Child therapy: Autism and Feeding Problems

While many children have picky food preferences, children with autism spectrum disorder (ASD) often have ritualistic or restrictive behaviors negatively affecting their food repertoire. Severe selectivity with food may lead to nutritional deficiencies and malnutrition. Below are answers to frequently asked questions regarding feeding disorders. 

What causes food selectivity?

      Many children with ASD have limited food inventories due to oral motor deficits, sensory problems, and/or other medical complications. Children who prefer puree, soft food, and/or dissolvable foods such as Cheetos may have an underlying oral motor deficit. The child may prefer softer foods because they have not fully developed the oral motor skills to adequately chew and swallow foods. Speech language pathologists are able to evaluate for oral motor deficits, and provide appropriate therapy to increase oral motor abilities for eating and swallowing. 

      Sensory problems may limit a child’s food choices based on color or texture. A child may avoid finger foods because they refuse to touch certain types of foods. Slippery or slimy foods may create a problem for children with sensory intolerance. One characteristic of children with ASD is rigidity. If a child approves of one brand of cereal, they become fixated on that brand and may refuse the generic brand. Occupational and speech therapist can target sensory tolerance of new textures and colors, as well as help expand a child’s brand and food options. 

      In some cases, limited food preferences may be caused from other medical complications including gastrointestinal (GI) issues such as reflux and abdominal pain. Certain foods may be avoided because the child experiences pain or discomfort while consuming these foods. Children with ASD, both verbal and nonverbal, may have difficulty conveying the discomfort to parents and caregivers.  

What is the difference between a feeding disorder and picky eater? 

      Feeding disorders typically involve extreme aversion or selectivity to food tastes and/or textures. Below is a chart to distinguish the difference between picky eaters and feeding disorders based on food groups, selectivity, resistance, effect on daily life, and response to motivation. 

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My child has a feeding disorder, what is next?

            Feeding therapy involves a comprehensive team consisting of, but not limited to, a speech therapist, occupational therapist, pediatrician, GI specialists, and nutritionist. Physicians and specialists can determine underlying medical conditions contributing to food intolerance, and provide the necessary medical treatment. Nutritionists ensure the child is receiving sufficient nutrition during each stage of treatment. Lastly, speech and occupational therapists address the oral motor, sensory, and behavior problems affecting the child’s food preference. Speech therapist are trained to provide individual treatment to increase the amount of food tolerable by the child. 

Contact Lumiere Children’s Therapyfor a full feeding evaluation. For strategies to incorporate during mealtime read our article here.





Nath, Sowmya. “Feeding Problems in Children with Autism.” Interactive Autism Network, 11 Feb. 2014, iancommunity.org/ssc/feeding-problems-children-autism.

“TREATMENT OF FEEDING DISORDERS IN ASD.” Interactive Autism Network, 15 June 2010, iancommunity.org/cs/therapies_treatments/treatment_of_feeding_disorders_in_as.

“When Does Autism-Related Picky Eating Cross the Line into a Feeding Disorder?” Autism Speaks, 25 July 2012, www.autismspeaks.org/blog/2016/10/28/when-does-autism-related-picky-eating-cross-line-feeding-disorder.