Friends and family told Stephanie Tom, “Kids will get hungry and then they’ll eat what you give them.” However, that was never the case with her son. “He could go a day without eating. Once he was diagnosed with autism, it made a whole lot of sense,” Tom said.

Although food selectivity is less recognized than the educational or emotional complexity of raising special needs children, it poses equally significant risks of causing nutritional deficiencies or interfering with food-based social interactions. Children with special needs, especially those on the autism disorder spectrum, often experience a more severe form of picky eating: food selectivity, which the West Virginia University Feeding and Swallowing Clinic defines as “the consumption of an abnormally limited variety of food.¹” Tom, mother to a teenage autistic son, provides insight for other parents of special needs children as well as the general public.

While most parents know the struggle of presenting vegetables to a toddler, Tom did not understand the severity of her son’s picky eating until his diagnosis with autism spectrum disorder (ASD) at the age of three. Tom consulted an occupational therapist who assured her that her son was not alone in experiencing food aversions, but the process of introducing new foods to his diet spanned many years and strategies.

Texture and temperature, among smell, appearance, taste, and color, are factors that commonly make eating certain foods stressful and uncomfortable for special needs children.² “Texture wise, he only wanted the extremes: things that were very crunchy, like crackers, and things that were very soft. Nothing in between, nothing lumpy, nothing with an unusual texture. Even now, for example, he’ll eat pizza when it’s been freshly made. But, although a lot of people like to eat cold pizza the next day as leftovers, he would not. So certain foods always have to be a certain temperature,” Tom said. 

The limited diet of children with food selectivity can make eating a balanced, nutritious diet difficult. Tom’s son experienced anemia around the age of five due to his diet. As he grew older, Tom saw that another challenge to his health was the appeal of fast foods; as they tasted the same every time, they fulfilled his criteria of predictability, which is common in many individuals with ASD. In order to incorporate more nutrition into her son’s diet while maintaining this element of stability, Tom recreated healthy versions of her son’s favorite fast foods.

“My son likes teriyaki chicken from Panda Express,” Tom said. “So I tried to find a recipe that I could make at home and tastes very similar. Since I knew he liked teriyaki chicken, then I tried to expand that to salmon with teriyaki or beef with teriyaki.”

The introduction of new foods is essential in creating varied diets that prevent health problems because consumption of a select few foods does not provide an adequate balance of proteins, fats, and carbohydrates, or sufficient amounts of vitamins and minerals. Another successful strategy for Tom was repeated exposure to new foods. At three years old, her son would eat fewer than twelve types of food. Yet, over time, Tom broadened his tastes by repeatedly presenting him with a new food over several months. 

Although she was met with varied success, Tom said, “You have to be persistent and not give up. For example, with kids that like frozen chicken nuggets and only of a certain brand, you can have them try frozen chicken nuggets of another brand or different shape. It’s always taking the part that works and building on it. You have to take baby steps.”

Within the home, two ways parents can ease mealtime discomfort are setting routines and creating a standard second food option. 

“Like many people with autism, my son likes predictability,” Tom said. “Our mealtimes are pretty much always at the same time. During the school year, which can be very stressful for him, he pretty much eats the same breakfast every day. I make him the same lunch every day. And maybe for dinner, we try to do something different.”

While parents may face judgment for enabling picky eating by preparing a second option, having a standard “Plan B” opens children to trying new foods without fear of going hungry if they cannot eat the new food. Moreover, Tom found that teaching her son to make a “backup food” himself eased any guilt or shame he felt by not liking or eating a new food. 

“For a long time, my backup food would be macaroni and cheese, especially those Kraft macaroni and cheese in an individual cup, because when my son was around ten, eleven, or twelve, he could make it on his own. I sensed that he kind of felt bad about himself when he wouldn’t want to try something. At that time, the backup macaroni and cheese was great because he could make it himself and [feel independent]. Instead of feeling like he had failed at something, he was just going to an alternative,” Tom said. 

Developing her son’s basic cooking skills over the pandemic also gave him independence in making healthy and nutritious dietary choices, a tool that grows more necessary as children with special needs become adults. 

“I’ve tried to teach him to cook simple things that he likes. He can boil pasta himself and get spaghetti sauce out of a jar. He can also make grilled cheese for himself,” Tom said.

In public, younger children with ASD may experience food-related meltdowns, where their loss of control of their behavior may be heightened by food aversion and over stimulation in a busy environment. While trying to calm down their child, parents may feel judged or embarrassed. 

“I remember how he was running out of the restaurant; we couldn’t finish the meal. We had to pack everything up, and someone else had to stay behind to pack up the food and pay the bill while I was chasing my son down the street,” Tom said. 

Tom believes patience and understanding are the only universal solution for those hosting special needs families to make meals less worrisome.

For restaurants, she suggests for staff to communicate with parents so they can better accommodate children with food selectivity. On one occasion dining out, Tom’s son, 7 years old at the time, couldn’t eat anything off the menu. Although Tom had bought him a Subway sandwich beforehand, the restaurant prohibited him from eating it inside. Despite her explaining that her son was autistic, she was forced to take her son outside to eat, breaking up the family’s meal. 

“I think the [waitstaff] can just ask the parent, ‘is there something that I can bring your child?’” Or, if they can talk to the parent and be guided by what the parent says, that would be super helpful for families,” Tom said.

At family gatherings, another way to prevent children with food selectivity from going hungry or feeling left out is to prepare a food they like for the general menu beforehand.

“As the parent of the person with autism, rather than enjoying yourself at the social gatherings, you’re very worried about, is my child going to eat something? Is he going to eat enough? And how is the host or hostess going to react if my son doesn’t eat it? You end up worrying more about all these interactions than actually enjoying yourself. That’s the take-home message: if the people that we share our meals with are more patient, that goes a long way to reduce our anxiety,” Tom said.

Although parents of children with special needs can find confronting food selectivity difficult, Tom points out the importance of doing so. 

“Eating is a very social activity. That’s why I tried to tell my son, ‘the reason why I want you to try different foods is because maybe when you’re older, and you’re in college, or if you’re at work, and a group of people want to go to a Japanese restaurant, I want you to at least have been exposed to that food so that you don’t miss out on that opportunity,’” Tom said. 

A little patience and understanding can allow parents of children with ASD and food selectivity to focus on their nutritional obstacles without the pressure of social stigmas. Behind the misplaced label of “picky eaters” is a community of people who deserve the same understanding lent to more visible aspects of the neurodivergent experience.

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