Children with autism can be extremely picky eaters and may suffer from a condition called PICA ie putting inedible things in the mouth. Deficiency in zinc, iron and magnesium can contribute to PICA. A poor appetite could also stem from B1 deficiency, yeast overgrowth and clostridia. Avoiding gluten and dairy is at the heart of a treatment protocol for children with autism. If the enzymes required to break down gluten and dairy don’t function well, or are not present at a sufficient level, these foods can contribute to neurological dysfunction. Many parents of children with autism have experienced marked improvements when following a GF/CF diet. Others report benefits from the GAPS or SCD diet.

Causes of picky eating may include:

Sensory Problems – several underlying medical issues including dysregulated gut flora can contribute to sensory processing challenges in autism.

Oral motor function delays –  Children with autism may have oral-motor delays which causes difficulty in moving food around their mouth. This results in them avoiding certain textures, gagging on food and restricting their willingness to try new foods

Constipation – common in autism and can result in children feeling full and not wanting to eat. Often caused from mitochondrial dysfunction. Treating constipation at face value alone will fall short in solving constipation.
Swallowing problems – can stem from a developmental delay or underlying medical issues like EOE common in autism (Eosinophilic Esophagitis)

Mitochondrial dysfunction – sluggish mitochondria often found in autism can affect digestion, chewing and swallowing.

EOE – immune dysfunction is common in autism and can cause white blood cells to attack the oesophagus causing inflammation and sometimes pain.

GERD – Gastroesophageal reflux disease. Many studies have established a link between picky eating and GERD

Mineral deficiency – impaired sense of taste and smell are often as a result of zinc deficiency.

PANS/PANDAS – both these conditions are common in autism and require an investigation. These conditions occur when virals or strep trigger a misdirected immune response which results in brain inflammation. Two common symptoms is OCD and picky eating.

Cerebral Folate Deficiency (CFD) – has been scientifically proven in some children with autism. Folate in the blood is normal but folate in the brain is low. Treating CFD can alleviate picky eating.

Yeast Overgrowth – is common in autism and can cause sleep disturbance, sensory issues, hyperactivity, picky eating, stimming and more.

Many parents struggle to change their child’s diet or eliminate processed foods including gluten and dairy. In addition to a paediatrician or medical doctor addressing the underlying causes of picky eating, a feeding program can be included in the child’s ABA (Applied Behaviour Analysis) program.

ABA is considered a scientifically validated pedagogical approach that has been time-tested and repeatedly proven to be effective throughout the lifetime of individuals with autism and other learning disabilities. This methodology for autism has been endorsed by the American Academy of Paediatrics and regarded by the US Surgeon General, a medical necessity for autism.

A feeding program will assist in desensitizing the child to foods they’ve  become aversive to. Eating and mealtimes should always be a pleasant experience and working with an ABA team who is able to support the child to overcome picky eating or PICA is essential in successfully treating autism.

In conclusion, even though psychiatric medication does have its place, it falls short in addressing the many symptoms and causes of autism.

For more information:

Ilan Gerschlowitz is the Founding Director of Catch Up Kids (ADHD) and The Star Academy (Autism) and author of Saving my Sons – A Journey with Autism.