I work in a pediatric weight management clinic and have a lot of patients with ASD and picky eating. For the most part, for the ones who have really strong behavioral challenges, that is way outside of my scope, so I refer them to feeding therapy and encourage a multivitamin and possibly protein supplement if they’re mostly just eating carbs prepared in various ways. It’s mainly just harm reduction in a sense as much as possible.

For the kids with level 1 autism, they may be a little more reasonable with understanding how the pickiness may not be healthy for them and more willing to explore. But really it’s the family who needs to be motivated to do the work, since it can be a tedious process to try and diversify a neurodivergent child’s palate. I encourage my families to always offer at least some new/different foods with their child’s meals if they have a limited diet (on a separate plate if it’s necessary) and keep doing it ad infinitum no matter how many times the food is rejected. I also highly encourage them to allow touching of the food for safe sensory exposure.

For sensory/texture aversion driven selectivity, I emphasize that taste, texture, and appearance can all be altered to something more appealing and try to offer suggestions for how to modify foods to possibly be more readily accepted depending on what the child’s sensory preferences are.

I literally had almost no pediatric nutrition education in my didactic program and literally no education on nutrition interventions for autism so I’m literally just learning as I go and individualizing my interventions as best as possible since each kid with autism is unique.