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Father feeding little girl outside

According to one study, “children with ASD exhibited more food refusal than typically developing children (41.7% vs. 18.9% of foods offered).“Another study concurs: “… children with autism have significantly more feeding problems and eat a significantly narrower range of foods than children without autism.”

This means that, if you have an autistic child who eats poorly, you’re not alone. Poor eating habits can lead to a wide range of nutritional problems which, in turn, can lead to problems ranging from health issues to attentional and behavioral problems.

“Poor eating habits” and “feeding issues” have several different causes and many levels of severity.

Resolving problems with feeding, picky eating, food intolerances, and nutritional deficits can have a positive impact on your child’s life. Here are some of the ways in which feeding issues can impact your child, along with some suggestions for addressing the problem.

Overcoming Feeding Problems in Autistic Children

Maybe your child won’t eat broccoli, apples, nuts, or breakfast cereals. Or won’t touch yogurt, milk, applesauce, soup, or oatmeal. In both of these cases, there’s a pattern: In the first case, the child is rejecting crunchy foods. In the second case, they won’t tolerate smooth or gooey foods.

Strategies You Can Try

There are a few simple fixes for eating problems related to sensory challenges:

Occupational Therapy for Autism

According to a review of multiple studies, there is “a strong relationship and significant correlation between eating problems and gastrointestinal (GI) dysfunction [in children with autism].”

This may mean that some of your child’s more extreme behaviors may be related to pain and discomfort from gas, bloating, diarrhea, or acid reflux. Solve the underlying problem, relieve the pain, and your child may find it much easier to focus, think well, control emotions, and behave more appropriately.

Signs of GI discomfort can include diarrhea, constipation, flatulence, or a hard belly. You may also notice your child pressing their stomach up against pillows or chairs to relieve pressure.

If your child is verbal and can describe their physical sensations, they might tell you when they are experiencing GI issues, or they may be able to describe their sensations if you ask.

If you think your child could be experiencing GI problems, you can take some important steps:

Milk, Dairy, or Gluten Sensitivity

Some children on the spectrum seem to have negative reactions to milk or dairy products (associated with lactose or a protein called casein) and/orwheat products (gluten). These reactions may or may not be allergies.

If you believe your child is responding negatively to either milk or gluten, you can consider starting a gluten and/or casein-free diet. It is very important, though, to ensure your child is getting enough nutrition—work with your pediatrician or with a dietitian to plan a well-rounded diet.

Like many children, autistic kids would usually prefer chicken nuggets and pizza to salads and fruit. Kids who have autism can get absolutely stuck on very few food choices and absolutely refuse to make even the slightest change.

While it is possible that these preferences have sensory or GI causes, it’s also possible that your child has developed a routine that is extremely difficult to change. People with ASD, in general, prefer sameness and function well with routines. But sometimes that can get in the way of proper nutrition.

If your child’s diet is really poor, and you’ve already addressed any sensory or physical issues, you’ll need to address the behavior.

There are several approaches you can take, and you can mix and match:

Resources and Research

A great deal of research has gone into the issue of autism and nutrition. Some findings are helpful in guiding families and doctors.

It’s important to note, however, that not all research is of equal quality, and some studies are conducted with a specific agenda in mind. For example, researchers may conduct studies in order to validate a product they want to sell or to convince parents that a particular perspective is correct.

Solid, replicated research studies have shown that:

Screening for Feeding Issues

Nicole Withrow and Jennifer Franck developed a screening tool called the Sensory, Aberrant Mealtime Behavior Inventory for Eating (SAMIE), which they applied through a survey to a large group of autistic children and teens. The tool helps parents and practitioners zero in on the specific challenges they need to address and provides some direction for action.

6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bandini LG, Anderson SE, Curtin C, et al.Food selectivity in children with autism spectrum disorders and typically developing children.J Pediatr. 2010;157(2):259-64.Schreck KA, Williams K, Smith AF.A comparison of eating behaviors between children with and without autism.J Autism Dev Disord. 2004;34(4):433-8. doi:10.1023/b:jadd.0000037419.78531.86Karling P, Maripuu M, Wikgren M, Adolfsson R, Norrback KF.Association between gastrointestinal symptoms and affectivity in patients with bipolar disorder.World J Gastroenterol. 2016;22(38):8540-8548. doi:10.3748/wjg.v22.i38.8540Kinnaird E, Norton C, Pimblett C, Stewart C, Tchanturia K.Eating as an autistic adult: An exploratory qualitative study.PLoS ONE. 2019;14(8):e0221937. doi:10.1371/journal.pone.0221937Sharp WG, Berry RC, Mccracken C, et al.Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature.J Autism Dev Disord. 2013;43(9):2159-73. doi:10.1007/s10803-013-1771-5Withrow N, Alvidrez L.The development of the Sensory Processing, Aberrant Mealtime Behavior, Motor Inventory for Eating (SAMIE) in children with an ASD”, Advances in Autism. 2019;5(4):268-281. doi:10.1108/AIA-08-2018-0025Additional ReadingCermak, S. Sensory sensitivity and food selectivity in children with autism spectrum disorders.Comprehensive Guide to Autism. Springer Reference, 2014. pp 2061-2076. doi:10.1007/978-1-4614-4788-7_126Sharp, W.G., Berry, R.C., McCracken, C. et al.Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature. J Autism Dev Disord (2013) 43: 2159. https://doi.org/10.1007/s10803-013-1771-5Coury, D, et al. Gastrointestinal conditions in children with autism spectrum disorder: developing a research agenda. Pediatrics. November 2012, VOLUME 130 / ISSUE Supplement 2Vissokera, R. et al. Eating and feeding problems and gastrointestinal dysfunction in Autism Spectrum Disorders.Research in Autism Spectrum Disorders,Volume 12, April 2015, Pages 10-21https://doi.org/10.1016/j.rasd.2014.12.010

6 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bandini LG, Anderson SE, Curtin C, et al.Food selectivity in children with autism spectrum disorders and typically developing children.J Pediatr. 2010;157(2):259-64.Schreck KA, Williams K, Smith AF.A comparison of eating behaviors between children with and without autism.J Autism Dev Disord. 2004;34(4):433-8. doi:10.1023/b:jadd.0000037419.78531.86Karling P, Maripuu M, Wikgren M, Adolfsson R, Norrback KF.Association between gastrointestinal symptoms and affectivity in patients with bipolar disorder.World J Gastroenterol. 2016;22(38):8540-8548. doi:10.3748/wjg.v22.i38.8540Kinnaird E, Norton C, Pimblett C, Stewart C, Tchanturia K.Eating as an autistic adult: An exploratory qualitative study.PLoS ONE. 2019;14(8):e0221937. doi:10.1371/journal.pone.0221937Sharp WG, Berry RC, Mccracken C, et al.Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature.J Autism Dev Disord. 2013;43(9):2159-73. doi:10.1007/s10803-013-1771-5Withrow N, Alvidrez L.The development of the Sensory Processing, Aberrant Mealtime Behavior, Motor Inventory for Eating (SAMIE) in children with an ASD”, Advances in Autism. 2019;5(4):268-281. doi:10.1108/AIA-08-2018-0025Additional ReadingCermak, S. Sensory sensitivity and food selectivity in children with autism spectrum disorders.Comprehensive Guide to Autism. Springer Reference, 2014. pp 2061-2076. doi:10.1007/978-1-4614-4788-7_126Sharp, W.G., Berry, R.C., McCracken, C. et al.Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature. J Autism Dev Disord (2013) 43: 2159. https://doi.org/10.1007/s10803-013-1771-5Coury, D, et al. Gastrointestinal conditions in children with autism spectrum disorder: developing a research agenda. Pediatrics. November 2012, VOLUME 130 / ISSUE Supplement 2Vissokera, R. et al. Eating and feeding problems and gastrointestinal dysfunction in Autism Spectrum Disorders.Research in Autism Spectrum Disorders,Volume 12, April 2015, Pages 10-21https://doi.org/10.1016/j.rasd.2014.12.010

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Bandini LG, Anderson SE, Curtin C, et al.Food selectivity in children with autism spectrum disorders and typically developing children.J Pediatr. 2010;157(2):259-64.Schreck KA, Williams K, Smith AF.A comparison of eating behaviors between children with and without autism.J Autism Dev Disord. 2004;34(4):433-8. doi:10.1023/b:jadd.0000037419.78531.86Karling P, Maripuu M, Wikgren M, Adolfsson R, Norrback KF.Association between gastrointestinal symptoms and affectivity in patients with bipolar disorder.World J Gastroenterol. 2016;22(38):8540-8548. doi:10.3748/wjg.v22.i38.8540Kinnaird E, Norton C, Pimblett C, Stewart C, Tchanturia K.Eating as an autistic adult: An exploratory qualitative study.PLoS ONE. 2019;14(8):e0221937. doi:10.1371/journal.pone.0221937Sharp WG, Berry RC, Mccracken C, et al.Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature.J Autism Dev Disord. 2013;43(9):2159-73. doi:10.1007/s10803-013-1771-5Withrow N, Alvidrez L.The development of the Sensory Processing, Aberrant Mealtime Behavior, Motor Inventory for Eating (SAMIE) in children with an ASD", Advances in Autism. 2019;5(4):268-281. doi:10.1108/AIA-08-2018-0025

Bandini LG, Anderson SE, Curtin C, et al.Food selectivity in children with autism spectrum disorders and typically developing children.J Pediatr. 2010;157(2):259-64.

Schreck KA, Williams K, Smith AF.A comparison of eating behaviors between children with and without autism.J Autism Dev Disord. 2004;34(4):433-8. doi:10.1023/b:jadd.0000037419.78531.86

Karling P, Maripuu M, Wikgren M, Adolfsson R, Norrback KF.Association between gastrointestinal symptoms and affectivity in patients with bipolar disorder.World J Gastroenterol. 2016;22(38):8540-8548. doi:10.3748/wjg.v22.i38.8540

Kinnaird E, Norton C, Pimblett C, Stewart C, Tchanturia K.Eating as an autistic adult: An exploratory qualitative study.PLoS ONE. 2019;14(8):e0221937. doi:10.1371/journal.pone.0221937

Sharp WG, Berry RC, Mccracken C, et al.Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature.J Autism Dev Disord. 2013;43(9):2159-73. doi:10.1007/s10803-013-1771-5

Withrow N, Alvidrez L.The development of the Sensory Processing, Aberrant Mealtime Behavior, Motor Inventory for Eating (SAMIE) in children with an ASD", Advances in Autism. 2019;5(4):268-281. doi:10.1108/AIA-08-2018-0025

Cermak, S. Sensory sensitivity and food selectivity in children with autism spectrum disorders.Comprehensive Guide to Autism. Springer Reference, 2014. pp 2061-2076. doi:10.1007/978-1-4614-4788-7_126Sharp, W.G., Berry, R.C., McCracken, C. et al.Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature. J Autism Dev Disord (2013) 43: 2159. https://doi.org/10.1007/s10803-013-1771-5Coury, D, et al. Gastrointestinal conditions in children with autism spectrum disorder: developing a research agenda. Pediatrics. November 2012, VOLUME 130 / ISSUE Supplement 2Vissokera, R. et al. Eating and feeding problems and gastrointestinal dysfunction in Autism Spectrum Disorders.Research in Autism Spectrum Disorders,Volume 12, April 2015, Pages 10-21https://doi.org/10.1016/j.rasd.2014.12.010

Cermak, S. Sensory sensitivity and food selectivity in children with autism spectrum disorders.Comprehensive Guide to Autism. Springer Reference, 2014. pp 2061-2076. doi:10.1007/978-1-4614-4788-7_126

Sharp, W.G., Berry, R.C., McCracken, C. et al.Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature. J Autism Dev Disord (2013) 43: 2159. https://doi.org/10.1007/s10803-013-1771-5

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