As many as 90% of children with autism struggle with feeding issues and eating problems.

Feeding and eating issues go beyond a child just being a picky eater. These issues can significantly affect growth, good eating habits, and the ability of a child to thrive physically and emotionally.

People with autism often have difficulty with fine and gross motor skills that can impede eating. Gastrointestinal issues are also common.

Communication deficits can make it hard for people with autism to convey their wants and needs regarding food. They also often have sensory issues that create food aversions.

Feeding therapy can help autistic children to eat more balanced and nutritious diets by improving their relationship with food and eating in general. Feeding therapy can therefore play a big role in improving physical health and promoting long-term healthy habits.

What Is Autism Feeding Therapy?

The feeding and eating issues that are common with autistic children can create additional health and nutrition issues.

Children with autism are often highly rigid and hypersensitive to textures, smells, and tastes. This can make them extremely limited in the types of foods they are willing to try and eat.

Feeding therapy can expand the diet of an autistic child and help to change negative behaviors related to eating and feeding. Feeding therapy is provided as part of a comprehensive treatment plan and can be part of speech and language therapy, behavioral therapy, and occupational therapy.

Trained and licensed professionals carry out feeding therapy for autism with the support and help of parents and caregivers.

Assessing the Problem

Feeding therapy will begin with an assessment to determine the specific reasons that a child has difficulties with feeding and eating. Underlying medical conditions — including food allergies and sensitivities, seizure disorders, pain, reflux, and gastrointestinal problems like diarrhea, stomach pain, and chronic constipation — should be ruled out and/or managed first.

Crying, throwing plates and food, choking, gagging, not sitting up properly, vomiting, and a refusal to eat are common ways an autistic child demonstrates feeding issues.

Sensory issues can keep people with autism fixated on only eating certain foods or eating things that are not food at all, such as rocks or dirt.

Some of the specific feeding issues associated with autism include:

  • Problems swallowing.
  • Difficulties chewing.
  • Poor posture and core body support.
  • Food aversions.
  • Rigidity regarding food and variations.
  • Sensory and texture issues.
  • Trouble feeding oneself.

How Behavior Therapy Ties Into Feeding Therapy

Feeding therapy aims to address the specific issues related to why the person is having issues eating and with feeding. Specialized speech and language therapists can help with feeding issues related to chewing and swallowing, for example. Occupational therapists can help to build gross and fine motor skills related to feeding. This promotes independence in eating and feeding oneself.

Autistic children often exhibit negative behaviors around mealtime to find a way out of eating or trying something new. Feeding therapy works with parents and caregivers directly to teach ways to redirect these behaviors and find ways to stop reinforcing them. This is often part of a therapy focus.

Applied behavior analysis (ABA) is a form of behavior therapy that aims to reinforce positive actions while minimizing undesired behaviors. ABA can help to improve behaviors related to self-care, including feeding.

Mealtimes and eating can produce a lot of anxiety for an autistic person and their family. Feeding therapy can provide effective tools for coping and managing that anxiety, helping clients to relax enough to eat and have fewer aversions to food and mealtimes.

Efficacy of Feeding Therapy for Autism

When feeding therapy is offered as a component of a treatment plan that also includes behavioral interventions, it can be helpful for autistic children in many ways. Feeding therapy has been shown to:

  • Improve self-feeding abilities.
  • Increase rates of trying and eating new foods.
  • Help children to sit appropriately for a meal.
  • Increase the amount of food consumed.
  • Decrease tantrums and negative behaviors related to eating and mealtimes.

Autism is a spectrum disorder. Greater levels of disability with communication and motor skills mean more therapy and intervention are needed. With more significant autism symptoms, it can take more time to see positive results with all types of therapy, including feeding therapy.

Who Offers the Therapy?

Autism feeding therapy is offered through a number of different types of providers, including:

  • Speech and language pathologists (SLPs).
  • Occupational therapy practitioners (OTs and OTAs).
  • Pediatric psychologists and psychiatrists.
  • Behavioral therapists.
  • Nutritionists or dieticians.

Occupational and speech therapy are often offered as part of an early intervention program or an educational plan through public schools. These providers typically focus on educational and social needs, which can include some expected mealtime behaviors. They are usually more effective in helping children who are on the high-functioning end of the spectrum.

If your child struggles with eating and feeding issues related to autism, the first thing to do is to talk to your child’s pediatrician about your concerns. Comorbid medical and mental health issues that can be present in conjunction with autism will need to be managed and treated as well.

Improving communication abilities is important. Since children with autism often have a hard time conveying their thoughts and feelings effectively, they may not be able to let a caregiver know when their stomach hurts and that this is why they do not want to eat.

Finding a Feeding Therapy Provider

Your pediatrician can give you recommendations and referrals to specialists who offer feeding therapy.

Feeding therapy may be covered by insurance. If your insurance plan provides coverage for applied behavior analysis (ABA), occupational therapy, or speech and language therapy as a treatment for autism spectrum disorder (ASD), feeding therapy can often be included under this umbrella.

Any additional costs not covered by insurance must be paid out of pocket. Specific costs will range between providers, but sessions typically run between $100 and $250 an hour.

More significant feeding issues are often managed through private providers. Feeding therapy can be performed in homes, clinics, or hospital settings.

If your child is struggling with feeding and eating issues, talk to their pediatrician and any other specialists who see your child. They may refer you to therapists who specialize in feeding issues. If your child already participates in ABA therapy, you can talk to your child’s therapist about incorporating feeding and eating therapy into their overall treatment plan.