Food and Autism

  • FosterWiki
  • Author:Sarah Scotland
  • Published:March 2022
  • Country: United Kingdom

Food and Autism

Food and Autism - An introduction to food and eating when working with children with autistic spectrum disorder.

An introduction to food and eating when working with children with autistic spectrum disorder.

Author: Sarah Scotland, Nutritionist

About the author

This page has been developed by Nutritionist Sarah Scotland who is dedicated to helping communities with nutrition and developing healthy relationships with food. She works with carers and children, including areas such as learning difficulties, domestic violence, families in crisis.

Through her own organisation, Wise About Food Sarah works with councils, community organisations such as the YMCA and housing groups. She now brings her knowledge and experience into the world of foster care.

Sarah has developed this page with the experts by experience in the field of foster care from FosterWiki combining her expertise with the real-life experiences of those who deliver care to children with ASD.

Introduction

One in 100 children in the UK has a diagnosis of autism spectrum disorder according to the British Medical Association, which also goes on to say that there are “delays and long waiting times for diagnoses”.

Autism spectrum disorder refers to a broad range of conditions. They are mostly characterised by challenges with social skills and are expressed in repetitive behaviours, speech, communication and nonverbal.

There is not one autism but many subtypes. They can be affected by genetic and environmental factors, and many foster carers will be caring for children with autistic spectrum disorders.

The way that children with autistic spectrum disorder learn, think and problem solve can range from highly skilled to severely challenged.

Children with ASD can often find communication really difficult and this can impact them expressing what they like and dislike and why. Eating can be a real challenge, for foster carers and children alike.

This page is a brief introduction to ASD children and food, both the issues and ideas to meet those challenges.

It’s important to remember that each child is unique and there is no one fixed approach to work with an individual child, each child will also present with different.

Children in care with ASD

When a looked after child with ASD comes into your care try to find out as much as you can about their eating routines in advance, find out what food preferences that particular child has and what their triggers are.

Try to find out what you need to have in place to replicate their preferences, what you need to avoid, what they dislike and what helps them feel safe, calm, and secure.

As we know many children go undiagnosed for a long time, and whilst we are not suggesting in any way you give a child a diagnosis, these behaviours may be familiar to you, and this page may help with issues around food.

What can be the challenges

  • There can be health implications with autistic children, some can be overweight, some may have low energy and nutrient deficiencies due to restricted food groups associated with ASD eating challenges. Be aware of specific nutrient deficiencies such as vitamin D and iron.
  • Digestion may be an issue, in particular constipation.
  • Children often find it difficult to understand what you are asking and may have difficulty expressing which certain foods they don’t like.
  • Avoidance of foods and aversion to food.
  • They can have difficulties swallowing, chewing or with jaw function.
  • Loss or change in appetite.
  • The child can have heightened senses and are on high alert all the time, they can find themselves feeling unsafe and uncomfortable, which extends to eating and food, they may not be able to eat in the same room as others.
  • They get easily distracted.
  • Children may be very stressed about sitting at the table.
  • They may feel pressure at mealtimes, and this may impact them.
  • Caregivers can also find mealtimes very stressful, and this can impact the child.
  • Some children have a dependence on milk.
  • Look and feel of food.

What can carers do?

It’s important to remember that each child is unique and there is no one fixed approach to work with an individual child, each child will also present with different.

For a child or young person with autistic spectrum disorder, there may be many reasons why they have a rigid diet and very specific requirements around food. However, it is possible with patience, knowledge, skill and understanding to work with some of the barriers for improved outcomes.
ASD children often have obsessions, routines and rituals which can help them manage stress and make them feel calm. When they feel stressed because they don’t understand what’s going on around them, obsessions and rituals let them take some control of their surroundings.

And some autistic children also have trouble with planning, so having a rigid routine or ritual helps comfort them and relieves feelings of stress and anxiety.

This section highlights some of the issues and some of the ways caregivers have worked with children to improve their daily lives around food, many of the team at foster wiki have children on the autistic spectrum.

Top Tips around food and eating

  1. Gather as much information as you can, either before a child is placed or when a child is with you keep recordings or a diary.
  2. Don’t change too much too soon.
  3. Expect the unexpected.
  4. Allow enough time.
  5. Reach out for support.

Familiarity with Food

ASD children can often feel safe with what is familiar, routine and the same.

At each meal there needs to be at least one preferred food, children need to feel safe and know that they can eat these foods.

Eating can often be problematic as autistic children may be rigid in what they like to eat and are often limited by textures, colours, and shapes of food.

Once a food has been accepted, it may be difficult to move onto a different brand or substitute food. This may be something to bear in mind when finding that preferred food.

Try and make sure that it is something popular and hopefully won’t get discontinued. Have a think about the transportability of the food, is it something that can be taken to the nursery or to school as a safe food to eat.

The texture/colour/shape

ASD children can have a very limited variety of food choices, and these may be very rigid preferences. The food may be chosen for all sorts of reasons. Bland foods might be the preference, this might be because they are easier to eat.

Children with ASD will rarely eat from all the food groups, and they may be over or underweight, and even once you thought you had food all sorted this might get dropped making the food selection even smaller.

  • Try introducing the week’s food and showcase what’s on the menu or ask the children to get involved and ask them what they would like to eat.
  • Be really visual, for instance, use a food chart.
  • Visual information may help to reduce anxiety by showing them what they are going to be eating and when, and when there may be an opportunity to try new food.
  • List the menu for the day or week and have a section at the bottom that says today I will try?
  • Have a good and bad list and let them try a portion of food from each list.
  • Keep a note of what actually is eaten to create your own picture of what works in a food diary, get your child involved in the food diary if appropriate.

Keep a food diary

Where did your child eat, how much did they eat, who was with the child when they ate, was the television on or off, were they engaged in anything else, and anything else that may be relevant to your individual child.

Sometimes older children like to be involved or even keep a food diary of their own.

Aversion, avoidance and trying new food

Remember when trying new foods that a child with ASD will take longer to accept new things to eat. A lot of patience is required.

When introducing a new food an autistic child might well use aversion and avoidance as tactics not to eat the food, they will wonder if it is edible.

  • When offering new foods keep the portion sizes really small.
  • Be aware that foods may need to be offered in different ways, for example, sliced apple or a whole apple? Butternut squash, serve as a boat, to be scraped out?
  • See if they will tolerate the food at the other end of the table.
  • Try and see if they will tolerate the food getting closer and closer.
  • See if they will engage with the food will they talk about it, touch it with say a fork.

Food play

If the child is not engaging try a phase of exploration, engagement, and play, getting to know the food, this encourages the use of all the senses and puts no pressure on the child.

  • Encourage food play with, when using their hands this is building the natural process of learning to eat.
  • Try and get the children into a world of make-belief, this is often where they feel safe and fun, they let their guard down, and let go of the tension.
  • This type of play can happen during mealtime, but also away from meals, whatever works best for the child.
  • Play with food, all sorts of plays. You may have to be one step ahead and be creative!
  • Follow your child’s lead.
  • At any time of tension, stop the game, it needs to be fun, it is all about breaking down boundaries.

Food exploring

  • Try touching with a fingertip, move up closer to the face.
  • Smell, hold it in the mouth and take it out again.
  • Take the food apart – how is it made up? This might be a surprise.
  • Weigh different foods.
  • Will it float?
  • Use visual cues – It will help them know what to expect especially when changing foods.
  • Try a food story – how to help the child move forward.

Sensory Issues and Texture

Autistic children have greater sensory ability than others, and maybe over or under-sensitive to taste, textures, and smells.

Often foods that only have one texture when eaten will be accepted. If food is eaten that is not what is expected they may well freeze with the food on their tongue, sensory overload has taken over and the brain has forgotten how to chew. In response to this, the food will be spat out of the mouth.

Often children will not eat fruit and vegetables. That is a concern for their nutrition, but it could be as simple as these foods have lots of complicated tastes and textures that are too difficult to comprehend.

Eating can often be problematic as autistic children are often rigid by what they like to eat and are often limited by textures, colours, and shapes of food. Sensory issues can be huge, so much that may not be able to be in the same room as others eating.

Lots of factors need to be taken into consideration, bland or spicy, texture, crunchy or sloppy, smell, intense flavours, strong smells.

Rewards and games

Try offering your child some of their favourite food when they try one small taste of new food.

Behaviour chart – points on the chart that work towards a reward.

Food books – Put pictures of food that your child likes at the beginning of the book and food that is disliked at the back, as your child tries new foods, they previously disliked they move to the front of the book. This gives your child a visual way to understand how they have progressed.

Try and make a food board game, use dice, and move around the different squares, landing on certain squares lead to eating a certain food.

Eating and Routines

Autistic children often don’t think about eating and can miss meals.

The child needs to be hungry to have an appetite, however, this can be trained as ASD children often react well to routine. So even if a child is not hungry, they will understand it’s time to sit and eat.

Familiar packaging – Autistic children have a keen eye for detail and do not like change. If a liked food is suddenly not eaten is this because the food labelling has changed?

Allow children to choose what they want to eat for the week and have a plan. Make a visual plan so they know what is going to be on the menu. If after the food has been made, they change their minds, as difficult as it is, allow for this. It may well be that they come back to eat later.

Preferred eating environments and their reactions to those settings vary as much as each individual child.

  • Explore and experiment with eating environments, your child may be happy to sit at the table with family, or maybe you could try a picnic in the living room, or outside in the summer, or occasional shared mealtimes interspersed with eating on their own.
  • Eating together and sharing a meal can be of benefit if the child is comfortable with it.
  • The rest of the family can act as role models, if they are eating different foods, then children are more likely to try them.
  • Exposure – it’s so good to see other people eating.
  • Spontaneity – eating with others may encourage trying new foods and food groups.
  • Be aware, however, that some children may be very stressed about sitting at the table.
  • Be conscious of any pressure and how this going to impact them
  • Caregivers can also often be stressed at mealtimes, so this is something to be mindful of.
  • Children with ASD have heightened senses so think about smells and noise, is the smell of the cooking too much, apart from the kitchen is there another room to eat in?
  • Being conscious of other noises at mealtimes, television/music/appliances can sometimes affect a child.
  • Being comfortable when eating is so important, it helps with feeling safe and calm. Make sure, the child has the right seating arrangement for them, be led by the child. Is the chair the right size and height, are knees are right angles and can feet touch the floor?

What Carers had to say

Links

Autism autistic autistic spectrum disorder eating food Sarah Scotland