Tips to Ensure Successful Mealtimes for Autistic Children

What you will learn:

Why mealtimes can be more challenging for autistic individuals or those with complex minds (SPD or ADHD). 
How to set your child up for success during mealtimes.

Why Mealtimes Can Be More Challenging for Autistic Children

In general, individuals with complex minds, including autistic people and those with ADHD, have more challenges with eating than their neurotypical peers. These challenges are often due to behavioral, sensory, oral-motor, or regulation challenges, or some combination of these factors.

Behavioral Considerations

Autistic children may be drawn to specific foods and may be very particular about the appearance, preparation, flavor, and texture of those foods. Some children may even prefer specific brands of foods and will decline other foods (even if they are very similar). For some children, processed and packaged foods are more predictable, as they have exactly the same taste and texture each time. This sense of predictability may help reduce anxiety.  You may want to try:

Removing food from its package and placing it into an unlabeled container when coming home from the store. This may help your child accept different brands or flavors. 
Avoiding the same foods in back-to-back meals. For example, if your child has Goldfish crackers for lunch one day, don’t offer it to them again until the following day. This helps prevent your child from "burning out" on a particular food (which is common with neurodivergent children and can reduce food options even further).

A little girl eating a muffin in a kitchen.

Sensory Considerations

Neurodivergent children often have difficulty "filtering" what sensory information is important. This is particularly challenging at mealtimes because meals are rich sensory experiences. Small distractions in the environment during mealtime can keep a child from focusing on eating or be so overwhelming that a child is too nervous to listen to their body's hunger cues. 

You may want to try:

Taking a look at the environment where your child eats. Get down to your child's level and look for any visual clutter, bright patterns, or lights that may be distracting. Think about noise. Close your eyes and listen for anything that could bother your child if your child is sensitive to sounds. These factors may keep your child from trying new food or eating enough food. 
Thinking about patterns with regard to your child’s preferences. For example, is your child repelled by foods that look wet or slimy? Do they dislike foods that are certain colors? Observing these patterns can help you discover ways to support your child more effectively during snacks and meals.

Oral-motor Challenges 

Some children may have delayed motor skills with their face, mouth, or hands. This may lead to challenges with the mechanics of biting, chewing, and swallowing. Children may intuitively avoid foods that they know they can't easily chew, such as certain types of meat that require more chewing. If you’re concerned that your child has difficulty with the mechanics of eating, you can have them evaluated by a speech and language pathologist or an occupational therapist that specializes in feeding. These professionals help identify specific concerns related to swallowing that may require additional support and provide at-home activities to develop strength and coordination to promote oral-motor development.

Schedule and Routine

All children are more successful when they have expectations around what they’ll be doing next. If you don’t know what is going to happen next from one moment to another, it would be challenging to prepare for what’s to come and feel confident making decisions. For example, if a child thinks that they may not have another opportunity to eat a cookie, it may become very important to them that they eat as many cookies as they can get right in that moment.

Also, many children have challenges with understanding and planning for the future, which requires executive functioning skills. Creating a visual schedule to help your child understand what their day will look like, including their meal plan, can reduce anxiety. If your child is receiving ABA services, their ABA team can assist with creating a visual schedule specific to your child's needs. There are also many examples of fun and engaging visual schedules available online.

You may want to try:

Creating a weekly schedule including school, extracurricular activities, therapies, and meals. Review this schedule with your child the night before, during their bedtime routine, and again in the morning if needed. This can help your child transition from one activity to another. 
Ensuring your child is eating regular and predictable meals, ideally at a table.  Most children will eat about every 2-3 hours. In general, children need to eat at frequent intervals because they’re growing so rapidly. It can help to set a timer or alarm to remind you when you should be offering a snack or meal to your child, especially if you aren't eating at the same time. Mealtimes that take place in the same environment can help your child relax and know what to expect.
Selecting snacks carefully, providing nutritious snack options, and giving those snacks in a structured environment rather than “on the go.” Calorie-containing beverages in particular can decrease your child’s appetite, making it harder for them to eat more nutrient-dense foods at your family’s mealtime. 
Arranging for at least one other person to eat while your child is eating. It’s no fun to eat alone, and children are more likely to try new food and eat more food if they observe others eating the same foods. Siblings can make great partners for modeling the behavior you’d like to see.

Regulation Challenges

Many children struggle to stay seated during meals. They may want to get up and move around, or they may get distracted by something in the environment. Many children are able to stay seated for longer periods if they’ve had physical activity before mealtime. If your child is working with an occupational therapist, physical therapist, or music therapist, they may be able to provide recommendations for a pre-meal sensory routine that can prepare your child for a successful meal.

You may want to try:

Using visual timers (egg timers or sand timers) to help your child know how long they’ll be sitting for a meal. Some children are bothered by timers or become more anxious around timers, so only use them if they help your child.
Creating appropriate expectations for how long your child should stay seated for a meal or snack. It’s difficult for many children to sit at a meal for longer than 30 minutes, and for younger children, five minutes of focused eating time may be a realistic expectation. They may need to get up from the table throughout their meal to "get the wiggles out.” The amount of time they can remain seated will likely increase as they get older.
Making mealtimes as relaxing as possible for all of you. Focus on the areas that you can control as a parent (Ellyn Satter's Division of Responsibility below has more information on this). Do not force-feed your child and don’t get into negotiations or bribery related to food.

If you would like guidance specific to your child, or if you have any concerns that your child’s nutritional needs are not being met, schedule an appointment with a Cortica nurse practitioner and a member of our feeding team or consult with your primary care physician.