My mouth was watering in anticipation when the server placed the plate of risotto in front of me. The smell was enticing, the flavor was on point, but the texture made me gag. I dropped my fork, severely disappointed, as risotto is usually my favorite food.
Risotto is supposed to be creamy, rich, and slightly textured. This was like someone put gravy over regular rice that was undercooked. Yuck!
Has this ever happened to you? Unfortunately, due to food texture hypersensitivity, autism spectrum disorders (ASD) can mean your child may experience something like this on a daily basis.
Maybe they would otherwise be an adventurous eater, but the allure of delicious sights and sounds is diminished by the way the food feels in their mouths. This can cause food aversions that break their hearts, as well as those around them.
Today, I would like to focus on hypersensitivity to the texture of food, how it affects children with autism, and what we as parents can do about it.
What is food texture hypersensitivity?
In short, food texture hypersensitivity is when a child is so sensitive to the texture of foods it causes restrictions to their diet. Children with food aversions, or who demonstrate a refusal to eat certain foods or food groups, are often labeled “picky eaters”.
New foods can pose a problem for a “picky eater”, and can cause anxiety. This is especially true if the way parents handle their picky eater’s behavior compounds the issue.
It is important for parents to understand food preferences, sensory sensitivities, and why their children with autism may have food aversion issues. With this understanding, it is important to deal with food refusal and feeding problems with utmost care and kindness. Harsh methods will only make things worse.
Is hypersensitivity to the texture of food common in autistic children?
Most children will experience food-related issues in their life-time. But is it more common in autistic children?
In an article titled Food selection and sensory sensitivity in children with autism spectrum disordersauthors Sharon A. Cermak, EdD, Carol Curtin, MSW, and Linda G. Bandini, Ph.D., RD wrote:
“Research and clinical observations indicate that food selectivity is a major problem in children with ASDs. One of the consistent themes in the food selectivity literature relates to food textures. It is possible that sensory sensitivity experienced by many children with ASDs may contribute to their difficulty with food texture and resultant food selectivity.”
Now that we know food sensitivity and ASD often go hand and hand, let’s look at some of the symptoms and issues it can cause. Then we will discuss some tips and tricks to help solve those issues.
What are some common symptoms of hypersensitivity to the texture of food?
Symptoms indicating a child may have a sensitivity to the texture of food can include:
- refusal to eat certain foods
- challenging eating behaviors
- ritualistic eating behaviors
- refusal to try new foods
- meal related tantrums
Children on the autism spectrum tend to have extremely narrow food selections. This means their dietary intake is limited. They may eat too much of one kind of food, and refuse to eat others.
The combination of textures can also play a role in the consumption of certain food. This can mean the way the food is presented to the child can be a problem.
For instance, a child who dislikes the texture of mashed potatoes, but loves to eat peas, may have a hard time accepting a plate of food where the two items are in close proximity to each other. This can cause anxiety, leading to challenging behaviors at the dinner table.
Looking into what causes this hypersensitivity can help us determine the best course of action to address food concerns, and the symptoms they cause.
What are some causes of hypersensitivity to the texture of food?
There are many issues that can cause hypersensitivity to the texture of food. Here are a few:
Sensory processing disorder (SPD) can cause texture sensitivities with food. If your child suffers from SPD, the texture of food can be painfully distracting and cause extreme anxiety. They may also suffer from sensory overload causing them to avoid food while in certain environments.
Experiencing sensory food sensitivities can lead to your child refusing any food that looks, feels, smells, or tastes like another food they had that triggered their sensory processing disorder. It can also cause them to want to stick to foods that they know are “safe” for them, even if a new food smells or looks appetizing
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Other causes can include dental or medical issues. Anxiety, and food allergies, and other comorbid issues may also play a part.
What are some concerns food texture aversion can bring?
Food is one of the most central things in any given culture. It brings families together, enriches the experience of new places and cultures, and, for many, eating is one of the most pleasurable experiences on the planet.
Autistic children may already struggle with social situations. The presence of food and texture sensitivities makes something that “should be” an easy entry point into social interaction, just another area of concern.
Not eating grandma’s food, for example, can become a huge issue of contention. Well-meaning friends and family who want children to be in on the experience and fun of a shared meal can inadvertently alienate them.
Making sure our children with autism, or without autism, have a varied diet, eat healthy foods, and learn to make good food choices throughout their life is high on most parents’ priority list. If our children with autism will not eat food that is good for them, we worry about their health.
We worry about medical problems, vitamin deficiencies, and their ability to grow strong. We may also worry about how foods that have been shown to reduce symptoms of autism challenges, and comorbid conditions can help if our child refuses to eat them. These are legitimate concerns; so how can we help them get what they need?
What are some ways to combat food aversions and help kids with nutrition?
Investigate the cause
Finding out why a child is sensitive to food textures is step one. Asking our child questions that help us understand what exactly they are feeling and struggling with can help a lot.
If your child is non-verbal, methods such as the PECS can be of assistance, as well as having them point to the area of their body that is being bothered. This can clue us in to if they are in pain from dental issues, or maybe their stomachs hurt from food allergies or anxiety.
You could also have them point to the specific food that offends them. Once the food is identified, you can figure out if it is just that food, or is part of a group of foods your child dislikes. This can help you understand why the child does not like it.
Some children with autism only like soft foods, refuse to eat anything but crunchy foods, some are enthralled with sticky-sweet or salty foods. You never know till you investigate.
Recruit the professionals
Enlisting the help of your child’s pediatrician can be a great first step in helping your child with their food aversion. This can lead to referrals for other professionals or serves such as:
- occupational therapy
- dental work
All of these and more could be possible, depending on what is causing your child’s diet woes.
Alleviate the core issue
Once your child is working with the proper team, you and your family can start putting into practice what you learn throughout the process. You can begin to tackle the core issues, solve them, and get your child’s diet under better control.
Change the approach
What a child eats can be more important than how a child eats. Sometimes all that is needed is a change in approach or presentation. Supporting your child’s needs to avoid certain foods or serve them in a different way is helpful.
Introducing a new food that is nutritionally sound, yet has the preferred texture, can be effective. For example, if your child only likes soft foods, a nutrient-dense smoothie could be the ticket, instead of forcing them to eat their spinach creamed. If picky eaters only enjoy crunchy foods, perhaps serving kale chips is in order instead of a kale salad.
In the past, practices such as making a child stay at the table until they cleaned their plate, the withholding of other foods till one certain food was eaten, or disciplinary action for refusal or meltdowns was common. Today, we can see that these methods do not address the real problems, and hopefully more effective and less damaging methods can prevail.
Picky eating can be caused by many things, and can become a threat to your child’s health. Don’t be discouraged, there is help! Your picky eating autistic child could be on the road to eating new foods, enjoying their food more, and remaining calm at the dinner table in no time!
Cermak, SA, Curtin, C., & Bandini, LG (2010). Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association, 110(2), 238–246. https://doi.org/10.1016/j.jada.2009.10.032
Chistol, LT, Bandini, LG, Must, A., Phillips, S., Cermak, SA, & Curtin, C. (2018). Sensory Sensitivity and Food Selectivity in Children with Autism Spectrum Disorder. Journal of autism and developmental disorders, 48(2), 583–591. https://doi.org/10.1007/s10803-017-3340-9