Expert: Dr. Sharon A. Mitchell - 10/30/2007

Question
My grandson is 19 months old, and was just diagnosed with autism.  Today, my daughter is having an extremely stressful day.  He is refusing to eat.  He only wants pretzels and veggie puffs.  She doesn't know where to turn and what to do to help her son try different foods.  He loved chicken pieces and now is refusing to eat it.  HELP!!!

Answer
I know just how frustrating and worrying this can be and sympathize with your daughter.

It's unfortunate, but poor eating often goes along with autism. And the food preferences can change, just as you describe with the chicken pieces.

It's also unfortunate that it's just not possible to force a child to eat. In fact, it's often recommended that parents NOT make food and eating an issue because it's one power struggle you can't win. The fight could show the child that in this area, he's the one in control. Or the fight could put undue importance on food, using it as a reward or punishment rather than mealtime being a pleasant family time.

There could be many things behind your grandson's refusal to eat his once-loved chicken pieces. The first thing I would do is visit the doctor. It's possible for a child to be ill, have a low-grade infection, etc. without giving a lot of outward signs that something is amiss.

If he's physically all right, then consider sensory issues. Is he disliking not so much the taste of some foods as the texture, how it feels on his tongue, the food's temperature, it's color (yes, color!) or if certain foods touch each other.

Have other things changed in this child's life? Anything in the environment, the people he lives with? Is he being asked to eat at an unusual time or in a different place? Such changes could all have an affect.

Do you have access to an Occupational Therapist? If so, such therapists are often useful in determining what might be behind certain behaviors, especially if the reasons lie within the sensory realm.

I've read some books on this subject that recommend giving the child anything that he will eat. While I understand that some food is better than no food, as a parent, it's hard to settle for such an imbalanced diet.

You might want to try allowing him to eat his preferred foods, but always offer him just tiny bits of what you would like him to eat. Having them available side by side might induce your grandchild to sample both offerings, especially if he sees that others enjoy both.

Or you could consider insisting that he eat one bite of what you want him to eat before he can eat his pretzel or veggie puff. Keep the atmosphere light and nonconfrontational.

Will the child drink nutritional supplements (such as Boost and Ensure)? Some kids think they taste like milkshakes. Will he drink fruit milkshakes you make in your blender? If so, these might be ways to ensure that he's at least getting some nutrients. Your doctor, public health nurse or dietician may have other suggestions.

I'm afraid I don't have a lot of solutions to this problem. It's a perennial one, shared by many, if not most parents of kids with autism.

Here are a couple articles your might find useful:

http://www.autism.org/pickyeater.html

http://www.iidc.indiana.edu/irca/Medical/mealtime.html

Sharon A. Mitchell
www.autismsite.ca