Key Points:
- Feeding disorder in autism involves extreme food selectivity, refusal, or disruptive mealtime behavior that goes beyond typical picky eating.
- Causes often include sensory sensitivities, anxiety, and behavioral patterns common in autistic children.
- Evidence-based support strategies, including ABA therapy, can help build healthier, more functional eating habits.
Research indicates that up to 89% of children with autism experience feeding challenges and disorders. A feeding disorder in autism refers to persistent eating difficulties that interfere with a child’s growth, nutrition, or ability to participate in typical mealtime routines. Unlike common picky eating, these behaviors are more severe and often tied to sensory processing challenges or behavioral rigidity.
Children with autism may limit their diet to only a few preferred foods, resist trying anything new, or show intense distress when their routine is disrupted. These patterns can create ongoing stress for families and increase the risk of malnutrition or growth concerns if left unaddressed.
In this article, we’ll go over the different signs of feeding disorders in autism, their causes, and offer some treatment strategies to help alleviate the issue.
Is Feeding Disorder in Autism a Medical Diagnosis?
Yes, in some cases, a feeding disorder in autism may be diagnosed as Avoidant/Restrictive Food Intake Disorder (ARFID), a recognized eating disorder that goes beyond typical food refusal.
This condition appears frequently in children on the autism spectrum due to their heightened sensitivity to tastes, textures, and even smells. Unlike anorexia or bulimia, ARFID isn’t about body image but rather about fear, discomfort, or extreme aversion to food experiences.
For a diagnosis to be made, the feeding issue must result in:
1. Weight Loss or Poor Growth
Feeding issues that lead to noticeable weight loss or difficulty gaining weight are a serious concern. When nutritional intake is insufficient, it can directly affect a child’s growth and development.
2. Nutritional Deficiencies
A lack of variety in the diet, especially if key food groups are avoided, can result in nutrient gaps. Deficiencies in vitamins and minerals can have long-term effects on a child’s health.
3. Dependence on Supplements or Tube Feeding
Some children with severe feeding issues may need supplements or tube feeding to meet their nutritional needs. This indicates that food intake alone is not providing adequate nourishment.
4. Interference with Psychosocial Functioning
Feeding issues can create stress within the family, especially when mealtimes become a battleground. Social situations, like eating at parties or school, may also become difficult or even impossible due to the child’s feeding challenges.
What Causes Feeding Disorders in Children with Autism?
Feeding issues in autism usually stem from a combination of sensory, behavioral, and developmental factors. Many children with autism experience discomfort or overwhelm during meals, leading to long-term food avoidance and emotional distress around eating.
Common contributing factors include:
When these issues persist, mealtimes can become battlegrounds, reinforcing the cycle of avoidance and refusal.
8 Signs of a Feeding Disorder in Autism
Recognizing a feeding disorder early can make a big difference in treatment outcomes. While every child is different, there are some clear signs that go beyond regular picky eating and indicate a more serious issue.
Common signs include:
1. Eating Fewer Than 10-15 Different Foods
When a child consistently eats fewer than 10-15 different foods, it indicates a limited and unbalanced diet. This can be a sign of picky eating that may lead to nutritional gaps and create stress during mealtimes.
2. Severe Resistance to Trying New Foods
Food neophobia, or the fear of new foods, is common in children but can be more pronounced in some. This severe resistance can make introducing variety difficult, affecting overall nutrition and mealtime enjoyment.
3. Meltdowns or Anxiety at Mealtime
Anxiety or meltdowns during meals are often signs that mealtime is a stressful or overwhelming experience. These emotional responses can be linked to sensory sensitivities, past negative experiences, or a lack of control over the eating process.
4. Gagging or Vomiting
A child who gags or vomits when exposed to certain textures or smells may have sensory aversions or a negative history with specific foods. These reactions often go beyond simple dislike and can indicate a need for specialized support.
5. Only Eating Foods of a Specific Color, Shape, or Brand
Children who insist on eating only foods of a certain color, shape, or brand may be dealing with rigidity in their food preferences. This limited acceptance can make mealtimes challenging and may be linked to sensory or psychological needs.
6. Refusing Entire Food Groups
Refusing entire food groups, such as vegetables or proteins, can lead to nutritional deficiencies and cause stress for caregivers. It often stems from sensory sensitivities, food neophobia, or strong preferences for certain textures or flavors.
7. Reliance on Pureed or Soft Foods
A child who continues to eat only pureed or soft foods after the toddler years may have motor coordination issues or sensory sensitivities to certain textures. Overcoming this requires gradual exposure to more solid foods in a controlled, non-threatening way.
8. Growth Delays, Low Weight Gain, or Nutritional Imbalances
Feeding difficulties that result in growth delays, poor weight gain, or noticeable nutritional imbalances can have long-term consequences. It’s crucial to address these issues early to support healthy development.
In some cases, children will eat normally at home but not at school or in public settings due to environmental stress.
How Sensory Processing Impact Eating in Autism
Children on the autism spectrum often experience sensory processing disorder (SPD), meaning they may be hypersensitive (overreactive) or hyposensitive (underreactive) to sensory input. This has a direct impact on how they experience food.
Sensory-related challenges may include:
1. Aversion to Crunchy or Mushy Textures
Children with aversions to specific textures may refuse crunchy foods like chips or soft, mushy ones like mashed potatoes. These sensory sensitivities can cause distress, making certain foods seem unappealing or even intolerable.
2. Discomfort from Mixed Foods
Foods that combine different textures or flavors, like casseroles or soups, can be overwhelming for children with sensory sensitivities. They may prefer foods that are served separately and maintain a consistent texture throughout.
3. Extreme Reactions to Smells or Temperatures
Strong smells or extreme temperatures—whether too hot or too cold—can trigger aversions or anxiety around food. Children with sensory sensitivities may refuse certain foods based on how they smell or feel when eaten.
4. Preference for Very Bland, Predictable, or Processed Foods
A preference for bland, predictable, or highly processed foods can stem from a need for familiarity and comfort. These foods often lack variety, making it challenging to introduce more nutritious or varied options into their diet.
5. Refusal to Eat Foods with Certain Colors or Appearance
Some children will refuse foods based on their color or appearance, such as rejecting green vegetables or foods with “unusual” shapes. This visual aversion can limit the variety of foods they are willing to try, even if the taste or texture is acceptable.
These reactions aren’t about being stubborn. For the child, these sensations can be physically uncomfortable or even painful. Addressing feeding disorders in autism often means working with these sensory sensitivities, not against them.
How Feeding Disorders Affect Family Life
Feeding disorders can create tension in the home. Parents may feel anxious about their child’s nutrition, frustrated by food refusals, or embarrassed in public settings. Siblings may notice the accommodations being made and feel confused or resentful.
Over time, daily life may revolve around trying to get a child to eat, leading to power struggles, skipped meals, or over-reliance on processed, preferred foods just to get calories in.
It’s important for families to understand that they’re not alone and that support strategies can reduce the stress around meals while encouraging gradual progress.
5 Treatment Options for Feeding Disorders
Feeding challenges in autism are complex, and no one-size-fits-all solution exists. Treatment is most effective when it’s personalized, evidence-based, and involves multiple specialists such as behavior analysts, occupational therapists, and dietitians.
One of the most effective tools for treating feeding disorders in autism is Applied Behavior Analysis (ABA). ABA focuses on understanding why a child avoids food and uses structured strategies to encourage progress over time.
Common components of a feeding intervention plan include:
1. Food Chaining
Food chaining involves introducing new foods by making small, gradual changes to the texture, shape, or flavor of foods a child already accepts. By linking unfamiliar foods to preferred ones, this strategy helps build tolerance without overwhelming the child.
2. Positive Reinforcement
Rewarding small successes, such as trying a new food or sitting calmly at the table, can encourage further progress. Positive reinforcement, like praise or small rewards, helps children feel motivated and supported as they explore new foods.
3. Desensitization
Desensitization involves gradually exposing a child to feared foods in a non-pressured, supportive way. Over time, this helps reduce anxiety or negative associations with specific foods, making them more tolerable without forcing consumption.
4. Modeling and Play
Using peers, siblings, or playful activities to introduce new foods in a fun, low-pressure environment helps reduce anxiety. Playful exposure makes mealtime a more relaxed and enjoyable experience, promoting positive associations with food.
5. Parent Coaching
Parent coaching helps caregivers learn how to support their child’s food-related goals without causing stress or battles. This empowers parents with the tools and strategies to create a positive eating environment while encouraging new food experiences.
Feeding therapy can be tailored to meet a child’s specific needs, whether it’s conducted in a clinical setting or in the comfort of their own home. In addition to traditional approaches, alternative therapies, such as the ketogenic diet, are gaining attention for their potential role in autism treatment. For more information on how the ketogenic diet could be incorporated into a comprehensive treatment plan, check out our article Exploring the Ketogenic Diet’s Role in Autism Treatment.
6 Practical Tips for Supporting Feeding at Home
While professional support is often needed, there are also practical, at-home strategies parents can begin using to reduce pressure and encourage curiosity around food. Helpful strategies include:
- Use visual schedules or charts to prepare your child for mealtimes.
- Offer choices within limits (e.g., “Would you like carrots or cucumber?”).
- Stick to consistent mealtimes and routines.
- Avoid using food as a bribe or punishment.
- Create a calm eating environment—limit distractions like screens.
- Celebrate small victories, like touching a new food or having it on the plate.
Patience is key. Feeding progress often takes time and consistency, but can yield meaningful change when supported with compassion and structure.
Give Your Child the Tools for Success with ABA Therapy
If your child is experiencing a feeding disorder and you’re looking for structured, compassionate help, Steady Steps ABA can support your family. We offer ABA therapy in Maryland, providing individualized, evidence-based treatment plans tailored to children with autism, including those facing mealtime challenges.
Our therapists work closely with families to build skills that matter: trying new foods, increasing food variety, reducing anxiety, and improving overall mealtime behavior.
Contact us today to learn how our ABA therapy in Maryland can help your child build a healthier relationship with food—and make mealtimes a positive experience for everyone.
