If someone’s autistic, it is likely to affect all aspects of their life from their relationships, education and employment to their health, hobbies and ability to look after themselves. For some people with autism, food and diet can cause significant challenges to their health and wellbeing.
As autism often goes hand-in-hand with sensory needs, this can impact a person’s reactions to the flavour and texture of food, causing them to avoid certain items or limit what they eat. This is known as ARFID – avoidant/restrictive food intake disorder.
According to The Royal College of Psychiatrists, ‘ARFID is a mental health condition. People with ARFID don’t eat enough food, or don’t eat enough different kinds of food to meet their energy or nutritional needs. This is usually bad enough that someone with ARFID loses a lot of weight, has serious nutritional deficiencies, needs food supplements (or even to be fed with a tube) or has other problems with their physical health.’
ARFID Connected to a Number of Factors
ARFID is common in people with ASD, the RCP says. In addition to the sensory factors of the condition, it can also be caused by fear of eating (perhaps due to experiences of vomiting or stomach aches) or an inability to sense when one is hungry.
The condition is not connected, they point out, to food allergies, lack of access to healthy food or the usual fussiness of young children who don’t like trying something new.
Living With Sensory Challenges
Mandy runs the Facebook page The Autistic Teacher. As you might expect, she is a teacher but she is also an autism adviser and the CEO of not-for-profit organisation Autism South-East. She has three children who have been diagnosed with autism– her fourth child has a diagnosis pending – and she herself also found out she was autistic as an adult.
She says that she and her family all have sensory issues around food. “I like beige, plain food and I don’t like anything gooey or yogurt-y,” she explains. “I think things should either be liquid or solid but not in-between! One of my children lives on chicken nuggets and the other loves plain pasta. I know a lot of people worry about getting the right nutrition but I found that my kids like the taste of children’s vitamins so that helps.”
Take the Stress out of Mealtimes
Mandy recommends taking a laid-back approach to a young person’s issues with food. “You need to be relaxed as a parent or you risk raising your children’s anxiety levels,” she comments. “Try and understand their sensory challenges – is it the texture they don’t like? The smell? Also be aware that sensory needs can fluctuate from day-to-day depending on whether a person is tired or anxious.
“Lessen the stress of eating by slowly introducing new things without pressure,” she continues, “and don’t force conversation at the dinner table. If someone needs to look at their iPad while they eat and feels calmer for doing so, why not?”
Mandy goes on to say that that parents shouldn’t give up hope that an autistic child will eventually learn to tolerate new foods as everyone has the potential to make progress and grow.
How to Cope With Eating Challenges
The Royal College of Psychiatrists has the following suggestions for helping people manage ARFID and autism –
- Provide a peaceful environment to eat in away from noise, chaos, interruptions and other people who are eating.
- Allow flexibility around mealtimes. This might mean snacking throughout the day or eating foods in a non-typical way – for example, breakfast cereal at dinnertime.
- Help the person to explore how food smells, looks or feels before trying to eat it.
- Allow the person to ‘stim’ while eating, perhaps standing, moving around or using fidget toys if they need to.
- Provide consistency and avoid unpredictability where possible – for example, don’t insist someone eats at the table one day and then allow them to eat in front of the TV on another occasion.
- Realise that the person may not be able to accurately identify when they are hungry or full.
- Don’t hide food items in other foods to get the person to eat something they don’t want to. They are likely to notice small changes and lose trust in you.
