Like all children, children with Autism Spectrum Disorder (ASD) need to eat well to have the nutrients that they need to grow, learn, and develop. Every child with ASD has a different personality and set of abilities that may affect what and how much they eat.
Children with ASD may be more sensitive to the taste, smell, texture, and appearance of food. The sounds and distractions around them might be more to take in. This can lead to feeding problems, such as picky eating and possible nutrient deficiencies.
For example, a child with autism may only eat (or avoid) foods with a certain texture (e.g. soft, smooth, puréed, or crunchy). They may only eat (or avoid) foods with a certain colour or flavour (e.g. sweet, sour, bitter, spicy, or salty). Or perhaps they will only eat a specific brand of food or food in a certain type of package. They may also refuse to eat new foods. Maybe they are struggling because there are too many distractions around them (such as TV or noise from talking). In addition to these challenges, they can have difficulty with functions that are imperative to eating well, such as:
1. Sensory Processing & Integration
This means that they have difficulty processing and interpreting external sensation (touch, taste, sound, etc.) and/or internal sensations (pain, digestion, hunger, satiety). The child may be hypersensitive (and therefore want/need very little stimulation) or hyposensitive (making them seek out more input). Or a child may be both! (For example, hyposensitive to touch and hypersensitive to sound, or vary depending on level of fatigue.) This may affect the acceptance of food based on color, flavor (spicy vs bland), and texture (crunchy vs soft).
2. Motor Planning
The ability to conceive of an action and then physically carry it out. For example, eating yogurt requires scooping up the yogurt, bringing it to the mouth, discerning the different textures such as fruit chunks, and swallowing the yogurt.
Sleep is often disrupted. This can potentially influencing appetite, mood, and behaviour. Chronic sleep deprivation is predisposing to obesity. The brain desperately needs sleep to rejuvenate its cells.
The net effect of all of these factors is a 4-5-fold increase in the odds of having feeding problems in children on the autism spectrum. This can often require caregivers and family members to make significant adaptations to their mealtime routines. And we haven’t even touched on food sensitivities/allergies/reactions, dysbiosis, or gut/immune system integrity!
How can I help you?
You do not need to go it alone. Let someone with education and experience in this specialized area of nutrition help you achieve success as quickly and "smoothly" as possible. Here are just some of the ways that a Registered Dietitian can help children with ASD eat better include:
1. Resolving Basic Nutrition Issues
First things first. Your child won’t be able to properly respond to any nutrition intervention if basic nutrition is still a problem. Easier said than done, I know! More often then not, children with ASD eat foods that are often highly processed, lacking in nutrients, and loaded with artificial chemicals, preservatives, excess sugar, and unhealthy fats. Therefore, step one is to transition your child onto a diet that consists of whole foods and eliminate all unnecessary artificial ingredients. This process takes time… one step (or bite) at a time.
2. Resolving Feeding Problems
Autistic children tend to have poor appetites, refuse new foods, accept a very limited variety of foods, and have a need for sameness or rituals around eating. Family mealtimes become a battleground. Parents will try anything and everything to get their chid to eat. Parents are often left feeling frustrated, overwhelmed, and defeated; why will none of their techniques work? Step 2 is for a dietitian to help with new strategies around the dinner table that can help resolve feeding challenges related to behavior.
3. Vitamin and Mineral Supplementation
Children with autism often eat a limited variety of foods. Even marginal vitamin and mineral deficiencies can result in: poor concentration, irritability, low appetite, mood disorders, sleep disturbances, and depressed immunity. A dietitian can to help to determine if supplementation is needed to help meet your child’s needs. This may be a long term strategy or a short term plan while establishing healthy food intake.
4. Heal the Gut
Research shows that gastrointestinal (GI) problems are more prevalent in autistic children than in their non-autistic peers. In a study published in the Journal of Developmental and Behavioral Pediatrics in 2006, 70% of autistic children were found to have a lifetime history of GI symptoms. This includes abnormal stools, constipation, frequent vomiting, and abdominal pain. Experts don’t know exactly why, but there are a number of good theories including a higher incidence of Leaky Gut Syndrome (increased permeability of the gut leading to poor absorption of nutrients and immune system irritation), imbalance of gut microflora (known as dysbiosis), food sensitivities, and an inability to digest certain types of carbohydrates. A dietitian can recommend ways to help relieve symptoms and determine if a specialized diet is right for your child.
5. Consider Special Elimination Diets
Speaking of specialized diets, there are a variety of diets suggested to treat children with Autism. Most have limited scientific evidence that conclude they are useful. For example, the Gluten-Free/Casein-Free Diet has shown to benefit a small group of children. Improvements when seen include reduced constipation, reduced reflux, better sleep, more attentive, and less stimulatory activity. A dietitian can guide you through testing of this diet, or others, to determine if it works for your child. Plus we need to ensure that specific nutrient needs are being met during the diet trial and afterwards.
Whether considering FODMAPS or Primal or Paleo or Feingold, whenever we restrict foods, we need to take into consideration specific nutrient intake, especially in growing children! A Registered Dietitian (especially one with extensive pediatric experience) is directly qualified to navigate this venture with you. From choosing the right nutrition program and supplements, to troubleshooting eating behaviours and habits, to ensuring that your child is consuming the nutrients they need to experience their most thriving experience of health, we are here for you.