Thanksgiving is a holiday that is steeped in tradition, and throughout America, our tables all tend to feature the traditional turkey, stuffing, cranberry sauce and pumpkin pie. Parents of children with autism want them to experience the richness of Thanksgiving’s traditional meal, but they may also be concerned that family members or guests will consider them to be picky eaters. However, food preferences in children with autism are more complex.
“A lot of kids on the autism spectrum are picky eaters, but not all. That’s important to know,” says Nikki Griffin, a board-certified behavior analyst with Chicago-based Envision Unlimited. The 73-year-old organization serves residents with intellectual and developmental disabilities, autism, and mental illness.
Griffin says that gastrointestinal issues tend to accompany autism and factor into children’s food preferences. Children can’t always verbalize stomach pain caused by acid reflux or constipation — or draw the connection between what they have eaten and the pain they feel.
If your goal is to help your child try everything this Thanksgiving — or even accept one new food on their plate, be sure to develop a plan before starting a new food acceptance protocol, Griffin suggests. Consult first with your child’s pediatrician and then with your ABA therapy team.
“Kids with autism can’t always tell us what hurts, so parents must be proactive and rule out medical issues,” she says. “Check out all the avenues first and your pediatrician is the best resource.”
What’s behind food preferences
Just as children with autism process input from lights and sounds differently from their neurotypical peers, they process food textures and tastes differently, too.
“A child may be sensitive to food textures,” explains Griffin. “Some prefer soft and creamy foods; others like sticky or crunchy foods. Some like tangy flavors and others prefer sweet or savory. It can be a challenge for parents who want to find nutritious and filling foods that their child prefers.”
Kids who are hypersensitive to food sensory input can be overwhelmed by strong flavors and intense textures. “Think about how dip on a chip can be both crunchy and soft. That can be too much for some kids,” Griffin says, adding that processed foods like chicken nuggets are often acceptable to kids with autism because they are consistent. “Each nugget has exactly the same texture, so kids know exactly what to expect, compared with a chicken breast, which is inconsistent from one bite to the next.” This concept can be generalized to other foods, too.
On the other end is the child who is hyposensitive (under-sensitive) and seeks out more sensory stimulation. While this child may not balk at flavors and textures, they may not recognize their own hunger cues.
“It may look like you have a picky eater because they would rather play than eat, but when they finally realize they are hungry, it can be an intense experience that turns into behavior issues at the table,” Griffin explains.
New foods at the Thanksgiving table
A little coaxing may be all it takes to get a neurotypical child to try a new food at Thanksgiving. But when a child with autism is already disrupted by a change in routine, asking for food flexibility might be a step too far, Griffin cautions.
“This might not be the best time to introduce new foods, so many parents just plan to include safe foods for their child at Thanksgiving,” she says. “Be aware of what your child can handle and consider if there is a need to potentially make the whole holiday stressful for the family.”
However, if you feel that your child can handle a new food this Thanksgiving, and it’s a goal you have for your family, Griffin offers some suggestions to be successful.
First, plan well in advance. “If you know you want your child to eat pumpkin pie, don’t wait until the holiday to expose them to it,” Griffin says. “Start a month early and don’t expect them to eat it on the first exposure.” Your child may tolerate the pie on their plate, or they may even want to touch it. “We let the child decide how to interact with the food, even if it means pushing it into the trash can.”
Consider the conversation you might have with extended family members who may share their opinions about your child’s food preferences. “If you are working with your child to broaden their accepted foods, tell family members not to be offended if your child won’t eat what they offer.
“Family members don’t always understand what goes into teaching a child how to eat a new food. You don’t have to go through their whole treatment plan, but maybe practice saying, ‘We are teaching him how to try this food,’” Griffin suggests.
Another route would be to teach your child ways to appropriately deny foods they don’t find appetizing. “Instead of a tantrum, teach them to say, ‘No thank you. I don’t want that right now,’” she says.
Finally, rely on your ABA team for help. “Any good food acceptance plan will include related service providers. For instance, we always consult with speech-language therapists to get feedback. We specialize in behavior but they specialize in the oral-motor mechanism, so we consult with them to make sure the eating plan is appropriate for the child,” Griffin says.
Learn more about Envision Unlimited, the Chicago-based 73-year-old organization that provides ABA therapy for children 2-17 years old with autism. Visit envisionunlimited.org/autism.