General Nutrition and Autism

Children with autism can have unique nutritional challenges. Further, nutritional deficiencies have been described in children with autism spectrum disorders (ASDs). Children with autism may not eat enough, which can sometimes lead to calorie, vitamin, and mineral deficiencies. Children with autism may also overeat, or eat “junk food”, which can lead them to become overweight or obese.

As a result, routine health maintenance with your family physician, pediatrician, or gastroenterologist is essential to ensure appropriate nutritional support for a child with ASD. Routine doctor visits allow consistent measurement of weight and height.

Following these measurements over time and a detailed dietary history may help identify children with ASD who are at risk for nutritional problems. Input from a registered dietitian may also be helpful.

Various nutritional deficiencies have been described in children with ASDs. These can be due to several reasons, such as limited food preferences or specific food/texture aversions. Food selectivity is common in children with ASD between the ages of 3 and 11 years, including picky eating and food refusal.

Children with ASDs can have poor protein intake as well as frequent nutrient deficiencies, including fiber, vitamin D, vitamin E, calcium, vitamin B12, and iron deficiencies. Food selectivity or picky eating is an important risk factor in the development of nutritional deficiencies. Children with a more restricted diet may be more likely to consume inadequate nutrients and develop nutritional deficiencies.

In addition to nutritional deficiencies, children with ASDs are also at risk of excess body weight. Risk factors for obesity in children with ASD may include reduced physical activity and increased intake of calorie-dense foods, such as snack foods, cookies, and potato chips.

If you suspect that a child with an ASD may have a problem with nutrition, the first step is discussing concerns with the child’s pediatrician. It may be necessary to fill out an extended dietary journal to help identify areas of potential deficiency or excess nutrient intake. Based on history or dietary journal, your physician may be able to determine if specific vitamin or mineral supplementation is needed.

Your pediatrician may also refer you to a pediatric gastroenterologist for a more comprehensive evaluation. Behavioral support from a registered dietitian or feeding therapist may be helpful.

If your child has a limited number of foods he/she will eat or is a picky eater, try some of the following tips:

• Introduce foods with a flavor or texture similar to a favorite food
• Introduce strawberries if the child likes strawberry ice cream
• Try low-fat frozen yogurt if the child likes ice cream
• Introduce fish sticks or fried vegetables if the child likes chicken nuggets

Expose children to new foods gradually.

Place new foods on the table only for the first few times, then perhaps on their plate without expecting them to try the food.

Do not force a child to eat all of a new food, but instead allow experimentation.

Allow only tastes, touch, or smell during introduction periods if needed.

Mirror desired behavior by eating new food as a family, and talk about the new food positively.

Remember that changing behavior and/or accepting new things can take time, effort, and patience.

Your child’s pediatrician or pediatric gastroenterologist may have support groups that can be helpful. If you are not already involved with speech therapy or occupational therapy, both of these therapy providers may be helpful in introducing new foods. Many centers also have feeding clinics or teams who can help patients with limited diets due to taste and texture sensitivity.

Additional information on nutrition is available on the Autism Speaks website, www.autismspeaks.org/nutrition.