective way to provide essential nutrients. Caregivers can mix vegetables, fruits, and even protein sources into a smoothie the child already enjoys.

• Tip for Success: Use a base the child likes, such as a preferred yogurt or milk, and gradually add small amounts of new ingredients to avoid noticeable changes in flavor. Blend thoroughly for a consistent texture.

5. Food Chaining Techniques for Broadening Food Preferences

• How It Works: Food chaining is a method where caregivers build off foods the child already accepts. By making slight changes to a familiar food, the child is slowly introduced to a variety of similar foods.

• Example Progression: If the child enjoys chicken nuggets, food chaining might involve first trying homemade nuggets, then progressing to baked or grilled chicken pieces, and finally, incorporating other proteins prepared in similar ways.

6. Behavioral Reinforcement Plans

• How It Works: Behavioral therapists use reinforcement strategies to encourage positive mealtime behaviors. For instance, the child may earn a reward for taking small bites or tasting a new food.

• Creating a Visual Reward Chart: A simple chart where the child earns stickers or check marks for trying new foods can be helpful. Once they reach a set goal, they receive a reward, such as extra screen time or a preferred activity.

7. Establishing a Mealtime Routine and Safe Space

• How It Works: Having a predictable mealtime setting and routine can help reduce anxiety. This might include using a preferred plate, sitting in the same seat, or listening to soft music during meals.

• Sensory-Friendly Eating Environment: Dim lighting, limited background noise, and clear mealtime boundaries help create a calming setting. Some children may also benefit from tools like weighted lap pads, which provide calming pressure and help them focus on eating.

The Autism Society
The Autism Society offers strategies and expert advice for addressing food aversions, building tolerance for new textures, and supporting children with autism who experience eating difficulties. Their materials emphasize creating sensory-friendly routines and incorporating behavioral therapies.
https://www.autismsociety.org