Nutritional Concerns of the Child with Autism Spectrum Disorder

Guest post by Kristine Kenny, MSN, RN, CPN, CAS

 Proper nutrition is a key component for growth and development of all children regardless of any medical diagnosis. The nutritional needs for a child with Autism Spectrum Disorder (ASD) are the same as any child without the disorder. However, there are many challenges as to why children with ASD have nutritional issues and may not be getting the proper nutrition as compared to children without the disorder. Serious food aversions, sensitives and behavioral challenges are a few of the causes for this population.

Nutritional Concerns of the Child with Autism Spectrum Disorder

Autism Speaks researchers state that children with ASD are five times more likely to have mealtime challenges such as tantrums, extreme food selectivity and ritualistic eating behavior. In addition, they found inadequate nutrition to be a common thread among the ASD population. Calcium and protein levels were abnormally low as a result of the poor nutrition. Calcium and protein are both essential building blocks for growth and the development of the child. This article will discuss the most common challenges associated with nutrition for children with ASD. 

Common Nutritional Concerns for the Child with ASD

• Sensory
• Environmental
• Repetitiveness or obsessiveness
• Medical Conditions and Eating Disorders
• Alternative Diets and Supplements

Sensory

Due to children with ASD having difficulties regulating their sensory systems, many of these children are over or under sensitive to the taste, smell, color and texture of foods. This can affect the way a child with ASD perceives mealtime and can be a source of anxiety for these children. Sensory issues can cause the child to limit food selection and to have many food aversions.

The National Autistic Society states that people who are hyper sensitive to smells and taste may prefer to eat quite bland food and may find strong smells overpowering. Whereas those who are hyposensitive to taste or smell, may prefer strong flavors and smells to wake up their senses. Certain smells and flavors may be a source of intense pleasure for some while others may find it nauseating and unbearable. Each child is unique with their differences. Another obstacle that was noted was the soft and hard textures of foods. This can impact the child’s intake adding more restrictions with food selection.

Environment

The environment in which the child eats could be another reason meal time is a challenge. One must consider the lighting, noise level and the comfort of the chair that the child is sitting on during meal times to assess if this is a cause for distress during meal times.

Repetitiveness

Some children with ASD prefer to eat the same kind of food every day for every meal. Research states that this oral fixation and food selectivity is considered a manifestation of the symptoms of ASD which include insistence on sameness, ritualistic patterns and inflexible adherence to routines. This pattern of repetitiveness over time can lead to very restricted food intake and inadequate nutrition for the child. It can also lead to food obsessions. Food obsessions can lead to over eating to the point of vomiting.

Medical Conditions and Eating Disorders

The American Academy of Pediatrics (AAP) states that children with ASD are at higher risk of having other medical issues. Some of the most common gastrointestinal issues are chronic constipation, diarrhea, feeding disorders, abdominal pain, Celiac disease and gastroesophageal reflux. All of these conditions will most likely affect the child’s intake of food. The AAP recommends discussing all concerns with the pediatrician.

The National Autistic Society reports that between 4% to 23% of people with ASD have an eating disorder. Reasons for those on the ASD having these disorders include sensory issues related to food intake. They may not have the ability to recognize hunger or fullness. This is known as interoception. It is our internal cue for one to stop eating when full or to eat when one is hungry. Pica is another eating disorder that can be seen within this population. It is when a person repeatedly eats things that are not food, such as dirt, paint chips and clay.

Alternative Diets and other supplements

Many parents put their child with ASD on alternative diets in an effort to help decrease some of their ASD symptoms. Common diets are gluten free (removal of wheat) and casein free (removal of milk products). Research states while many of these diets are safe, they have the potential for nutritional deficiencies particularly on a growing child.

In addition to the alternative diets, many parents have their children on a variety of different supplements, like vitamins to enhance their nutrition. This additional supplementation can lead to other GI disruptions that result in nausea, vomiting and diarrhea. The AAP declares special diets and vitamin supplements may be popular but doesn’t mean that they are safe or necessary.

Guidance and Resources

Raising a child with ASD can be challenging. The AAP recommends discussing your concerns with your pediatrician first. The pediatrician can recommend other experts who specialize in fields of nutrition and ASD that can help your child. They include dietician, nutritionists, dentists, occupational therapists, speech/language therapists and behavioral therapist. Parents are guided by these experts to help get their child on the right nutritional path and work as a team with these experts to provide the best nutritional care that is unique to your child’s and family needs.

Looking for more information, you’ll enjoy these:

• How to Prepare Your Autistic Child for a Trip to the Doctors

• Autism 101- What is Autism Spectrum Disorder

• How to Advocate for Your Child with Autism Spectrum Disorder (ASD) in a Medical Setting

• Siblings of Autistic Children: Common Concerns and Effective Strategies

• How to Connect With Parents (Locally and Worldwide) After an Autism Diagnosis

Key Takeaway

Ensuring that children eat properly and get all of their daily nutrients is a challenge for most parents. Understanding that children with ASD are at increased risk for having nutritional challenges is vital. Awareness of environment and sensory needs around foods and mealtimes are key. It is essential for parents to talk with the pediatrician first before trying special diets and supplements. And lastly it is imperative for the parent to realize that there are experts that can help with the nutritional issues that your child with ASD might be having.

Kris is a mom of 3, one of whom has autism. She is a pediatric nurse, assistant nursing professor and author. When she has free time, she enjoys exercising, baking and binge watching TV series. Learn more about her at Autism Healthcare Books!