Food and Autism: Is Your Child a Picky Eater?

January 29, 2024

University Hospitals Rainbow Babies & Children'sExperts in Children's Health

An angry child seated at the table glares at his food

Many children are described as picky eaters during different stages of their development. Children with autism spectrum disorder (ASD) are more likely to have significant issues related to food and eating.

Christine Barry, PhD, a pediatric neuropsychologist with University Hospitals Rainbow Babies and Children’s, shares strategies to help parents when choosing and preparing food for a child with autism.

How Autism Affects Eating Habits

Common symptoms of autism include an insistence on sameness, rigidity and sensory issues – all of which can interfere with food choices and eating. Children with ASD often have very restricted diets, with a preference for only a few food items. For example, they tend to be routine-oriented, they may only eat foods on a certain colored plate or in a specific order.

In addition, children with ASD often have aversions to certain smells, textures or flavors, which further limits their food choices. These issues make it difficult for parents to ensure their child is eating a well-balanced diet. It can also contribute to a stressful mealtime experience for the entire family.

Children with autism are also more prone to gastrointestinal (GI) issues, such as diarrhea or constipation, and may have specific food allergies. If you’re concerned about your child’s limited diet, first discuss options with your pediatrician. A referral to a GI specialist may be a good place to start to rule-out any underlying medical condition contributing to your child’s picky eating.

Ease in New Foods

Children with ASD may avoid certain foods or types of food. Rather than forcing the issue, try taking it step by step:

Look at pictures of new foods in books or magazines. Bring your child to the supermarket and ask them to help you choose a new food to try together.
Prepare the food, but don’t force your child to try it. Your child could start by just smelling or licking the new food the first time it’s offered. Sometimes getting familiar with new foods in a low-pressure, positive way can help your child expand their diet. You can do this for several days in a row.
Try introducing new foods that are similar to something your child already likes. For example, if they like maple and brown sugar oatmeal, try offering apple and cinnamon oatmeal.
Praise your child for every small step. Give positive feedback as your child makes progress towards tolerating looking at, smelling, licking and tasting new foods.

Make Mealtimes Comfortable

Most kids with ASD like to keep things predictable. Making mealtimes as routine as possible will help your child feel more comfortable and less stressed about eating. Here are some tips:

Prepare your child in advance of eating with a mealtime story.
Try to serve meals at the same time every day.
Let your child choose their seat at the table.
Include one of your child’s favorite foods at every meal.
When dining out, prepare your child as much as possible. Make a reservation so you don’t have to wait and print out the menu ahead of time.
Have a “plan B” dish that your child likes in case their favorite food isn’t available.

Ask for Help

If you’re concerned about your child’s diet or eating habits, ask your provider or a nutritionist for help. You could also consider working with an occupational therapist to develop a feeding program.

According to Elizabeth Diekroger, MD, a developmental/behavioral pediatrician with UH Rainbow, “If you are considering any special diets, talk with your child’s healthcare provider first. You may want to work with them or a nutritionist to get started. Sometimes limiting the diet of child that is already restricted can make it challenging to maintain appropriate nutrition.”