Lynne Mielke, MD

Yes, picky and selective eating is actually a quite common concern for children with autism. If you rolled your eyes looking at the steps above because your child with autism has never had a full day's serving of vegetables in their life, you are definitely not alone. As if getting kids to eat their veggies isn’t challenging enough, research shows children with autism have significantly more eating challenges than their peers who are not autistic.

In addition to sensory difficulties that can lead to a lot of anxiety with food, autistic children are 4x more likely to have gastrointestinal issues such as stomach pain and discomfort. This creates the perfect storm for extra extra picky eaters - and a lot of added obstacles and concerns for parents. 

The difficulties associated with autistic children and food can cause a wide range of concerns from children being underweight to overweight (overweight children can still be at risk for nutritional deficiencies!).  This can lead to slower than normal growth and nutritional deficiencies like low vitamin D and calcium levels. Even when given multivitamins, many children with autism are still found to have some of these nutritional deficiencies.

Here are some tips:

1. Keep to a schedule - setting schedules for meal and snack  time can help picky eaters build up their appetite throughout the day
2. Minimize distractions - removing distractions like screens and toys can help your child be more engaged at mealtime 
3. Approach new foods together - Make new foods less scary by trying them together. Touching and smelling the food together before tasting it 
4. Support choice & control - Allowing your child to pick which foods they eat will help them feel more in control 

For more tips, check out our guide for getting a complete diet.

It may not seem obvious, but eating is a complex behavior that involves perceptual, emotional, and cognitive processes. And we know that children with autism process things differently. While many of us look forward to things like our afternoon snack, it may be an activity that causes a lot of anxiety for your child.

Parents describe food selectivity being determined by a few of the following factors: texture (69%), appearance (58%), taste (45%), smell (36%), and temperature (22%). Uniform texture, bland and neutral color foods are reported to be overwhelmingly preferred by more than 90% of children with ASD.