Autism Spectrum Disorder (ASD) is a condition that affects how a person interacts, communicates, and experiences the world around them. One of the everyday challenges that often gets overlooked is how autistic children relate to food. Many are extremely picky eaters, not just because they prefer certain foods, but because textures, tastes, and even the way food looks or smells can feel overwhelming.
Their eating habits aren’t just a matter of being fussy; they stem from sensory sensitivities, difficulty with change, and even physical differences in how they process food, says Dr Sanket Goyal, Consultant - Paediatrician and Neonatologist, Marengo Asia Hospitals, Gurugram. “Children with ASD frequently exhibit a strong preference for carbohydrate-rich and high-fat foods like white bread, pizza, cakes, cookies, and ice cream. This pattern of selective eating often results in inadequate intake of essential nutrients such as vitamin D, vitamin B12, vitamin C, calcium, and zinc,” he says.
Additionally, many children on the spectrum consume fewer dairy products than their neurotypical peers, increasing the risk of nutritional imbalances. “Children with autism often experience significant food aversions due to sensory sensitivities. The taste, smell, or texture of certain foods can be overwhelming, leading to a limited diet and nutritional deficiencies," he explains.
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According to Dr Goyal, the primary reasons behind food-related challenges in autistic children include:
- Sensory sensitivities: Many autistic children have heightened sensitivity to textures, smells, or temperatures, which makes eating certain foods overwhelming. This can lead to rigid food choices and refusal of varied diets.
- Underdeveloped oral motor musculature: Some children on the spectrum struggle with chewing and swallowing due to weak oral motor skills. This makes it difficult for them to consume a variety of foods, further restricting their diet.
- Behavioural challenges at mealtime: Rigid routines and difficulty adapting to new situations can turn mealtime into a stressful event. Many children with ASD insist on eating only specific foods or refuse to eat in unfamiliar settings, leading to mealtime battles.
Speaking about the consequences of restricted eating habits, Dr Goyal shares that Autistic children are more prone to eating disturbances, with research suggesting that between 51 percent to 89 percent of them struggle with food refusal.
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These restrictive eating behaviours, he adds, can lead to various health disorders, including:
- Acid reflux: A diet dominated by processed and high-fat foods increases the risk of acid reflux, leading to digestive discomfort.
- Eosinophilic esophagitis (EoE): This chronic immune condition causes inflammation of the esophagus due to food sensitivities. Many children with ASD are at higher risk due to their restrictive eating patterns.
- Constipation: Low fibre intake from a lack of fruits and vegetables often leads to chronic constipation, adding to discomfort and distress. “Restricted diets in autistic children can have long-term health implications, affecting their growth, digestion, and well-being. Identifying these patterns early and making gradual dietary changes can help improve their health," says Dr.Goyal.
He insists on creating a positive mealtime experience. “Supporting autistic children with their eating habits goes beyond just offering different foods, it requires understanding their sensory needs, reducing stress around mealtimes, and encouraging flexibility in a way that respects their preferences”
Dr Goyal shares these strategies to help autistic children develop healthier eating habits :
- Reduce mealtime stress: Avoid pressuring the child to eat unfamiliar foods, as this may increase anxiety and resistance. Instead, create a relaxed and positive eating environment.
- Introduce new foods gradually: Slowly exposing the child to new textures and tastes, while pairing them with familiar foods, can help expand their diet.
- Build on preferred foods: If a child enjoys certain textures or flavors, introduce nutritionally similar alternatives. For example, if they like mashed potatoes, offer pureed carrots or avocados.
- Encourage flexibility: Making small, gradual changes to their diet over time can help autistic children become more adaptable to new food experiences.
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