In fact, many of the students I teach are prone to pickiness. They have additional sensory challenges related to autism spectrum disorder (ASD) that make eating certain foods difficult. For example, one of my kindergarten students, Jacob, refuses to eat anything outside of the scheduled snack time or lunch hour, and will throw any unfamiliar food from his plate onto the floor. His teachers and I are working on how to integrate a garden snack during his regular snack time, pairing a new food like grated cabbage salad, with a familiar brand of crackers, a food that falls within his comfort zone.
Like Jacob, about one in 68 children nationwide deal with the challenges of autism, an increasingly prevalent developmental disability. A recent research study showed that children with ASD are five times more likely to have mealtime challenges, such as tantrums, extreme food selectivity and ritualistic eating behaviors. They may refuse to eat one or more food groups (often preferring carbohydrates), accepting only foods with certain textures, flavors or colors. They may even gag when trying new foods or display anxiety over the presence of foods on their plate. One parent explained to me that her son only likes to eat white foods with soft textures, like mashed potatoes, oatmeal, and some cereals. In order for him to get the proper nutrition, she juices fruits and vegetables and serves them in a covered cup that hides the color. Even if a child doesn’t have a sensory disorder, he may show a preference for consistency during mealtimes, only eating a specific brand of yogurt and drinking a certain type of juice box, for example.
Chronic eating problems increase a child’s risk for poor academic performance, social problems and diet-related diseases such as obesity and adolescent heart disease. Inadequate nutrition is more common among children with autism, in particular low intakes of calcium and protein. So, despite challenges, it’s just as imperative to introduce children with ASD to a variety of nutrient-dense foods. Luckily, there are a variety of strategies that parents and teachers can use to encourage these children to try new things.
Last week, I led my first cooking class for parents called “Cooking Healthy Meals for Picky Eaters.” While we prepared a healthy snack, dinner, and dessert, we shared some mealtime strategies for picky eaters, including children with autism-related sensitivities. One of the most important general guidelines is just practicing patience and calmness. Most children need to try foods over a dozen times before they are willing to eat it. Children with ASD may take an even longer time to warm up to a new food. I constantly remind myself of this when I hold tastings in class—even if they refuse to eat it, exposing students to a sweet potato is one step closer to them eating it.
Also, creativity when preparing a meal can help sidestep texture-related food aversions. One parent noted that her child has problems with chunky tomatoes in spaghetti sauce. For her, a simple fix is to puree the sauce to make it smooth. We talked about the possibility of even adding in pureed greens or sweet potatoes to up the nutritional content.
Talking about the food’s texture—touching it, smelling it, examining it—before actually tasting can also reduce some of the stress around eating the food. During one class, the students and I harvested broccoli from the garden, some of which had just begun to flower. Before we even approached tasting, we talked about plant parts, and how the part that people like to eat (the broccoli floret) is actually a flower. Looking at the vegetable in a different context made it seem more approachable, and most students were willing to give it a try.
Another parent noted that her child is more likely to eat things that are accompanied by a familiar dip, like ranch dressing. Including familiar items on the plate along with new foods can lower a child’s anxiety about trying a new vegetable. In our cooking class, we made a healthier version of ranch for dipping sliced carrots, broccoli, bell peppers, etc. (You can find the recipe here!). Allowing a child to choose which vegetable he or she wants to put in the dip will give him some control over what he or she eats, decreasing some of the food-related stress.
Sometimes, it may even be necessary to “hide” vegetables or healthy ingredients in a picky eater’s meal, a technique popularized by the books Deceptively Delicious and The Sneaky Chef. Macaroni and cheese with pureed butternut squash, blueberry muffins with mashed banana and chick peas are some examples of sneakily nutritious, but familiar foods. The dessert we made in our cooking class fell along this theme: ABC (Avocado Banana Cocoa) Pudding with natural sweetener.
In the long run, continually exposing children with ASD to new foods through meal planning and cooking together, gardening, and playing food-related games can help expand their palate and establish healthy eating habits. Praising a child’s successes in taking risks at the table, even seemingly small ones, like just touching the food to his or her chin or lips, is important. Because for children with ASD, the first bite of a radish or whole wheat bread or a baked sweet potato can be a scary experience, but it can also be an important step on a lifelong journey of health and wellbeing.