Eating disorders are complex mental health conditions that affect individuals across all ages, genders, and backgrounds. Neurodivergent children and youth may be at increased risk of exhibiting disordered eating behaviours or developing an eating disorder.
Understanding Neurodiversity and Eating Disorders
Neurodiversity refers to the natural variations in the human brain that influence learning, attention, mood, socialization, and sensory experiences. Some more recognized types of neurodivergence include Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). Neurodivergent individuals may experience unique challenges especially when it comes to nutrition and eating behaviors. It is important to recognize when your child’s eating behaviors could be signaling a more serious problem than “just picky eating”.
What is Avoidant/Restrictive Food Intake Disorder?
Children with an Avoidant Restrictive Feeding Intake Disorder (ARFID) may fall within one or more of these categories:
- A very selective eater who may have strong negative reactions to smells, tastes, textures, or colors of foods. They may be highly fearful of new foods and have had negative experiences related to unfamiliar foods.
- Some children may have an overall lack of interest in eating, have a very low appetite, or find eating minimally enjoyable or not at all.
- Some children are afraid of what might happen when they eat; for example, having had frightening experiences like pain, an allergic reaction, choking, or vomiting.
- Avoidance of entire food groups or rigid eating behaviours or patterns
- Intense anxiety around mealtimes or eating in front of others
- Ritualistic food behaviors (e.g., eating foods in a specific order, separating food items)
- Highly sensitive reactions to food (e.g., texture, taste, shape, smell, colour)
- Emotional or physical distress or shutdowns related to food
- Challenges with socializing because of the above eating behaviors
- Your own extreme distress and frustration in trying to understand and manage your child’s challenging behaviours
Could my Child have Avoidant Restrictive Food Intake Disorder?
Avoidant Restrictive Feeding Intake Disorder (ARFID) is a type of eating disorder where individuals limit the amount and/or variety of foods they eat. Unlike the other eating disorders, food avoidance or restriction is not related to distress about body shape, size or weight. Instead, in ARFID, selective eating is motivated by a lack of interest in eating or food, sensory sensitivity (e.g., strong reactions to taste, texture, smell of foods), and/or a fear of negative consequences (e.g., of choking, vomiting, or having an allergic reaction). Neurodivergent children are more likely to exhibit signs of ARFID.
It is normal for children to prefer processed foods – they are consistent in taste, texture and smell, which can feel safe and comforting.
What Problems Can Happen with Avoidant Restrictive Food Intake Disorder?
ARFID may lead to physical health problems from poor nutrition. Children with the disorder may:
- Not get enough vitamins, minerals, and protein leading to nutritional deficiencies
- May lose weight when expected to be gaining weight
- Do not grow as expected leading to delayed puberty
- May be using supplements to maintain weight
- May lead to medical instability
- 1. Validate Their Experience – Acknowledge that their challenges with food are real and not “just being difficult.” It is important to avoid judgment or pressure to “just try harder.”
- 2. Role Model – Model healthy mealtime habits for your child. Serve and eat a variety of foods without the expectation that they must try everything. When the child has an opportunity to see others eat and enjoy the foods presented it can reduce their anxiety around trying the food themselves.
- 3. Collaborate, Don’t Control – Involve your child in decision-making around shopping, cooking, and meal preparation. Offer limited choices to not overwhelm but to respect autonomy wherever possible.
- 4. Find Neurodiversity-Affirming Professionals – Seek support from clinicians who are trained in both eating disorders and neurodivergence. Standard treatment approaches may need adapting to meet your child’s communication and sensory needs.
- 5. Adjust the Environment – Make mealtimes predictable, calming, and sensory-friendly. Avoid overwhelming settings and try not to make food a battleground. This will only make eating more challenging for your child.
- 6. Focus on Safety, Not Weight – Support recovery through nourishment, self-understanding, and emotional regulation, not appearance or weight gain alone.
Resources for Avoidant Restrictive Food Intake Disorder
Short ARFID Screening Tool for Parents and Carers: A screening tool designed to help parents and carers identify whether their child’s eating habits are a flag for the possibility that they are experiencing avoidant/restrictive food intake disorder (ARFID).
Empowering Caregivers with Strategies to Support Children with Symptoms of Avoidant/Restrictive Food Intake Disorder (ARFID) – BC Children’s Hospital: A webinar by BC Children’s Hospital that aims to empower caregivers in supporting children who have symptoms of ARFID, discuss what ARFID is, and review when eating patterns may fit with ARFID. Practical strategies for caregivers to support their child will be shared, along with specific tips for managing eating concerns that are happening alongside physical symptoms like stomach pain or nausea.
Beyond Picky Eating – FEAST: A resource for families and caregivers supporting a loved one with ARFID offering practical strategies for understanding the condition, reducing mealtime conflict, and supporting food exploration at home.
Neurodivergence – Ellyn Satter Institute: This resource provides guidance for feeding neurodivergent children by building trust and creating a low‑pressure eating environment.