Feeding problems beyond picky eating are exceedingly common among children, especially those with Autism Spectrum Disorder (ASD). While many children are selective about what they eat, children with autism face even greater challenges, with around 70% of children on the spectrum experiencing some level of food selectivity or autism feeding issues. These issues can range from eating only a small variety of foods to avoiding entire food groups, creating a significant barrier to maintaining a healthy diet.
Yet, despite the widespread nature of autism feeding issues, many children fail to receive timely care for these problems due to hurdles with health insurance, prohibitive distance from feeding therapy providers, and a shortage of specialized feeding programs. This often leads to further complications, including malnutrition and behavioral issues, that affect both the children and their families.
The Root Causes of Autism Feeding Issues
For children with autism, the issue of food selectivity often goes beyond mere pickiness. According to Dr. Amy Drayton, director of the pediatric feeding program at the Munroe-Meyer Institute at the University of Nebraska Medical Center, autism feeding issues are deeply tied to the neurological aspects of the disorder. “For individuals with autism, part of the syndrome is that they can be restricted in their interests and get into behavioral grooves,” she explains. Children with autism may become fixated on certain foods to the point where they act as though other foods aren’t even considered edible.
This issue is particularly prevalent in children with ASD, as the restricted interest and difficulty with sensory processing can make trying new foods especially challenging. A child who has limited food preferences may only be willing to eat a narrow selection of foods, such as fruits or specific snacks, potentially leading to nutritional deficiencies.
The Impact of Autism Feeding Issues on Families
Feeding problems in children with autism are not just a medical concern; they can significantly impact family life. Autism feeding issues can make mealtimes stressful, frustrating, and isolating for families. Dr. Laura Phipps, a board-certified behavior analyst at the Munroe-Meyer Institute, points out that feeding difficulties often require careful planning, financial resources, and sometimes, full-time attention. “Eating is something we do every day multiple times a day, and for children with feeding difficulties, these challenges can take over their life and their caregiver’s lives in ways that severely limit their access to positive life experiences,” she explains.
The Importance of Specialized Feeding Therapy for Autism
Fortunately, there are specialized programs designed to help children with autism feeding issues overcome their challenges. These programs, which often integrate various therapeutic disciplines, are essential in addressing the complexities of feeding difficulties in children with autism. The Munroe-Meyer Institute, for example, offers both outpatient and intensive outpatient programs, bringing together a team of specialists, including BCBAs (Board-Certified Behavior Analysts), licensed psychologists, dietitians, speech-language pathologists, pediatric gastroenterologists, and occupational therapists. The SEEDS (Starting Early Eating and Developmental Skills) program at Munroe-Meyer Institute specifically caters to children with autism, providing early intervention that is crucial to improving long-term outcomes.
Programs such as these aim to address not only the child’s food preferences but also the underlying behavioral and sensory issues that contribute to autism feeding issues. By offering a multidisciplinary approach, these programs help expand the child’s food variety and improve mealtime behavior.
Barriers to Accessing Feeding Programs
While the need for specialized feeding programs is high, access to these services is often limited. Dr. Drayton estimates that there is usually only one or zero feeding programs per state, which means that many families are forced to travel great distances or face long waiting lists for care. Many programs have waiting lists of 12 months or more, making timely intervention difficult. This shortage is compounded by barriers related to health insurance, with many families struggling to secure reimbursement for feeding therapy services.
Furthermore, the lack of trained professionals is another major hurdle. There is a shortage of registered behavior technicians (RBTs) and Board-Certified Behavior Analysts (BCBAs) who are qualified to provide feeding therapy for children with autism. While some providers may try to address feeding issues, without proper training, the effectiveness of such treatments may be limited.
The Success of Comprehensive Feeding Programs
Despite these challenges, feeding therapy programs that do exist report high success rates in treating autism feeding issues. For example, patients at the Marcus Autism Center’s multidisciplinary feeding program show significant progress. Children who enter the program eating only three foods are often able to expand their diet to include at least 19 foods, including fruits, vegetables, starches, and proteins.
The success of these programs highlights the importance of comprehensive care for children with autism feeding issues. When families have access to specialized feeding programs that are integrated with other autism therapies, children benefit from more holistic care that addresses both their nutritional and behavioral needs.
Overcoming the Hurdles: The Need for Expanded Access
The growing recognition of autism feeding issues as a serious concern has led to efforts to expand access to specialized services. The Marcus Autism Center, for example, has been working on increasing training opportunities for BCBAs through pilot programs and developing intervention plans like the Managing Eating Aversions and Limited Variety (MEAL) Plan-Revised. These efforts aim to ensure that more professionals are equipped to treat autism feeding issues and help families navigate the complexities of feeding therapy.
In addition, the shift toward billing feeding therapy as mental health or health and behavior services, rather than strictly under ABA services, may make it easier for families to access care. This approach aligns with the Mental Health Parity and Addiction Equity Act, which may provide more streamlined reimbursement for autism feeding issues therapy.
Conclusion
Addressing autism feeding issues early is essential for both the physical and emotional well-being of children with autism. With specialized feeding programs offering hope and the potential for meaningful improvements, it’s crucial for families to seek help as soon as possible. The path to a varied, nutritious diet and healthier relationship with food is achievable with the right interventions. As awareness of autism feeding issues continues to grow, it is vital that we work to remove the barriers that prevent families from accessing the care they need. With the right support, children with autism can thrive, not just in their eating habits but in all areas of life.
