How to Help a Picky Eater with Autism
Many children with autism won't eat certain foods because of taste, texture, smell or color.
Jackson Cointot was more than a finicky eater when he was 3 years old. His extremely limited diet of pizza, cheese curls and Cheerios led his desperate parents to search for help and nutritional guidance.
Before being diagnosed with autism at age two-and-a-half, Jackson was eating baby food and a small variety of other foods. Gradually, his strong gag reflex and an aversion to eating with a spoon resulted in him choosing only carbs and snack foods – a common problem for children on the autism spectrum, as well as some typical children.
An estimated 25 percent of typical children develop feeding or eating problems, but among children with autism it is as high as 80 percent, according to the Indiana University Resource Center for Autism in Bloomington.
Taste, texture, smell or color
Allison Cointot, 36, Jackson’s Ridley Park, PA mom, and her husband, Keith, looked into intensive food-therapy programs and force-feeding options.
Instead, they decided to have Jackson work with behavior analyst Jennifer King, the owner of Teaching Together, who says that the majority of children she works with who have autism are extremely picky eaters, which often translates to problems with taste, texture, smell or color.
The family’s goal for Jackson was to add more nutritional food choices, fruit, vegetables and textures – basically anything other than carbs.
“I use a softer and gentler approach than many other behavioral programs,” says King.
King takes foods that the child used to eat and encourages him to begin with touching, smelling and licking the food and then take a bite – all of this is done with patience, positive reinforcement and family cooperation.
“I make feeding therapy fun. The long-term goal is for the child to eat fruits and vegetables,” King explains, “but the short-term goal is for the child to learn to trust me.”
King may take a picky eater’s love for French fries as a gateway for her to try sweet potato fries and, eventually, carrot and red pepper sticks.
“Many children will try crunchy foods as opposed to squishy foods, like soft veggies. After we’ve been working for a while, children will go along with me and try Nutella on a sandwich, with or without peanut butter, and after a year or two they may have graduated to roasted broccoli.”
She says often parents want the child to eat the entire portion, while King sees one bite as a victory.
Her advice: “I would say to go slow, go back to the foods like apple sauce the child used to eat. I know that parents get frustrated, but there is a light at the end of the tunnel. Most of the children I have worked with have been successful in meeting their goals. Almost all of them have been able to add all five food groups back into their diet.”
So, how did King’s therapy and the family’s follow-through change the life of Jackson, now a 4-year-old preschooler?
“My son now eats every texture and items from every food group,” says Allison. “Our family can go to a restaurant and can find items for Jackson to eat. He is getting vitamins and nutrients. He was starting to gain weight by eating all those carbs and now his belly is thinning out. Mealtime is no longer a battle and he can make his own choices.”
Her advice for parents of children with autism who are picky eaters? “Consistency pays off,” explains Allison. “Find the program for your child and your family that is the best fit.”
Food issues a common problem
Developmental pediatrician Caroline Eggerding, who has been diagnosing and treating children with autism for 37 years, is well versed in family eating and feeding concerns.
“In my experience, a child who has a diagnosis with autism and eats well is the exception,” says Eggerding, the division head of pediatric neurology and development at Cooper Children’s Regional Hospital in Camden, NJ.
“The majority of the toddlers and children on the autism spectrum have fairly intense food likes and dislikes, and extremely limited diets. Rarely do parents bring in a child who has no eating or feeding rules,” she says, “and like all early intervention, we should be embracing this and addressing it early on.”
Eggerding believes many of the eating issues stem from the fact that some children with autism have a more sensitive taste system. For example, one reason many children with autism refuse green vegetables, such as spinach and broccoli, is that those foods can be bitter to their taste buds.
“This can be a lifetime of challenges that hopefully get better over time. Feeding therapy is a long-term process,” Eggerding says. “By the time you get to feeding therapy, there has often been a whole history of negative experiences that haven’t been effective.”
Parents have an instinctual need to feed their children because it connects them to their role of nourishing their children. “When the experience goes badly, it can be extremely overwhelming,” she says.
How to help a typical child with eating problems
Philadelphia mom Casey Debaecke’s son Max, 9, started food therapy with King in October 2016 because he was only eating two things – Purdue chicken nuggets and Ellio’s pizza. Max, who is “typical,” had been eating a large variety of foods until the birth of this brother, Luke, now 6.
Casey and her husband, Michael, weren’t just worried about Max’s nutrition, but were concerned that their small child had also fallen off the growth charts.
“We were at our wit’s end over this and my pediatrician was telling me to give him a smoothie,” Debaecke recalls. “We had tried everything and we were distraught.”
She watched as King gave him a reward of a gummy bear for touching, licking, smelling or taking a small bite of a food during her “food game.” After working with Max during the past two years, his mom is thrilled to say that her son is gaining weight.
“Now Max eats burgers, chicken teriyaki, carrots, red peppers, and so much more. In a million years, I never would have expected to say this. It is a huge relief. What we accomplished changed his life and helped our entire family.”
Her advice to parents of any child who has eating issues? “Start as soon as you sense a problem,” Debaecke says.
“I wish we had started this sooner, and that we hadn’t waited a year and a half to seek help,” she says. “Friends or grandparents may say that your son or daughter is just being a picky eater, but the earlier you address this, the better it will be for the entire family.”
Debra Wallace is a freelance writer.