Feeding children who have ADHD (Attention Deficit Hyperactivity Disorder), autism spectrum disorder (ASD), sensory processing disorder (SPD), or any other range of neurodivergent conditions can present unique challenges for parents and caregivers. Difficulties with sensory sensitivities, restricted diets, and behavioral issues may cause mealtimes to be stressful for not only the child but often the whole family. However, with the right strategies and a patient approach, it is possible to establish healthy eating habits and provide balanced nutrition.
1. Establish a Routine
Creating a structured mealtime routine can help neurodivergent children feel more secure and prepared. Parents can set consistent meal and snack times to establish a sense of predictability. Notify the child before upcoming meals, providing visual cues if necessary, such as a schedule on the fridge or a timer on the counter. Consistency and predictability can help reduce anxiety and resistance during mealtimes. Keep in mind that children need three meals and 2-3 snacks per day (morning snack, afternoon snack, and often evening snack) to get their nutrition needs met. In addition, visual aids can be particularly helpful for children with ADHD or autism. Use visual schedules, charts, or pictures to illustrate the sequence of mealtime activities, such as setting the table, washing hands, and eating. Visual supports provide clear instructions and promote independence and self-regulation.
2. Create a Calm and Distraction-Free Environment
Minimize distractions during meals by creating a calm and quiet environment. Turn off the television, avoid toys or electronic devices at the table, and create a soothing atmosphere. This can help the child focus on eating and reduce sensory overload. Some children enjoy calming music at meals, some like talking through their day. Experiment with what atmosphere works best for your child. Most of all, keep pressure and expectations away from mealtime conversations. When children feel pressured to eat certain foods, their stress response often halts their appetite and willingness to eat.
3. Allow Meal Accommodations at Home
In the same way that schools allow accommodations in the classroom for many neurodivergent children, think through what kind of accommodations your child might need at meal times in order to be successful. This can look like a stool below their feet so their feet aren’t hanging or a wobble cushion which has been shown to increase focus. Similarly, some children with sensory issues may have a hard time eating if certain strong smells are present or the foods create a loud crunching noise when eaten by the family. As much as we want to help our children overcome these issues, it is acceptable to allow them accommodations that will help them eat their meal. We can eat outside in the summertime if food smells are particularly triggering. Some children may require noise-canceling headphones if loud foods make them uncomfortable. Helping our children get their energy needs met should be our primary goal. Using accommodations could help reach that goal.
4. Remember that “Fed Is Best”
Ellyn Satter, child feeding expert, created her hierarchy of food needs which applies to children and adults. This food hierarchy of needs demonstrates that providing your child enough food, no matter the type, is instrumental in then being able to experiment with novel or instrumental food. As dietitians, our first goal is to ensure that your child is getting enough food to meet their needs, even if this is only their selective preferred foods. After we have established that your child is getting his nutritional needs met, we can experiment with ways to expand their diet. Often sugar, dyes, and preservatives are thought to impact behavior, however, studies show that less than 10% of children who eliminate sugar, dyes, and preservatives show behavioral differences. Eliminating these foods can cause more harm than good when it impacts a child’s ability to get enough food and may cause increased eating disorder behaviors such as binging these foods.
5. Experimenting with Variety
Expanding the diet of neurodivergent children is usually a slow, gradual process. Children with ADHD, ASD, or SPD may exhibit strong preferences or aversions to certain textures, tastes, or smells. However, we can expose children to new foods in safe ways. We can put new foods on snack plates instead of the dinner plate. We can encourage them to touch, smell, or lick a new food. We can involve them in meal preparation to increase their interest in new foods. Celebrate small victories with food, such as touching broccoli or licking a tomato.
Feeding children with ADHD or autism can be a complex and individualized process. By implementing these best practices, you can help establish positive mealtime experiences, promote healthy eating habits, and ensure your child receives balanced nutrition. Remember, patience, consistency, and understanding are key when supporting your child’s feeding journey.
By, Andrea Cox, RDN, LD