This article discusses problem feeding in autism and compares picky eating to problem feeding, a distinction created by Dr. Kay Toomey.

Do you have a picky eater on the autism spectrum?

Yes?

I disagree.

No, I’m not undermining the feeding challenges you see in your child with autism. Actually, it’s the opposite.

Picky eating is something most parents identify in children at some point in their lives. Many experts actually believe selective eating preferences are a natural part of growing up. Saying no to foods is a way for children to assert themselves and, way back when, a more nuanced sensitivity to bitterness (which may contribute to pickiness in toddlers) was a form of protection from eating potentially poisonous foods.

Autism and Picky Eating

An even higher percentage of autism parents (estimates are as high as 89%) report eating challenges in their children. We tend to call this pickiness by default, but autism eating behaviors often look different from traditional picky eating.

When children don’t respond to traditional picky eating strategies, severely restrict their diets, drop favorite foods, and/or have maladaptive reactions to eating (like gagging), the term “picky eating” no longer applies. There are several terms that describe a more serious relationship with food.

Picky Eater vs Problem Feeder

The distinction of picky eating vs problem feeding was created by Dr Kay Toomey. See her definition here.

Below is a summary of how the two compare.

Problem Feeder

• Has a very limited diet.

• Might permanently stop eating preferred foods.

• Cannot tolerate touching new foods or having them on their plate.

• Does not eat foods from every food group.

• Has strong preferences related to texture.

• Might struggle to eat with others.

• Might not be able to share their family meal.

• Requires more than 25 exposures to accept a new food.

Picky Eater

• Eats a wide range of foods, typically 30 or more.

• Goes through phases with eating, but maintains core diet.

• Can tolerate new foods on their plate and might touch them.

• Eats at least one food from every food group.

• Eats at least one food from most textures.

• Is comfortable eating with others.

• Can share at least parts of the family meal.

• Will add new foods after 20-25 exposures

Autism and Picky Eating

Many parents tell me that when they share their child’s eating struggles they’re often told “Oh, he’ll grow out of it” or “Just wait, she’ll eat when she’s hungry.” For problem feeders and kids with autism, this isn’t the case – you know that from your own experience.

If you aren’t sure where your child falls on the picky eating spectrum, consider a feeding evaluation.

Recap

Problem feeding is a more extreme expression of picky eating. Whereas picky eating might resolve on its own, problem feeding is rarely just a phase. If your child aligns with the characteristics of problem feeding, you might want to consider working with a dietitian, feeding therapist, or specialist.