Transcript for
ADHD, Autism and food: Supporting neurodivergent children at mealtimes

Narrator (00:02): 

Welcome to the Emerging Minds Families Podcast. 

Nadia Rossi (Host) (00:05): 

Hi, I’m Nadia Rossi and you’re listening to an Emerging Minds Families Podcast. Before we start today’s episode, we would like to pay respect to the traditional custodians of the land on which this podcast is recorded, the Kaurna people of the Adelaide Plains. We also pay respect to all Aboriginal and Torres Strait Islander peoples, their ancestors and elders past, present, and emerging from the different First Nations across Australia. 

(00:34): 

In today’s episode, we are welcoming back Anna Ritan. Anna is an accredited paediatric dietitian, nutritionist with over 12 years’ experience who specialises in paediatric and neonatal nutritional therapy and dietary education. Today, Anna is joining us to share how we can support the neurodivergent children in our lives at mealtimes. Welcome back, Anna. 

Anna Ritan (Guest) (00:55): 

Thank you for having me. 

Nadia Rossi (Host) (00:57): 

Anna, can you share with our audience what we mean when we say neurodivergent? 

Anna Ritan (Guest) (01:03): 

Yeah, that’s a good question because a lot of people use the term nowadays, and it’s a very broad term to describe individuals whose brain or cognitive function is considered different to neurotypical or typical. 

(01:18): 

So it usually encompasses individuals that are living with autism spectrum disorder, like ASD or even ADHD, attention deficit hyperactivity disorder and even co-occurring conditions under that as well. So it might be attention deficit disorder or pathological demand avoidance or other sorts of issues that are just making the brain work a little bit differently. 

Nadia Rossi (Host) (01:42): 

Thank you for that. It’s always really great just to have a general understanding of what it means for our listeners. 

Anna Ritan (Guest) (01:47): 

Yeah, yeah. And all brains are different, so I think it’s a nice way of kind of describing that people do things in different ways or learn things in different ways. It doesn’t necessarily mean that it’s a bad thing either. 

Nadia Rossi (Host) (01:57): 

Absolutely. Anna, what are some of the common behaviours we see in neurodivergent children at mealtimes? And we’re thinking about mealtimes can be all sorts of things for all different families. And so when we’re thinking about a neurodivergent child at mealtimes, what might be some of the reasons behind their behaviours? 

Anna Ritan (Guest) (02:15): 

Yeah, it’s a really good question and I will say that the majority of children that we see that do have, say autism spectrum disorder or even ADHD, a lot of them will have difficulties with eating or mealtimes. So even the studies show that upwards of 50 to 80% of children with ASD will have feeding difficulties. So it’s very, very common to see these sorts of challenges at mealtimes. 

(02:41): 

And there are some common things that we might see. It’s usually because eating is the most sensory-based task that we do. So we have to coordinate our entire sensory system in order to eat well. So that means we have to have sight, sound, touch, smell, taste. We have to understand our internal cues for hunger and fullness, so that’s called interoception. We have to understand how we use our body in space, which is proprioception. 

(03:08): 

And another component to eating as well is also being able to coordinate all of our muscles that we need to do at a mealtime. We need to be able to sit upright, have really good trunk control. We need to coordinate all of our muscles for chewing and swallowing. 

(03:20): 

So it’s actually quite a really complex task to do. And you think about a child with ASD or even ADHD, where their brain functions a little bit differently. Their sensory systems might be more sensitive to things like sight, sound, taste and smell of foods. So, eating becomes really, really challenging. They might not have the motor planning or executive functioning to be able to coordinate the skills of eating well. 

(03:42): 

So, we kind of just think that eating is something that you just do, but it’s really not. It’s so complex. And for children that have cognitive functioning that is slightly different, they will struggle with mealtimes. 

(03:53): 

So, some of the common behaviours that we might see is extreme food selectivity. So we see children who are more restrictive with the types of foods that they’ll eat, so that you might only see children who eat beige foods and they’re avoiding all of the colours. So we’re avoiding all of our fruits, not eating any vegetables, and everything is just kind of like a beige, white colour because they might be sensitive to the sight of different types of colours in food and that might be really, really overwhelming for them. So everything has to be white. 

(04:20): 

That’s one example, but food selectivity can be. Because of the texture of foods, we see children that are, for example, only managing dry, crunchy textures and they’re not having anything wet or anything fresh, like fruit or vegetables. We can have children who are very sensitive to taste changes as well. 

(04:36): 

So extreme food selectivity is something that we can really see in children who are neurodivergent. We can also see difficulties even just sitting down to have a meal. Something that we think is so easy to do, but sitting down and sitting still is really, really challenging for a lot of children who are neurodivergent, or even yet being able to coordinate the skills for eating. So that can be quite challenging for families as well. 

(04:59): 

We might see children that have big emotions around mealtimes, so they’re just not coping with the sensory aspects of what’s presented to them, or the mealtime itself they might have really big meltdowns when it comes to eating. So there can be some quite big challenges that families face around mealtimes when their child is neurodivergent. 

Nadia Rossi (Host) (05:19): 

And with these common behaviours, what are some ways, or do you have any examples on ways to support them in these behaviours at mealtimes? 

Anna Ritan (Guest) (05:30): 

Yeah, I think the most important thing is really understanding your child, working out what it is that’s their thing. Is it that they don’t like different things on their plate and that’s really triggering for them, or is it that they find it difficult to sit at mealtime? 

(05:45): 

So once you work it out, then you can adjust what you do. But from a general perspective, just being really routine with food is important. So, having a structure and a mealtime routine can be really helpful for children who are neurodivergent. A: because they usually like routine- 

Nadia Rossi (Host) (06:03): 

Sure. 

Anna Ritan (Guest) (06:03): 

… anyway, but it does provide structure to the day and helps to limit, I guess, behaviours that you might see in terms of all-day grazing or really erratic eating behaviours that we might see in children who struggle to recognise their internal cues. So, that recognising hunger or fullness could be difficult. 

(06:21): 

So having a mealtime routine really helps them to understand and learn about what mealtimes are, and that we feel full after, and that we have a break. So that can be really important for children. 

(06:32): 

The other thing would be having really supportive seating. So if your child is struggling with sitting still, having them up at a kitchen bench with their legs dangling and a no-foot support is probably not going to be the best spot for them to be sitting. It’s really important that children at mealtimes as well. 

(06:49): 

And even I guess our own approach, being mindful that we don’t want to be setting our expectations to be unrealistic. If you’ve got a child that’s avoiding all fruits and vegetables and they’re struggling with that, presenting them with a meal that’s all fruits and vegetables is probably not going to go down well. 

(07:06): 

So some of it is us actually adjusting our expectations and being a little bit more considerate at mealtimes and serving things that they can manage and that build confidence, and then we can work from there. 

Nadia Rossi (Host) (07:16): 

And do you feel like language plays a part in that as well, like the way that parents talk to their children around or about mealtimes? Is that helpful? 

Anna Ritan (Guest) (07:26): 

Yeah, if we think about a child who’s struggling with eating and they’re not even really sure why. And I guess one of the other things I didn’t even talk about is if this child has communication difficulties that we might see with ASD, they might not even have the language to be able to explain some of the things that they’re feeling in their body, whether it’s hunger, whether it’s fullness, whether they don’t like something. 

(07:46): 

So how we communicate at a mealtime is really, really important. So I think in this sense, what we want to do is set children up to succeed. And by doing that, we don’t want to label food as good or bad because if they’re, say a child that’s really struggling with eating fruits or vegetables and they are preferencing, I don’t know, chicken nuggets or hot chips or their preferences are dry, crunchy packet food. If we start labelling all of that food really bad, then that’s going to have a negative impact on how they’re feeling about the foods that they’re eating. 

(08:21): 

They might also feel like they’re failing a little bit, which we don’t want them to do. We actually want them to feel successful at a mealtime so that we can build the skill of eating. So the language that we use is really important. 

(08:32): 

And I guess the other thing to consider too is if your child is struggling, sometimes we can, because we want them to eat, we have really, really good intentions about them eating, we might use perhaps motivators to try and get them to eat. “If you eat this, you can then have this later, or if you don’t eat this, then we’re not going to have the iPad later.” 

(08:50): 

So sometimes we can use consequences to motivate eating, which also can have a negative effect as well. 

Nadia Rossi (Host) (08:55): 

Just finding that balance. 

Anna Ritan (Guest) (08:57): 

Yeah, yeah, because if they’re actually struggling with eating, the consequence is not going to outweigh the struggle that they’re feeling in the moment. 

Nadia Rossi (Host) (09:03): 

Sure. 

Anna Ritan (Guest) (09:04): 

So it usually doesn’t work anyway. And if we think about a child that’s perhaps struggling at a mealtime, they are going to have increased levels of cortisol, probably with stress. They might have increased adrenaline because they’re a little bit stressed at a mealtime as well. 

(09:18): 

So they’re often things that interrupt our appetite signals anyway, that we might often lose our appetite. So we do want our mealtimes to be generally, calm, as calm as they can be. 

Nadia Rossi (Host) (09:26): 

As calm as they can be. Yeah. We did talk about, you mentioned before mealtimes, like setting up an environment, having proper seating, predictability of the routine that can be really supportive for a neurodivergent child. 

(09:39): 

I’m wondering what about after the meal? Is there something that parents can be doing after the meals that can make mealtimes something that the child can then look forward to? 

Anna Ritan (Guest) (09:49): 

Yeah. I guess, after the mealtime, if we think about routine, we probably just actually want to involve them in putting their plate away, bringing their plate up to the sink, possibly even being responsible for putting whatever they haven’t eaten away for scraps for later, or it might be putting it in the composting bin. 

(10:06): 

And the reason why we do that is if they haven’t managed to eat it at the mealtime, we’re encouraging a little bit of interaction with it after the meal, though we’re kind of like, “Okay, well you haven’t eaten it, but let’s take it over here and we can pop it in the composting bin or we can feed it to the chickens or we can do all these other things with it.” 

(10:22): 

So we’re still kind of encouraging, I guess interaction with the food even though they might not have eaten it, which is important. And I guess just generally, ending the meal on a positive note. So it might be that you have a conversation about something that’s not necessarily food-focused so that everyone’s feeling calm at the end of the meal. 

Nadia Rossi (Host) (10:39): 

It’s removing that, I guess the pressure. 

Anna Ritan (Guest) (10:41): 

Removing some of the pressure. 

Nadia Rossi (Host) (10:42): 

Yeah. 

Anna Ritan (Guest) (10:42): 

Yeah. 

Nadia Rossi (Host) (10:43): 

We talked about the home environment wonderfully. What I took from that is that parents can have some kind of control over that home environment and the child may feel more comfortable in their home environment. 

(10:55): 

I wanted to talk about when we’re outside of the home, maybe at a restaurant or at a friend’s house and we’ve gone to dinner there and how we can support neurodivergent children in that environment. 

Anna Ritan (Guest) (11:08): 

It can be trickier, and even if I think back to a lot of the children that I see with ASD or even ADHD, they can struggle in social environments with eating. A: if it’s very noisy. This would be a very loud environment if you’re out at a restaurant, and that can be very difficult then for children to regulate their sensory system in order to eat well. 

(11:30): 

That’s why a lot of children may also struggle to eat at school because it’s more of a loud environment. Lots of people are eating at the same time, so eating then can become more difficult. So the same sort of thing can happen if you’re going out into a restaurant. 

(11:43): 

So I guess preparing your child beforehand, if they are sensitive to noises and sounds, like bringing noise-cancelling headphones along with you can be really great for those children, so they can still sit down and enjoy their meal. You might even look at looking at the menu beforehand. 

Nadia Rossi (Host) (11:58): 

Sure. 

Anna Ritan (Guest) (11:58): 

So, is there something on there that my child’s actually going to eat? If you have a child that is okay eating nuggets and there’s nuggets on the menu, then at least you know there’s something there that they can eat. 

(12:09): 

So, taking your child somewhere where there’s not even suitable option is probably not going to work well. So yeah, having a bit of consideration to the type of meal you’re kind of taking them out to is also useful. 

(12:20): 

I guess in another case you might just need to bring something along that’s safe for them, so they can still eat around others, or they’ve got some of their safe foods with them as well. 

Nadia Rossi (Host) (12:27): 

Yeah. Oh, I love those tips to just even check the environment before you go. A lot of restaurants have images online. Is that helpful to prepare them for the environment they might be stepping into, visually? 

Anna Ritan (Guest) (12:39): 

Absolutely. Yeah, visually you could even explain where they’re going to be sitting, or what’s going to be happening, or they might even have to wait for their food because even that can be challenging for some children. So just talking them through the process beforehand. 

(12:50): 

And don’t be scared to go out though, because I feel like sometimes too, families are like, “Oh, this is too difficult. We won’t do it.” It’s really important that you guys still go out and enjoy your life together, and it’s a really good environment. Some children do really well. They might try something they’ve never tried before because it’s not at home. 

Nadia Rossi (Host) (13:06): 

Yeah. 

Anna Ritan (Guest) (13:07): 

So, the environment’s different, so some children might surprise you with what they’re willing to try or show interest in. 

Nadia Rossi (Host) (13:12): 

And when we go to a friend’s house or a family’s, is that just a bit more about explaining to that family for the kinds of food the child prefers to eat or maybe bringing food along? 

Anna Ritan (Guest) (13:26): 

It could be either of those options. Even family functions, if you think about Christmastime, other family celebrations like birthdays, it can be really hard if your child doesn’t enjoy the food. Lots of children won’t even eat their birthday cake. It doesn’t matter that it’s sweet and lots of people will enjoy it, if you’ve got sensory issues, you might not enjoy eating cake. 

(13:45): 

So explaining that to family, I think is important beforehand because if they’ve got an understanding of it as well, then there doesn’t have to be that running commentary around what they’re eating, what they’re not eating, and then the child’s then perhaps feeling also, a little bit upset about the fact that they’re not able to do or eat certain foods at a party as well. 

(14:06): 

So, explaining it beforehand, it might be bringing food with you. So if they like a particular brand of food only, then that’s okay to bring that with you along and have a little lunchbox that’s separate. Or yeah, you can talk to your family or whoever’s hosting and say, “My child has some food preferences. What are you serving?” And then you can work out if there’s going to be something there that you think they’re going to eat. 

Nadia Rossi (Host) (14:25): 

Anna, I wanted to talk about siblings and how in a family we can have a neurodivergent sibling and a neurotypical sibling, and how parents can find ways at mealtimes to be supportive of the whole family unit. Acknowledging that mealtimes are hectic, but how families and parents can take the whole family into consideration at mealtimes or what they may want to think about. 

Anna Ritan (Guest) (14:56): 

Yeah. Look, it’s certainly challenging if you’ve got a child that’s perhaps very, very restrictive in the foods that they’re willing to accept and you’ve got another child that perhaps might eat whatever’s served. That can be very difficult. 

(15:09): 

I guess we still want to bring both children to the table and have a lovely family meal or at least a family meal, attempt a family meal together. It might not be all the time that that’s possible, but even a few days a week because that modelling is really important, that if you’ve got a child that’s eating the family meal, then that neurodiverse child is watching that and learning. 

(15:28): 

So that’s really important as well, just modelling, eating a variety of different foods and being around different foods is really important. So it can be a really good learning experience. I guess, how you manage it. If you’ve got a child that’s having big emotional meltdowns around food, it can be a little bit more challenging, but I think considering the environment, perhaps pairing them before the mealtime happens, that can help to also keep everybody else, I guess calm at the mealtime too. 

Nadia Rossi (Host) (15:51): 

Yeah. The big emotions that can be experienced at mealtimes or the preferences over certain foods. If they are struggling, what advice do you have for parents in this time? 

Anna Ritan (Guest) (16:03): 

So usually, I would say we want children to eat. So if that means we’re serving preferred foods at the mealtime, then it’s okay to serve preferred foods and just be okay with that. Sit down with your child and go, “Okay, which foods do you like? Which textures do you like?” Depending on their age, they might not be able to communicate that with you, but just having a bit of an understanding about their food preferences so you can make sure that there’s something on their plate that you know they’re going to eat is really important. 

(16:32): 

And then the rest of the family meal can be served in the middle of the table. It’s still a lovely food exposure. If they’re tolerant enough, you might be able to put a little bit on their plate next to their preferred food. Some children might find that difficult, others are okay with that, without the pressure to eat it. 

(16:48): 

So it’s really just, I guess considering what their preferences are so that you can make sure that there’s something on their plate to eat. And usually, what that does is because they can see something safe, they’re more likely to sit down and eat the meal with you as opposed to presenting something that they really don’t like and then there’s no other safe options, then they’re probably really going to struggle with that. 

Nadia Rossi (Host) (17:11): 

I love that, the exposure to the food and visually showing the child and giving them that freedom to try, or just to look, or to touch, or to smell, or just to see- 

Anna Ritan (Guest) (17:22): 

Yeah. 

Nadia Rossi (Host) (17:23): 

… and get used to it, I guess. I understand it’s such a spectrum and I feel like it’s so hard to try and talk about it all in the one go. And so I really appreciate the kind of examples that you’re providing. And hopefully for our listeners, they are able to find some things that they can try. 

Anna Ritan (Guest) (17:40): 

Each child was going to be very different depending on how, I guess their sensory system is working at the time. So yeah, it might just be a matter of trial and error or working with your therapist to work out how best to support your child at home as well. 

Nadia Rossi (Host) (17:51): 

And I wanted to touch on the parents in the situation and acknowledging that it can be challenging and their behaviours can be challenging. And so what advice do you have for parents who are struggling? 

Anna Ritan (Guest) (18:03): 

Yes, it’s a really, because it is difficult for sure, and lots of families really dislike mealtimes because it is so challenging. So my advice is, I like to reframe the child as it’s not necessarily a conscious choice they’re making to be struggling at mealtime. Any child wants to please their parent. If they could, they would. They’re just really struggling with the mealtime. 

(18:26): 

So, I guess it’s kind of just reframing that a little bit can be helpful. So we’re not necessarily seeing it as necessarily defiant or not doing as they’re told. They’re just generally struggling with some of the skills that are required to eat well because their sensory system is different, because their muscle coordination might be different, because they’re struggling with certain textures. 

(18:46): 

So, reframing that is important. And I guess just having lower expectations of ourselves as parents. I think sometimes we just have massive guilt around what our kids might be eating or that they’re not eating fruits or vegetables. So we tend to get in our heads a little bit around feeling guilty that they’re not eating these foods. 

(19:04): 

And yes, they’re important, but it does take time to learn to eat those foods. And as long as you’re being considerate in the mealtime and you might be serving the foods without pressure and modelling eating it, that’s really all we can do as a parent. That’s our role, is just to provide exposure to the food in a non-pressure way, model eating it ourselves, and then it’s really our child’s responsibility to decide what they’re eating. 

(19:28): 

And I think sometimes too, you might’ve gone through the effort of preparing a meal and then your child doesn’t eat it. It can be really frustrating. In that scenario, I would say it’s okay that you sit down and still enjoy your meal. And then by you doing that, you’re actually modelling a really positive mealtime environment to your child. So that’s fantastic. 

Nadia Rossi (Host) (19:44): 

I wanted to go to some of our audience members who know a neurodivergent child, maybe their child is friends with a child that is neurodivergent and they want to invite them over for dinner, or lunch, or they’re having a play date. 

(19:58): 

What are some questions that you can ask that parent of the child who is neurodivergent so that you can set up a supportive environment for that child? 

Anna Ritan (Guest) (20:08): 

Yeah. So you can definitely ask them about their preferences. Do they have any food preferences? Is there anything that they really don’t like eating? And it might mean that you do modify slightly what you’re preparing, so that way they can feel comfortable and eat something at mealtime as well. 

(20:23): 

It’s actually probably going to be a useful situation because it is useful for children to learn to eat in different environments. So it’s probably positive if the child’s able to go over and experience another mealtime at another household because the environments can be slightly different and they might end up trying something new or being exposed to something they haven’t seen before. 

(20:41): 

So sometimes that can actually spark a little bit of interest in a child, as well that they might be a bit more curious about a food because they saw their friend eating it, or their friend’s mom cooked this at their household. So it can be a positive, thing too. 

(20:55): 

So I don’t necessarily think they should cater specifically, but they should be considerate, as in serving something they’re not going to be eating anything of is probably not ideal, but also, it could also be a good learning experience. 

Nadia Rossi (Host) (21:06): 

Yeah. Anna, I’m wondering about when families may need extra support for their child. How do they start that journey if they’re noticing that there are these challenging behaviours around mealtimes? What is the steps that they can take to get their child extra support that they might need? 

Anna Ritan (Guest) (21:22): 

That’s a really good question. If your child is struggling at mealtimes and they are neurodivergent, then getting the right support is really important. So it could be going to your GP in the first instance just to say that we’re having some difficulties with eating. 

(21:38): 

The other thing is to, if you do have NDIS funding, then actually going to your support coordinator or your plan manager to see if you’ve got some feeding therapy allocated, or when you are planning your services, talking about nutrition goals or feeding difficulties is really important so that you can be adequately supported to access those services. 

(22:01): 

It does require a little bit of advocating for your child in that sense. And sometimes, I think feeding, unless it’s really, really challenging, you might have other priorities at the time. And it is important to also raise that feeding is an issue so that you can plan for it and have some nutrition goals. 

(22:17): 

Seeing a dietitian is going to be really important because nutrition is so important in children who are struggling to eat and avoiding whole food groups. And even seeing a speech or feeding therapist could also be really important. 

(22:29): 

And lots of children who are neurodivergent might go on to do feeding therapy and using different approaches to try and broaden or widen the amount of foods that they’re actually eating and accepting. 

Nadia Rossi (Host) (22:40): 

I wanted to talk about the team around the child, the practitioners that you just mentioned. And how can practitioners best support families that are struggling at mealtimes? 

Anna Ritan (Guest) (22:51): 

So for practitioners, really having a very good understanding of who’s involved with the child, because if we just think about just ourselves and only what we’re doing, then we don’t see the rest of the picture. So understand, who’s on the child’s team? Is there a physiotherapist? Is there an OT? Is there a speech pathologist? 

(23:14): 

So that way, you can understand what sorts of supports they’re also accessing and what other issues might actually be impacting their eating, because if they’ve got fine motor skills, they might not have the coordination to actually feed themselves and that could be a barrier to eating well. If they’ve got communication difficulties or they’ve got oral motor issues or delays with chewing and swallowing, then that’s going to affect their eating as well. 

(23:37): 

So you really have to have a good understanding of who’s in their team and understanding of their whole picture of what’s going on for the child. So what we call that is kind of like interdisciplinary or multidisciplinary teamwork is really important as a practitioner. 

(23:51): 

And then just reaching out to the other practitioners. “Can I have a bit of a summary of what you’re doing with the child so I can better understand how to support them?” I know that I’ll often do joint appointments. 

(24:03): 

So if I’ve got a child that’s also doing feeding therapy, I’ll also go in at the same time and we might do a little bit of nutrition work and then I can see from a feeding point of view, how the child is also coping as well. So, really understanding and having that multidisciplinary outlook on the child is really, really important. 

Nadia Rossi (Host) (24:20): 

There’s so much, I think that parents hold in their brain about their child. And so to have that team really communicate with each other and be there, just as a parent hearing that, I just go, “Oh, that’s such a relief that, that is an approach that practitioners can take.” 

Anna Ritan (Guest) (24:36): 

And I absolutely would encourage any practitioner to do that and to reach out because the risk in the community is that you can become just quite isolated and just focus on just your one thing, but there’s so many things that can impact the child. Even reaching out to the paediatricians and understanding what’s going on medically for the child could be really important as well. 

Nadia Rossi (Host) (24:56): 

Anna, I wanted to go back to something you mentioned about nutrition for neurodivergent children and how nutrition is important to support the health and wellbeing of a neurodivergent child. So can we talk a bit about that? 

Anna Ritan (Guest) (25:07): 

Yeah, it’s a really great question and nutrition is so important. And because children are still growing, we still need to meet their nutrition requirements to support their growth and development and be able to participate in school and participate in their therapy. 

(25:21): 

So for children who say, are very, very restrictive in their eating, so they’re not eating enough food over the day or they’re not eating any fruits or any vegetables, then they might not have the ability to concentrate as well in the classroom, or they might not have enough energy to participate in the therapies that they need to. 

(25:40): 

So it’s really important that we look overall at the child’s diet. And there are certain nutrients that are really, really important in our brain health and functioning. So for example, if you’ve got a child that’s avoiding all of our protein foods, they might become iron deficient, and then iron deficiency can impact our development and our brain health as well. 

(25:58): 

So it’s really important just to look at all the different nutrients that our child is eating if they are neurodivergent. Some children, as well will just struggle generally to just eat enough because they don’t perhaps recognise their internal cues for hunger. So they could go really, really long periods of time without eating. Sometimes that’s due to medication in children with ADHD. It can be a side effect of medications. 

(26:22): 

They might go all day without eating at school or really, really long periods of time without eating, and other times it’s just not having a sensory understanding of what hunger is in the body and so they just don’t eat, or they have really erratic eating behaviours. 

(26:34): 

Now if you think about what happens to us when we’re hungry, is we feel really upset. We can get angry, we can become unregulated, especially in children. So if we have a child that’s not eating all day, or struggling with eating, or not getting enough calories, it can really affect their behaviour, their learning, their concentration, even their emotional regulation. So, really important to make sure a child is nourished. It can really affect their mental health and wellbeing if we’re undereating consistently during the day. 

(27:00): 

The other interesting thing that comes up for children that are neurodivergent from a nutritional perspective is that children with ADHD can generally have lower levels of Omega-3, which is essential for brain development in children as well. So, sometimes supplementation might be required too. 

Nadia Rossi (Host) (27:18): 

I was going to ask about that, of how parents can then help their child to meet their nutritional requirements. And is that a conversation with your support team about what you would then try to do as a parent to help your child meet those requirements if they’re being very restrictive in their eating? 

Anna Ritan (Guest) (27:33): 

You absolutely should be working with a health professional to kind of work out, “Okay, these are the gaps in the child’s diet.” You might even do blood work with your paediatrician to give you an idea of what’s happening on a micronutrient level if there is some iron deficiency or vitamin C deficiency, B12 deficiency, because we’re avoiding whole food groups, which is very common. 

(27:50): 

So it is important to, I guess have those discussions first. But yes, usually there is some sort of supplementation that will be required, specific to the child’s individual needs. Sometimes we might use oral nutrition support drinks because children just aren’t able to eat enough during the day, or have not enough calories and not enough appetite drive. They don’t have enough energy, so we might be supporting them in those ways as well. 

(28:12): 

We usually try to make it very individual to the child, so as in we’ll have a consult, we’ll do an assessment, we’ll run through the diet, we’ll work out what nutrients are missing? Are we getting enough calories? Are we growing well? And then we’ll work out how to support the child that way. But it’s certainly a discussion to have, and you can start that either with your paediatrician or GP as well, if you’re still waiting to get in to see somebody to talk about their nutrition. 

Nadia Rossi (Host) (28:36): 

Thank you. Anna, I always like to leave our audience with a few takeaways. So if you could leave our listeners with a couple of things from our talk today, what would they be? 

Anna Ritan (Guest) (28:47): 

They would be that eating is difficult, a lot of the times for children who are neurodivergent, not because they’re being difficult, but because the skill of eating is difficult for them to manage, or they don’t have the skills to actually eat well. 

(29:03): 

So, I think reframing that is really important to understand that it’s just another skill that they’re going to have to learn and they will need support to do that. Nutrition is important for children who are neurodivergent. So, it is important to make sure that your child is being supported in that sense. 

(29:18): 

So if they’re avoiding whole food groups or there are concerns for nutrient deficiencies, then getting some support is really, really important because it can significantly impact and improve their overall wellbeing, and mental health and wellbeing as well. 

Nadia Rossi (Host) (29:31): 

Thank you so much for joining us today. I think our listeners can take away so much from our discussion, and just recognising it is such a huge topic. And so thank you for providing some things that we can take away from it and hopefully, try in our home and support families. 

Anna Ritan (Guest) (29:46): 

Thank you for having me. It’s really an area that I’m so passionate about because I know so many families do struggle at mealtimes. And perhaps there’s not enough support out there or even recognition that this is actually very difficult for children who are neurodivergent. So, thank you for having me. 

Nadia Rossi (Host) (30:00): 

Yeah. Oh, thank you so much. 

Narrator (30:03): 

Visit our website at www.emergingminds.com.au/families for a wide range of free information and resources to help support child and family mental health. Emerging Minds leads The National Workforce Centre for Child Mental Health. The centre is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.