From Our 2010 Archives

Mealtime a Challenge for Some With Autism

By Jennifer Thomas
HealthDay Reporter

WEDNESDAY, Feb. 3 (HealthDay News) -- If you think your child is a picky eater, consider what Ryan Kemp's parents faced when he was a child.

Instead of eating a few crackers, Ryan, who is autistic, would polish off box after box and grow agitated if his parents tried to take it away. If they weren't watching, he'd eat entire jars of tartar sauce.

At various times, Ryan was obsessed with a single food item -- peanut butter and bacon among them. If his parents tried to limit his intake, Ryan would compulsively pull his hair and pinch his arms to the point of bleeding.

"I remember him as a child. He loved cherry tomatoes. I'd see his towhead out in the garden picking them off the vine, and he wouldn't come in until he'd eaten all of them," said his father, Pat, who recently left his job as a General Motors executive to become the executive vice president for awareness and events at Autism Speaks, a New York City-based non-profit group.

For the parents of children with autism, dietary issues, including obsessive eating or excessively picky eating, are an all-too-common facet of the neurodevelopmental disorder. Though there are no good statistics on the prevalence of eating issues among children with autism, experts say they hear from parents grappling with mealtime issues often, said Geraldine Dawson, chief science officer for Autism Speaks.

Some research has suggested children with autism are more likely to have nutritional deficits of certain vitamins and minerals, which might be caused by their restrictive diets. Some could be attributed to children going on gluten- and casein-free diets (wheat-free and milk-free) that some believe help with autism, Dawson said.

"In typically developing children, eating problems are relatively common, affecting 20 to 40 percent of kids," Dawson said. "In children with autism, eating problems are even more common, can be very severe and can take many different forms."

Brenda Legge's struggle with her son's food aversions -- and her desire to reach out to other parents grappling with a similar problem -- led her to write the book, Can't Eat, Won't Eat: Dietary Difficulties and Autistic Spectrum Disorders.

Legge said her son's food issues were apparent even before she realized he was autistic. He refused to breast-feed and would hardly eat baby foods, recalled Legge, a writer who lives in London. As other children's food choices widened, his narrowed, she said.

"The list of foods he would tolerate was tiny compared to the list of foods he took an instant dislike to," Legge said. "If something was the wrong color, shape or texture, he would reject it. If it got as far as his mouth and tasted funny, he would reject it. If a manufacturer changed the look of food packaging, he would reject it. If he didn't like the smell of something, he would reject it."

Autism is a complex disorder and so, too, are the reasons for the dietary issues, Dawson said. Many autistic children have a strong need for consistent routine or "sameness," Dawson said. "They want things exactly the same way and that includes the food they're eating," Dawson said. "To introduce a variety of food or to have changes in food may cause stress and anxiety."

Children with autism can also have sensory sensitivities, making them averse to certain textures or tastes. Some autistic children, for example, will eat only soft foods, or only crunchy foods or swear off entire food groups, Dawson said.

Motor difficulties, such as problems with eating or swallowing, can affect some children. Autism is also associated with gastrointestinal problems, such as constipation and diarrhea, leading some kids to avoid eating.

That doesn't mean the issues are insurmountable, however. Dawson recommends having children evaluated at a center that specializes in treating kids with developmental disabilities. Those centers usually have a nutrition specialist who will evaluate the child's diet to make sure they are getting proper nutrition and can suggest strategies for dealing with food issues.

And through a process of trial-and-error, autistic children and their families have come up with their own ways of making mealtimes easier.

Ryan Kemp, who is now 26, has overcome some of his food issues, although he still slathers tartar sauce on everything from sandwiches to pancakes. Ryan's parents learned to anticipate when he was growing upset and attempt to divert his attention. They shaved his head and keep his nails short to keep him from hurting himself. Wearing long-sleeved, snug fitting spandex shirts has also lessened his urge to pinch.

"It's a challenge," Pat Kemp said. "Every day and every child is different."

Brenda Legge's son, Harry, is now a 19-year-old college psychology student. His eating habits are much improved, Legge said, much of it due to his determination to try new things and from a better understanding as he matured about healthy eating habits.

"When a child won't eat, it has an enormous effect on the immediate family. Everything revolves around mealtimes and finding new and ingenious methods of getting your child to eat," Legge said.

Copyright © 2010 HealthDay. All rights reserved.

SOURCES: Pat Kemp, executive vice president, awareness and events, Autism Speaks, New York City; Geraldine Dawson, Ph.D., chief science officer, Autism Speaks, New York City; Brenda Legge, author, London