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Neurodivergent kids with severe feeding challenges need dietetic support

Crop woman pouring milk for little girl
Photo: Alex Green/Pexels

Dietitians Australia is urging the Government to ensure children with autism and mild to moderate developmental delay who are at risk of or are experiencing severe and enduring eating challenges because of their neurodivergence, have guaranteed access to a dietitian within the new Thriving Kids Program.

The peak body is concerned that the risk and prevalence of eating and nutrition challenges among these children are not well understood or acknowledged, and insists that parents are assured their child will receive the dietetic therapeutic supports they need under the new program.

“It is very common for autistic children and children with developmental differences to have strong sensory aversions to food, which can significantly impact their nutrition intake and quality of life,” Dietitians Australia President Dr Fiona Willer said.

“Avoidant Restrictive Food Intake Disorder (ARFID) is one prevalent example of a complex eating disorder many neurodivergent children experience[1], among others, including Paediatric Feeding Disorder.

“For many autistic children and children with mild to moderate developmental differences, the heightened sensory sensitivity they experience creates a range of complex challenges for them when it comes to eating food.

“This is not fussy eating. It involves severely restrictive ways of eating, repetitive eating patterns and even anxiety or fear of certain foods.

“For a child with psychosocial-related eating challenges, mashed potatoes might feel like glue in their mouth, the smell of cooked vegetables may be enough to trigger nausea, and the sight of mixed foods on a plate might create panic for them.

“A child may select what for them is a ‘safe food’, a familiar consistency, a certain brand, texture or flavour, and actively avoid or restrict foods that create strong sensory overwhelm for them.

“These disruptive and damaging eating patterns can lead to long-term complications such as malnutrition, bone density loss, muscle weakness, gastrointestinal issues and, in extreme cases, organ damage,” Dr Willer said.

“In the short term, not eating enough or not eating enough of nutritious foods disrupts sleep, their ability to attend and focus at school, mood, energy levels and a child’s capacity to engage and connect with friends, family and communities.

“However the good news is, early detection, support and understanding for these children and their family and caregivers, can change the course of their life.

“With the therapeutic support and nutrition intervention, guidance and counselling from a dietitian, we can protect children from developing serious long-term health impacts.

“Consistent, regular dietetic support is required for effective prevention, treatment and management of severe and enduring feeding challenges, as a critical complement to the therapeutic support provided by the child’s occupational therapist and psychologist.

“It is vital that dietetic support is clearly listed as an available support for autistic children and those with mild to moderate developmental differences within the Thriving Kids Program.

“There are not sufficient options for these children to receive the ongoing dietetic support they need within other publicly funded health services.

“We urge the members of the Thriving Kids Advisory Committee to deeply consider the eating related challenges many neurodivergent children in Australia face when designing the Thriving Kids framework.

“Most importantly, we urge them to listen to the lived experienced of people with disability, and those with severe and enduring feeding challenges, and Australia’s Disabled People’s Representative Organisations who are making it very clear that any reduction in individualised support for these children will cause long term harm.

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