Paediatric Psychology Team Toolkit - Eating Difficulties

The aim of our toolkit is to provide advice, activities and general resources to help families to manage some every day challenges and difficulties around eating and mealtimes.  As a parent, you are the best person in your child's life to support these difficulties, however, working with all key people in your child's life to ensure consistency is paramount and essential for success.


Feeding challenges are common issues with children with complex needs and autism.  Children’s nutrition and mealtime behaviour's are common issues for parents everywhere but is a particular challenge for children with complex needs and autism as they are more likely to be overly selective in what they will and will not eat, therefore, as a result, many of them have less nutritional variety in their diets.  Fear of new foods and food refusal are also a common concern for parents.

Guide for parents:

  • Consider physical problems - it is not uncommon for children with Autism to have medical issues that can affect eating
  • Relaxing mealtimes - many children with Autism can experience anxiety at mealtimes.  Fear and anxiety can shut down hunger by putting the child's body in a state of 'fight or flight', therefore it is important to prepare your child for mealtimes using visuals or relaxation techniques
  • Sit together at the table for mealtimes - it is important to incorporate a routine, therefore build on the visual cues so your child learns they eat at the table.  Eating together also helps your child learn through your imitation and more likely to try new foods.
  • Support your child's posture - often children have poor body awareness which can cause discomfort at the table, ensure your child's feet are supported and they are comfortable, therefore they will focus more on eating than keeping on their chair
  • Gradually introduce new foods - children often fear certain aspects of new foods, such as, colour or texture.  It is important to understand these fears, however, try to gradually exposure will help them to control and eventually eliminate these fears
  • Set regular meal times - space meals and snacks throughout the day, the idea is this will train your child's internal hunger signals to specific mealtimes
  • Encourage exploring and playing with messy food - Children learn through play, and this includes playing with food. Encourage your child to interact with food through his or her senses. Talk about the look and feel of foods. Make interesting shapes using utensils at first if necessary.  Your child may not eat what they are exploring but this is a firm starting point then gradually build upon
  • Remove food from branded boxes and containers - if your child will only eat one specific food put it in a clear container, gradually rotate brands as much as possible, therefore your child is less likely to get stuck on specific taste, look and texture
  • Concentrate on the food NOT the child's behaviour - try to ignore challenging behaviors at the table as much as possible. Many children learn to escape the family meal by engaging in spitting, whining, banging on the table and the like. Focus on positive behaviour rather than the negative behaviour

Children often eat a wider range of foods than you originally think, therefore a good starting point is to complete a food diary. This could reveal some causes of the eating difficulties, whether over-eating or restricted eating. It can also help try to work out whether it is the amount, type or range of food being eaten which is the core issue, and then what underlying problems, or sensory issues, may be involved.

Useful downloads:

Food Diary

Eating difficulties handout

Steps to feeding


Useful websites:

National Autistic Society - Eating

NAS - Visual support


Sensory Experience

Many children with Complex Needs experience sensory difficulties, being over or under sensitive to sight, sound, smell, taste and texture.  This can affect a child's experience of meals and their relationship with food, and cause anxiety around food.

 If this is causing your child difficulties then you can seek help and support from the Peterborough Occupational Therapy Service



Eating & Drinking difficulties

Children who have oral, motor and/or sensory eating/drinking difficulties can be supported by the Speech and Language Therapy Team.

 If you have concerns over a child's eating/drinking and are a Health Care Professional please contact the Speech and Language Therapy team directly to discuss your concerns. If you are a parent, please visit your child’s GP or discuss your concerns with their Health Visitor in the first instance.

 Email: cpm-tr.SLTmailfor


The page was last updated on 23 June 2020 by paediatricpsychologicalservices.

Cambridgeshire and Peterborough NHS Foundation Trust
Elizabeth House, Fulbourn Hospital
Cambridge, CB21 5EF

T 01223 219400 (open 8:30am to 5pm)
F 01480 398501

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