Autism, Food Choices and Behavior

I frequently see the phrase “my child only eats” in the media followed by a list of processed foods such as packaged macaroni and cheese, chicken nuggets and french fries. Why is that? One key reason is familiarity; but, another reason is often the addictive quality of processed foods. Though it is far easier to stick to the “favorite foods,” a variety of food choices is not only key to proper nutrition but has positive effects on behavior as well.

It’s a myth that an autistic person will only eat a few foods. However, it is a pattern that we on the autism spectrum frequently fall into–if we do not WORK to maintain a healthy diet of a variety of foods. Therefore, parents of autistic children will have to labor to get their child(ren) to eat more than a few foods. Our “variety” of food choices likely will be more limited than the variety of diet that a neurotypical person eats, that is true, but a healthy diet, with probable additional vitamin and mineral supplements needed, CAN and should be done.

When one has processed foods in the diet, the body will crave them versus natural foods. Processed foods are terrible for the GI systems of everyone, but particularly for those on the autism spectrum who may have genetic-related problems with absorbing certain types of food or nutrients–much less artificial colors and preservatives. The result is not just poor nutrition, BUT likely poor behavior. In particular, if you notice any abdominal bloating in your child, your child has significant GI issues including food allergies or at least food intolerances. How do you act when you have a horrible stomach ache?

However, there may NOT be any visible signs of GI problems. My autistic daughter has a mast cell disorder which causes large histamine releases–her stomach does not always visibly bloat up; but, she does have mood changes. The GI tract and the brain have very connected nervous system communication. My daughter’s anxiety goes through the roof from changes in brain chemicals caused by adverse changes in her gut. Increased anxiety means potentially more meltdowns, at minimum. Anxiety and/or aggression are not the only possible mood changes, however, an autistic child may have. Does your child seem hyperactive or chatty after candy, drinks or food with artificial dyes or preservatives in it?  It’s not your imagination, there’s a connection. I could always tell when my child had dyes or sugary junk food after being at a friend’s house–as she would be unusually chatty and “happy” in a hyperactive way when she got home.  Bottom line:  Gut health in someone on the autism spectrum is critical for proper nutritional health and behavior.

Testing for nutritional deficiencies, allergies  etc.

Take your child to an Allergist physician and have food allergies tested for.  Additionally, find a primary care practitioner who practices functional/integrative medicine so he/she is willing to check Vitamin D levels, problems with “B” vitamin adsorptions, need for more Vitamin C for immunity (and even more is needed–if your child has Ehlers-Danlos, which is a collagen disorder), iron deficiency, trace mineral deficiencies, or heavy metal toxicity. Get all of those issues corrected or at least dealt with.

How to expand your child’s diet

Yes, processed food is a huge time saver and often times cheaper than real food. Get rid of it. If you have to eliminate one food at a time–while introducing one natural food at a time–then at least do that until you eliminate all of the processed foods.  Get rid of all candy, foods and drinks which contain artificial colors/dyes. No artificial preservatives. Eliminate anything that has aluminum such as sodium aluminum phosphate. No high fructose corn syrup. Get rid of anything with partially hydrogenated oils. Olive oil and coconut oil are okay. Very few people have celiac disease but many are getting an intolerance to wheat. Eliminating gluten has significantly improved the behavior in some autistic children. Restricting dairy may have beneficial effects as well, but be sure to substitute something like almond milk in order to maintain healthy bones and teeth in the growing child.

Try different ways of presenting healthy food. Maybe your child hates the texture of cooked carrots but likes the crispness of raw carrots–or vice versa.  We on the autism spectrum like order, but it is not always logical how we came up with the particular order we like. Present the food as whole versus in pieces.  Present it plain vs. ketchup, jam or some type of sauce on it.  Make sure the food is not touching or runs into other foods on the plate. Minimize the number of foods in front of your child at the same time.

Sensory issues and food

Sensory issues affect not only food choice but digestion. Smell seems to be a non-negotiable factor.  If your child hates the smell of the particular food, don’t fight it; take away the food.  Specifically for autistic people, texture is critical also, but sometimes texture can be adjusted to over time. Smell doesn’t seem to work that way. There may be other sensory issues affecting mealtime as well. Try putting a new food on the plate and encourage your child to touch it with his fingers. (For awhile, my daughter would only eat salad with her fingers. If I said she had to use a fork, she wouldn’t eat the salad). If that’s successful, encourage the child to take it in his/her mouth and move it around. It is NOT required to swallow it. If your child won’t touch or move it around in the mouth, just keep putting the food on the plate every day for several days (go up to 2 weeks if necessary). Eventually, the child may decide to eat the food. Additionally, there are certain behaviors done at mealtime that can increase or decrease how much the autistic child eats.

Conclusion

People on the autism spectrum tend to make a few food choices favorites. Though it takes work, persistence in introducing a variety of healthy foods into the diet is imperative for not only proper nutritional status but is likely to improve undesirable autistic behaviors as well such as reduced meltdowns.

 

Autism and Mealtime

So I have been reading a lot of blog posts about neurotypical parents and their struggles with their autistic child or children at mealtime. If your family has an enjoyable mealtime where everyone is ready to join hands and sing Kumbaya, then this article is not for you. On the other hand, if mealtime at your house is more like hell on earth, and you go to bed at night craving Valium, then read on.

Psychologists and all sorts of pro-family professionals like to extol the virtues of family mealtime. It’s the part of the day when everyone in the family gets together to compare notes and agendas about the day, and check-in as it were. Additionally, as if contending with society’s norms wasn’t enough, you probably have relatives and friends who are quick to remind you of the importance of “3 squares a day,” “eating everything on your plate because there are starving Africans,” “mealtime is synonymous with family time” etc. etc. ad nauseam.

But, how about we look at mealtime from the perspective of an autistic person. I have been on the autism spectrum for many years and I raised a daughter on the autism spectrum so I would like to share some observations. I don’t purport to know what it is like for every autistic person, but I can give some perspective to the neurotypical out there. As the vast majority of autistic children have some type of sensory issue, let’s look at what mealtime may be like from the viewpoint of one with sensory issues.

  • Light:  Is it bright in your kitchen or dining room at mealtime? Most people don’t eat in the dark unless the power is out, so chances are there is a fair amount of light emanating from light bulbs at dinner as well as sunlight during the day.  Does your child act up when in the presence of fluorescent light, bright sunlight or just a well-lit room?
  • Noise: Is it quiet like a library at your breakfast or dinner table? Or is there a lot of talking, bustling about, moving of chairs etc.?
  • People: Does your child get antsy/agitated when around more than 1 person at a time? Does your child prefer a lot of alone time? How does/he she react with a group of people around a table?
  • Textures/Taste: Does your child only like certain textures of food?  Certain colors of food?  If there is more than one item on the plate, does he get agitated if the food touches or starts running together? Does unfamiliar food send your child into a meltdown?
  • Smell: Does your child have a heightened sense of smell? Do certain smells agitate him? How about a variety of smells all at once?

Is it any wonder your child does not do well at mealtime or refuses to eat?

When I raised my daughter, she and I were the only ones in the home and as I mentioned, we both are on the autism spectrum. The family meal concept (breakfast, lunch, dinner) went out the window early. Your child probably only likes a few foods. We on the autism spectrum will eat the same foods most of the time, if you let us, until we either get tired of the food (which can take a VERY long time) or we have something else put in front of us that looks more interesting. I have eaten peanut butter sandwiches for lunch (or sometimes for dinner) pretty much every day for the decades. Really.

My daughter and I when she was growing up, rarely liked the same foods at the same time or wanted to eat at the same time of the day. I could have forced us to have mealtime, but it seemed counterproductive. Yes, we did eat a meal together on occasion outside of the home at a restaurant or at a relative or friend’s house. I do advocate having a “group meal” once in a while to teach your child about the neurotypical world, but forcing your autistic child into 2 or 3 family meals around a table per day is going to put you into an early grave.

Suggestions to Help with Mealtime

Do yourself and your nervous system, not to mention the poor overloaded nervous system of your child on the autism spectrum, a favor, and try to give your child small amounts of no more than 1 or 2 foods at a time. Combine that with an eating environment that is one to one and surrounded by low light, low sound and low disruption. In other words, have eating take place in an environment as soothing as possible. I’m sure you experiment with foods to see what your child likes but don’t make the mistake of just giving your child the same food choices over and over. He won’t get proper nutrition. Above all, don’t give up. Just because your child does not like the food now, doesn’t mean he won’t want to try it 3 months from now or a year from now.

Please do NOT battle with your child over eating. Battling over food and food choices in general turns eating into an anxiety-producing activity which can lead to life-long eating problems and even eating disorders. Try to introduce new foods slowly over a few days. Put it on his plate and encourage him once to try it. Then just wait and see if he tries it on his own. You may have to try the food every day for 3 or 4 days and THEN he may try it. Don’t expect miracles overnight. Be patient. Eventually, try giving foods from different food groups at intervals during the entire waking day to maintain nutrition. Resist the temptation to believe “my child only likes …” and repeatedly just give him that food. You are not doing him any favors.

Important Note:  If you notice your child with abdominal distension and he doesn’t want to eat, take him to an Allergist to have him tested for allergies and sensitivities.  Very common in autistic children.

Revised Feb 2019