Let Them Eat Cake

It is well known that neurodiverse children, especially autistic ones, are often picky eaters with obtuse and specific criteria for what is and is not edible. Something that isn’t often discussed is that these preferences and aversions don’t typically go away. By focusing primarily on children, the current paradigm is to force the child to ‘expand their palate’ or ‘eat healthy’ by making them eat foods for which they are averse. Ignoring the adult population’s continued food aversions hides the fact that the intended goal is almost universally unmet. In practice, this means that many children end up enduring what amounts to physical and psychological torture for effectively no reason. The goal of providing adequate nutrition and healthy foods is an admirable one; the problem is with the steps taken to achieve it.

Before getting into food specifically, it’s important to acknowledge sensory differences. A commonly held misconception is that everyone shares basically the same sensory perceptions and experiences. Neurodiversity often comes with sensory differences, which can include synesthesia, in which the person will experience one type of sensory input interpreted through another sense. For example, the colour blue may be visually appealing to someone with average senses, while to another it feels like a screeching sound. The intensity of the perception can also vary immensely, either with increased sensitivity (hyperesthesia) or decreased sensitivity (hypoesthesia). A person may be incapable of feeling heat, while an innocuous sound like a drop of water hitting can be agonising.

A question seldom asked is why a specific food is disliked. The answer to this question varies greatly by person and food, and may not be obvious to an outside observer. Even when an answer is given, it may be disregarded as unsatisfactory. It’s possible that this disregard stems from a lack of understanding rather than ill intentions. The inability to relate makes it hard for someone that doesn’t have sensory problems to empathise. To give an example, imagine the taste of cinnamon. Now imagine someone branding your tongue with a hot iron and kicking you in the gut. Forcing the former experience on someone may not seem that bad, but hopefully forcing the latter experience on them would be recognised as tortuous. The latter is an example of what the experience may feel like to a neurodiverse person (having both allodynia and hyperalgesia) being forced to eat foods for which they have an aversion.

With these experiences in mind, this may seem like a dilemma to someone faced with a particularly picky eater. Forcing these unwanted foods causes distress, and does not have the desired outcome. So, how does one provide adequate nutrition and sustenance? The truth is that it will depend greatly on what is causing the aversion. Any sense could be linked, so determining the cause dictates how to adapt. The first choice is always to find alternate options that do not trigger the response. If the way the food looks is the cause, try to find ways to alter the visuals, like using food dye to change the colour. If texture is the problem, find ways to transform the food, for example blending a chunky soup until it is smooth and uniform. If taste is the issue, determine what about the flavour is causing the problem. Oftentimes there are too many flavours at once, so try having individual ingredients as their own dishes instead of making a stew, or leaving out all seasonings (and adding them back to cooking one at a time to find tolerances).

What if all of that doesn’t work? If at all possible, involve a nutritionist or dietitian for meal planning to make sure all nutritional needs are met. Try introducing new foods through positive reinforcement (such as providing rewards or praise for trying new foods) and move at the person’s comfort and pace. Find ways to make the experience enjoyable or rewarding. Try to find the healthiest options the person enjoys and keep those as standards. Some people are happy to eat the same thing for every meal; it may be easiest to find a standard meal that can be produced in bulk, then determine what deficiencies there are, if any, and use supplements to make up the difference. Remember, the focus is on being healthy - and mental health is a part of that equation. Try to let the rectangle stay angular instead of forcing it through a circular hole; forcing it through the circle may work if you cut off the edges, but then you no longer have a rectangle. Finding the hole that fits makes the process easier and less damaging.