Hi, my name is Stephanie, and today I want to talk to you about
same food or food selectivity in autism. The official term for this appears to be
food selectivity, but a lot of autistic adults online
might make references to something they call same foods or even
safe foods. I believe this is actually a part
of the phenomenon called food selectivity,
but kind of like a subset or subgroup. So, to begin all of this, let's first talk
about food selectivity. Someone who has issues with food selectivity is going to
be more than your average picky eater. This could be a lot more
restricted, just kind of like how it is for a lot of
autistic people, how we have restricted patterns
and ways of doing things, this also falls under that. So, it's not
just like, oh, my child is picky and doesn't like
things sometimes. This is a bit further than that.
An article written in association with The Davidson Institute for Talent
Development says the following: While picky eaters
eat a limited number of foods from each food group,
selective eaters have aversions to many more foods
or have unusual aversions such as avoiding all cereals, all meats, all
cold foods, all foods with a certain color, etc. According to
research done by Susan Mayes, a professor of psychiatry,
atypical eating patterns were present in 70%
of autistic children, which is 15 times more common than in neurotypical
children. Using a parent interview to study the prevalence of atypical
behavior in children with ASD and children with a history of language
disorders, Dominick et al. found that more than 75 percent
of autistic children showed atypical eating behavior
compared to only 17 percent in the group of children with a history
of language disorders. And while neurotypical children have a
prevalence of selective eating ranging from 10 percent to [35] percent,
this rate range goes up to 46 to 89 in autistic children. From this
information, it is quite clear that food selectivity is very prominent
in those who have autism or autistic
individuals. In fact, this is increasingly being
considered as a signal or a sign that a medical
professional should refer a child to
see if they have autism because of how prevalent it is
in autistic people. Now, this food selectivity thing
can actually make a lot of sense if you really think of it in the scope of the
autistic experience. Autistic people tend to have
a very different sensory experience than the average
person. These very unique sensory profiles can
make someone oversensitive or undersensitive to any kind of sense. So,
that could be textures and smells and sounds and stuff like that, and of
course, that same sensitivity, hypersensitivity or hypo-
sensitivity can apply to food. Even the feeling of full or
hunger can be affected in autistic people.
Those who have what some people call oral fixations, or basically
tend to mouth things or like to chew things or stuff like that,
might be more likely to have these kinds of
food preferences if they're seeking or wanting to avoid certain sensations in
their mouth, specifically. Additionally, the same things that we can be very
particular about in general, such as finding certain
textures or colors or whatever to be soothing or off-putting, can, again,
also apply to food. Now, because autism tends to be comorbid and can be co-
morbid with a laundry list of other conditions, it is
very important to find out if something else is going on
before you kind of chalk it up to just a sensory aversion or not liking something
for sensory reasons. So, there could be something going on
with their teeth, their gums, or really any other part of the
digestive system that would cause them to avoid certain
foods or just food in general. This is
especially important to look into because
a lot of autistic people specifically have GI
or gastrointestinal issues. Some research suggests that at least
half of all autistic children have significant gastrointestinal symptoms
and researchers have many times found unique forms of inflammatory bowel
disease in these children. So, if the issue doesn't actually stem
from something medical, then it is quite likely
that sensory has a play in what is happening with food
selectivity. Many parents report their autistic children as
only eating foods that are room temperature, crunchy,
or even certain foods from certain restaurants.
Environment can actually also play a role in this. So, being around
unfamiliar people or in an unfamiliar setting, or even
having, like, the wrong color or the wrong kind of plate or utensil - these sorts of
things can be even anxiety inducing or off-putting to autistic
people and that might affect part of why they might be food selective.
And obviously, in situations where they might be stressed out, just
refuse food altogether. So, now that we've talked about what
food selectivity actually technically is, I would like to address the concept of
same food; sometimes people call them safe
foods. I really feel like this is almost a way of stimming and not necessarily an
actual stim because stims require repetitive behavior
basically, but in a sense, that same kind of
structure and repeating to bring comfort. So, it's
not necessarily, I don't think you can really
count that as a stim because it's not, like, happening over and over
within a short amount of time. However, I believe the function can often
be similar. That also means that some autistic people
might stim to soothe themselves or regulate,
they might find certain foods to be soothing and going to those
same foods can cause a less stressful experience overall.
It's something you know how it's going to taste, you might know how to prepare
it, it, you know, maybe you know how to order
it the easiest, you have like a script for how you order it or how you buy it
or whatever it is. Something that is familiar and constant
and consistent, and as autistic people, we tend to like
those kind of things. Much of the time I've noticed that same
foods tend to be things that are easy to prepare or easy to otherwise access.
I believe that food choices, much like a lot of other
life choices that autistic people make, can be
really influenced by, well, the autistic experience
and trouble with executive functioning. So, if there are multiple steps to
something, those types of things kind of pile on,
right? So, if I choose, like, the easiest route
for me, the one that is most familiar, the one that I know how to
handle, the one that doesn't take a whole lot of complicated things to get to,
wouldn't I kind of do the same thing for food?
So, it's much easier when you're not feeling it and you realize,
hey, maybe I'm hungry. At that point, a lot of times, if you've reached the point
you've realized I'm really hungry, a lot of autistic
people do not have the energy to expend on making themselves a really fancy meal
or figuring out how to go about all that. It's like ramen or like spaghettios
or hot pockets - that's one of mine, just something that is simple and easy, or hop
in the car and go get your favorite meal at your favorite fast food restaurant or
something like that, or pop in the chicken nuggets or
something. Something, that's very simple because
a lot of times, again, when you're out of energy and out of
the ability to, like, put all those things in, especially because you're hungry,
it's gonna influence what kind of food you
want to eat or that you will prepare for yourself. Some people
are more strict on same foods than others.
Some might just kind of get on a kick and for, like, a month
they might have the same thing almost every lunchtime or something because
it's predictable, they have discovered that the sensory
experience was fine or delightful. It may have gone down
well and not caused GI issues. There are many reasons why
someone might choose their same food or whatever reason they
just really like it and that's that. Some people will only
eat certain foods for years on end and
they'll just go stock up on, like, bulk amounts of this
food because that is what they find comforting
and predictable, and it's what they know they'll eat. And
so, this kind of same food situation, where someone might eat the same exact
thing for lunch and dinner and breakfast, like,
there's their breakfast food the entire month that's all they'll have for
breakfast and all they'll have for certain things.
So, it's different for different people. I think it's kind of funny because
I mentioned the concept of food selectivity and
same food to my husband and he said, you don't eat the same thing every day.
And then he goes, well, because I don't let you. [laughs]
Because we tend to eat together, I might want
the same thing over and over, but he's not interested in that, or he'll be like,
ugh, again? And kind of push me towards not eating
the exact same thing every day. But a lot of times, if he's not around,
I'm probably gonna have a hot pocket for lunch every day
and that's just, that's just gonna be how it is.
And unfortunately, I have ruined some foods for myself that I have gone
all same food on for a while and then all of a sudden, one day, it was just like,
I don't like this. And it's very problematic when you've gotten a lot of
this food because you realize, I really do like this, and I'll eat this
every day, and and then a month later, you're like, I
don't want it anymore. So, the problem with food selectivity
is that it can cause nutritional problems. One study found that 53%
of autistic children had intakes that were below the recommended nutrient
intake for one or more nutrients, including iron
vitamin D, vitamin C, niacin, riboflavin,
and zinc. While the majority of these children didn't consume adequate amounts
of fruits and vegetables, 94% ate foods on a daily basis that were
considered to be in the fatty and sugary groups. Having
nutritional habits like these and deficits in the
actual nutrition can obviously cause problems,
maybe even turn into major medical problems.
So, how do we address food selectivity? The first thing I'd like to say is that
if it is not actually significantly negatively
impacting someone's health, I don't know how much it's worth
going after. Because if it's not a major ordeal, maybe some of their same foods or
their food selectivity, they're capable of getting most their
nutrients, it's not causing them any medical problems or health issues,
then really, other than it being annoying to some people,
I don't really think that it's necessary to change. However, obviously,
there are situations where it's going to be like, ... you can't just
eat chicken nuggets for the rest of your life. That's not going to give you
the nutrients you need, and that's going to significantly impact you
for, you know, however long you're in your body because you're eating chicken
nuggets all the time and that's it. Now, another thing I want to also say up
front here is that a lot of times when we start
talking about helping to expand palets or helping with feeding
and stuff like that, a lot of people turn to
ABA or ABA-like programs for feeding, and I would
highly, highly recommend against doing that. A lot of times ABA feeding
programs can either just not help, but a lot of
times it's at danger of making things worse. And
food is one of those things that is very easy to develop
a disorder around, and I would just be very,
very, very careful about how we treat food
with people who can develop rituals around things very easily.
So, ABA is just one of those things I don't believe is a good idea
for addressing food selectivity that is causing harm. Now, there are approaches
that are much more appropriate in addressing food selectivity issues in
autistic people. Working with a team of dietitians,
occupational therapists, and psychologists can increase
effectiveness. Things such as food records or 24-hour diet recalls can
help a dietitian determine what nutrients may be at risk to be able
to possibly supplement in other forms. Occupational
therapists can use a sensory integration approach including deep touch pressure
and proprioception to decrease sensory defensiveness,
which may play a significant role in why autistic people
are selective eaters. They can also modify the environment to reduce stimuli
to help the autistic person tolerate the sensory issues surrounding eating.
Social stories, sensory stories, meal time stories, or written charts
may help to prepare the autistic person for different foods.
I hope this video helped you to understand what food selectivity is, the
concept of same or safe foods and their ties to autism, and ways
to help when food selectivity is becoming a
nutritional or health issue. Thank you all so much for watching. I
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