Eating Problems & Feeding Therapy

No one really knows why so many children with autism are picky eaters, says Kimberly Kroeger-Geoppinger, an assistant pediatrics professor at the Cincinnati Children's Hospital Medical Center. But there's no doubt that it's a common phenomenon. That means that parents' permissiveness is probably not the cause. Kroeger says there are several possible reasons for autistic children's pickiness. "We know that children with autism tend to select down, eliminating one food from their diet at a time. The reasons could be sensory (a new discomfort with a particular smell, taste or feel), or even a randomly developed routine."

 Very often, says Kroeger, kids with autism will slowly start to reject previously favored foods. You might find that your child won't eat a certain food one day, and rejects it again the next. If that happens, he may be working toward absolute rejection of the food. If you see that happening, start right away with the next steps in this guide! Otherwise, it's possible that your child will self-select herself down to just a few foods, served in only one way, at one particular location.

While nutrition is an important consideration, says Kroeger, it's not the most important concern when helping a picky eater build his food selections. Instead, she recommends, start building with a food that's similar to those your child already eats.
For some children, it might be easiest to start with a food that has a similar flavor (trying fresh strawberries if a child likes strawberry ice cream); for others the texture may be the most important issue (adding corn chips if a child likes potato chips).
If you do have concerns about nutrition, it's fine to give your child multivitamins. Choose the type your child is most likely to tolerate, be they crunchy, chewy or liquid.
 Many children with autism are resistant to new foods. To keep from turning the dinner table into a battle field, it's best to choose steps that allow your child to be successful.
A first step to introducing a new food might be simply placing the food on your child's plate. If even that leads to problems, you can start by placing the food on the child's plate for only a few seconds.
As soon as your child is successful with that first baby step, reward him! Rewards vary from child to child, but should include warm praise, a hug if that's something she likes, and a "motivator" such as a small amount of a preferred food or time doing a preferred activity.

 Once your child tolerates a new food on his plate, says Kroeger, it's time to move on to the next small steps. You can customize this plan to your own child - if necessary adding or subtracting steps:
  • Touch the food
  • Smell the food
  • Bring the food to lips
  • Touch the food with tongue
  • Take a taste of the food
  • Taste the food every day for two weeks
If a child continues to reject the food after tasting it every day for two weeks, says Kroeger, it's probably time to decide that this is just not going to be a preferred item.

 It's easy to get frustrated with a child who simply won't eat anything new. But it's important to avoid setting up a situation in which you and your child are vying for power. The best way to avoid a power struggle is to set the bar low enough that your child will almost always succeed. That may mean micro-mini steps at first - sniffing a food, tasting with the tongue, and so forth - and the journey may take a while. But as your child succeeds, step by step, and wins your pride and motivating rewards, you may find it a more pleasant way to set your goals.

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