#290 - Nutrition for Neurodivergent Children with the Autism Dietician

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC January 10, 2024

#290 - Nutrition for Neurodivergent Children with the Autism Dietician

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Nutrition for Neurodivergent Children with the Autism Dietician

Brittyn Coleman is a Registered Dietitian, Autism Nutrition Expert, and the Founder of the Nourishing Autism Collective. She helps parents of children with autism to nourish their kids confidently in a gradual, sustainable way. Through her practice, she has been able to support thousands of parents to expand their child’s diet in a sensory-friendly way and help them get the nutrients they need to feel their best and thrive.

Download FREE Nutrition Guide: https://autismdietitian.ck.page/guide

Join Brittyn’s community at: https://www.nourishingautism.co

Brittyn’s Website: https://www.autismdietitian.com/

Follow Brittyn on Instagram: https://www.instagram.com/autismdietitian/

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Nutrition For Neurodivergent Children With The Autism Dietician

Britton Coleman is a renowned dietitian who specializes in the nutritional needs of autistic children and leads the Nourishing Autism Collective. Her primary goal is to help parents broaden their children's diets to ensure they get essential nutrients.

A Family Connection

Britton's interest in nutrition began with her mother's commitment to her autistic brother's well-being, demonstrating the significant impact of diet on physical and mental health. Her passion for supporting individuals with autism and addressing the lack of understanding about autism and nutrition has driven her to pursue an education in dietetics at the University of Oklahoma Health Sciences Center (OUHSC). 

Dietary Support For Autism

Through the Nourishing Autism Collective, Britton provides comprehensive nutrition counseling, community involvement, and techniques to address picky eating for parents. She shares essential nutrients for a balanced diet, meal tips, and expert knowledge through "The Roadmap," a five-step guide to effective diet management. 

By evaluating and slightly adjusting current eating habits, significant improvements can be made without drastic changes. The roadmap suggests strategic dietary changes, especially for children with selective eating behaviors.

Helping Parents Navigate Diet Changes

Parents often face an overwhelming array of therapy options for their child, tasked with the challenge of prioritizing immediate needs like preventing elopement or improving speech over other factors like diet. Although the importance of nutrition is recognized, it tends to become secondary to these urgent concerns.

Many people delay taking action because they fear significant, overwhelming changes, believing themselves unprepared for such shifts. Britton created her membership program to help parents overcome these challenges. 

Britton has created an "inner circle" within the community with another dietitian to answer families' questions quickly. She also hosts monthly Q&A sessions, offering a space for individuals facing challenges to seek advice and share their concerns. 

Optimal Supplements To Enhance Your Diet

Britton emphasizes educating members on the essential qualities to seek in supplements rather than endorsing particular brands to accommodate her membership site's diversified global audience. With members spanning from the UK and Australia to India and Canada, access to specific supplements can differ greatly.

Thus, Britton highlights the importance of knowing what constitutes a high-quality multivitamin, focusing on the value of active vitamin forms for better absorption in children. This approach makes absorption easier, reduces the body's effort, and considers genetic differences that can impact how vitamins are absorbed.

The goal is to select multivitamins rich in essential vitamins and vital minerals to offer complete nutritional support. Here are some foundational nutrients Britton recommends: 

  • Vitamin D: Vital for strong bones and teeth and also contributes to healthy brain function.
  • Magnesium: Helps with improved sleep, stress, and calms overactive muscles.
  • Omega 3 fatty acids: Supports positive behavioral changes, such as reduced hyperactivity, impulsivity, communication, and focus.
  • Zinc: Supports improved immunity and contributes to better mental health.
  • Iron: Helps with energy production and contributes to better cognitive function.
  • Calcium: Supports strong bones, teeth, and proper muscle function.
  • Manganese: Regulating the nervous system and improving cognitive function.
  • Iodine: Proper thyroid function and promoting healthy brain development.

Helping Kids Struggling With Taking Medication

Britton prefers using a syringe instead of mixing supplements into food or drinks, which can change their taste and texture. The Haakaa brand is her choice because of its dual-spout design, which delivers medication efficiently and channels milk directly to the back of the mouth to help children with sensitive palates.

Britton cautions families against concealing medicine in food, highlighting that it undermines trust between the caregiver and the care recipient. It's important to respect dietary preferences when boosting nutrition. 

ARFID Or Something Else

ARFID, or Avoidant Restrictive Food Intake Disorder, represents a unique eating disorder category. Although it shares classification with disorders like anorexia and bulimia, its distinction lies in the absence of body image concerns.

Children with ARFID avoid specific foods, not due to concerns about weight gain or body image, but because of profound anxiety related to the food. This fear frequently stems from previous traumatic experiences with food.

Sensory challenges that children cannot manage may influence their behavioral patterns. Hence, ARFID is characterized as an extreme form of selective eating, surpassing mere preference.

Diagnosing ARFID

According to Sciencedirect.com, the DSM-IV's categorization of feeding and eating disorders was confined to children under six years old. However, Avoidant/Restrictive Food Intake Disorder (ARFID) imposes no age limitations on diagnosis. 

ARFID identifies a group of individuals who struggle to meet their nutritional needs due to persistent eating difficulties without concerns related to body image or weight. The DSM-5 introduces four specific diagnostic criteria, labeled criteria A to C, all of which must be met for an ARFID diagnosis to be confirmed.

A. An eating or feeding disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with one (or more) of the following: 

  • Significant weight loss (or failure to achieve expected weight gain or faltering growth in children)
  • Significant nutritional deficiency.
  • Dependence on enteral feeding or oral nutritional supplements.
  • Marked interference with psychosocial functioning.

B. The disturbance is not better explained by a lack of available food or an associated culturally sanctioned practice.

C. The eating disturbance does not occur exclusively during the course of anorexia nervosa or bulimia nervosa, and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced.

The DSM-5 now includes a new diagnosis of pediatric feeding disorder (PFD). This classification is beneficial as it recognizes children with eating behaviors outside the Avoidant/Restrictive Food Intake Disorder (ARFID) criteria yet have a severely limited diet due to factors like medical conditions.

When To Worry About Picky Eating

Picky eating is concerning if, after 24 months, extending possibly to three years, your child's diet lacks variety, specifically if they consume fewer than 20 different types of food. In such cases, it's prudent to consult your pediatrician.

If a child mainly eats snacks, acting quickly is smart; however, if they have a varied diet, immediate action may not be needed. But, if their diet narrows to under 20 items, it's vital to act for their nutritional health.

If the variety of items drops to 10 or fewer, consulting a feeding therapist is recommended. Given the lengthy waiting periods, securing an appointment early is prudent—even if it proves unnecessary.

Consider The Child's Weight Gain

Percentiles play a role in tracking growth, yet they can sometimes obscure real worries parents might have regarding their child's dietary variety and eating behaviors. Your child needs to remain within their growth percentiles, as this typically signifies they're getting the essential calories necessary for development.

This perspective overlooks potential critical deficiencies, such as those in vitamin D or iron, making the matter more intricate than merely adhering to a growth curve. It becomes frustrating when concerns are overlooked with the justification that the child's growth is on track, ignoring the broader issues involved.

The quality of food is pivotal in maintaining a child's health. Ensuring that a child remains at a healthy weight for their age is essential, as heavily processed foods, despite being calorie-dense, lack the vital nutrients our bodies require.

Additionally, when considering autism, it becomes clear that a diagnosis of autism in a child's medical history can prompt premature conclusions. People may too quickly ascribe selective eating habits or various challenges directly to the autism diagnosis, bypassing attempts to gain a deeper comprehension.

Tips For Successful Home Feeding Therapy

Avoid

Eliminate familiar, comforting foods. Slowly incorporate new foods since children with sensory issues or autism might not eat solely because of hunger.

  • Eliminate familiar, comforting foods. Slowly incorporate new foods since children with sensory issues or autism might not eat solely because of hunger.
  • Avoid forcing children to eat. Instead, use strategies to enhance their relationship with food. Forcing a child to eat may work temporarily, but it's not a long-term solution.
  • Forcing a child to stay at the table until they eat makes them ignore their hunger or fullness cues. Gentle guidance works better.

Implement

  • Reduce the stress related to food, nurturing a healthy relationship with it. 
  • Use a sensory-based approach to introduce new foods, respecting their comfort and pace.
  • Find a healthy balance by tuning into the child's needs and recognizing verbal and nonverbal overstimulation cues.

Using Food As A Reward: A Big Mistake

Food possesses profound psychological and emotional significance. When we elevate a particular food item to the status of our utmost craving, our thoughts become governed by either the anticipation of reward or the pressure of restriction. 

A holistic approach to nutrition focuses on fueling our bodies with a wide range of nutrients, going beyond mere moderation. To encourage children to eat their meals, offering a sweet treat alongside the main course often leads to them choosing the dessert first because of its perceived higher value. 

By integrating dessert into the meal as a standard element, we can diminish the undue emphasis placed on it. Even if children choose to eat their dessert initially, this approach lessens the excessive attention it receives. 

Britton recommends avoiding food rewards at meal times to sidestep adverse outcomes. It's better to offer non-food rewards or, better yet, adopt a positive reinforcement approach, such as allowing the child to pick a particular item they want.

Final Piece Of Advice

Start with the fundamentals and progress methodically. Success is achieved through gradual improvement, not by abruptly eliminating all "bad" foods or striving for an impeccable diet, which often results in burnout. 

Adopting a slower, more deliberate approach is essential, though it may seem less thrilling. Britton's method highlights the importance of patience and consistency, showing how vital they are for sustained progress and discovering the true worth of lasting results.

 

 

 

 

BORING, BUT NECESSARY LEGAL DISCLAIMERS

While we make every effort to share correct information, we are still learning. We will double check all of our facts but realize that medicine is a constantly changing science and art. One doctor / therapist may have a different way of doing things from another. We are simply presenting our views and opinions on how to address common sensory challenges, health related difficulties and what we have found to be beneficial that will be as evidenced based as possible. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your children. Consult your child’s pediatrician/ therapist for any medical issues that he or she may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Under no circumstances shall Rachel Harrington, Harkla, Jessica Hill, or any guests or contributors to the podcast, as well as any employees, associates, or affiliates of Harkla, be responsible for damages arising from use of the podcast.

Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We try our best to keep things fair and balanced, in order to help you make the best choice for you.


This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.

Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC
Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC

Rachel Harrington, COTA/l, AC, CPRCS, and Jessica Hill, COTA/L, CPRCS are Harkla's in-house Certified Occupational Therapy Assistants (COTA) and Certified Primitive Reflex Clinical Specialists. They have been working with children for over 6 years in outpatient settings. They specialize in creating easy-to-digest, actionable content that families can use to help their child's progress at home. Jessica and Rachel are the in-house experts, content creators, and podcast hosts at Harkla! To learn more about Jessica and Rachel, visit the Harkla About Us Page. Make sure to listen to their weekly podcast, All Things Sensory by Harkla for actionable, fun advice on child development.


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