picky eater - another sign of autism?

Lisa - posted on 07/23/2012

Hi Aleia, what would I ask to have him tested for and does insurance cover it? Thanks.



Hope - we do have him in early intervention for his speech, our pediatrician referred us at 18 months. It did get him up to 50 words, now we are working on putting words together into phrases. It really puzzles me that he has such a hard time talking but yet catches on to other things pretty quickly.....

Hope - posted on 07/22/2012

My son is 2 and eats: mac'ncheese, noodles of the spaghetti Os, tiny fish crackers and level 2 baby foods. Any thicker textures he gags and vomits. My sister, who was an Early Interventionist told me to try some textural tests and document my son's reaction for a week. (So I would have some more concrete info for my son's doctor.) Often at my son's doctor visits, I would hear, "Your son is a picky eatter. Keep trying different foods." At first my son had the same reaction to every sensory hand/foot test: did not want to touch the objects such as: playdough, small bowl of dried beans/grits/ oatmeal. He does like to now play with playdough. I did't wait for a doctor's referral for Early Intervention services for my son. I contacted BabyNet services Locally and they did a free evaluation. My son is going to get Occupational therapy soon for his sensory/feeding issues. He already has Speech Therapy. (He only says about 4 words and signs 1, "more". He just had his STAT screening with Developmental Pediatrics Autism division. We are to continue to do therapy and are to continue to get further evaluated and on the "waiting list"/ in the process of it all. The screening divsion told us they were glad that we didn't wait to get therapies going for our son. Check with your local autism or early intervention services, many take insurance and some (SC statewide) for example are free up to age 3yrs. If you are worried about your son's health, then don't wait for a second opinion. Get some help. Good luck.

Aleia - posted on 07/20/2012

Get him test by a psychologist.

Lisa - posted on 07/16/2012

thanks Margaret! You really put my mind at ease. He is such a happy, well-mannered, clever, sweet little guy so it is hard to believe that autism would be a diagnosis (his pediatrician said definitely no about autism at his 18 month visit and did not mention it at his 2 year check-up either). However, I still worry because he is now 25 months and is still not combining words, although he is starting to say a lot more individual words (is saying around 50 words - which is still low according to some milestone charts). I am just puzzled as to why he is having such a hard time talking.......

And with the food issues -- every day is different. He will have good days where he will eat what we give him with no fuss and he will eat an adequate amount and on those days, I feel like there is nothing wrong.. However, there are other days where he will sometimes kick and scream before I can manage to get him in his booster seat at the table and once food is served, he pushes it away and refuses to eat and will get really upset at the dinner table to the point of actual tears. Those days I worry that there could be something wrong. We are meeting with an OT in a week and a half so she can check him for any oral motor issues and she will observe him eating. It's going to be a long week and a half becuase I just want to know what is going on.....

Margaret - posted on 07/13/2012

Hi Lisa! My daughter will be 3 in a few weeks and she has PDD-NOS on the autism spectrum. I suspected it between 12-18 months when she wasn't hitting certain milestones. Her pediatrician recommended she see a developmental therapist at her 2 year appointment, where it was confirmed that she was on the spectrum.

I'm not an expert, but it sounds like your son may just have a speech delay and is just a picky eater like most children at that age. Every child on the spectrum is different so it's hard to say. My daughter was really just grunting and babbling at age 2. With speech therapy she's speaking more now.

Regardless, I say trust your gut. It doesn't hurt to take him to a developmental therapist for an evaluation. I'm so glad I did when friends and family were telling me I was being paranoid. Early intervention was the best thing I ever did for my daughter. She's going to be 3 and the progress she's made over the past year has just amazed me.

Hope this helps!

Lori - posted on 07/03/2012

P.s. I don't force my kids to eat. I have issues with food texture myself and as a child would gag and throw up, so I never force or require my children to eat foods that make them gag. We ask that they lick a particular food then graduate to holding a small piece in their mouth, but if they cannot take the next step (chewing) without gagging, we never push it. To this day I won't eat foods that my grandma forced me to eat (then gagged on and vomited) when I was a kid. Thankfully my parents didn't push it. I am still a picky eater (and I'm not autistic ;)), but I do eat a lot more foods than I did as a kid.

Lori - posted on 07/03/2012

Kristin, I would push for a referral to a pediatric neuropsychologist, pediatric psychologist or a developmental pediatrician. If he is crying with eating, a developmental pediatrician might be your best bet so they can rule out other conditions. I have three sons with autism- all three are different. My oldest, in addition to being autistic, also has a condition called eosinophilic esophagitis, which is an allergic condition in which the child is having an allergic reaction in the cells of their throat, which causes irritation. It can cause difficulty swallowing and pain in the esophagus (my son described it as a stomachache). It took my son nearly dying of complications to be diagnosed. :( While it does sound like it could be oral defensiveness, I am also paranoid about EE (a lot of people previously diagnosed with "reflux" are now known to have EE). If he seems to be in pain when he eats, I would definitely bring that up. My son was very thin and because he has a high pain tolerance, we had no idea in pain. Even now, he IS super picky, all three of my autistic kids are picky eaters, he is my pickiest. Obsession with letters or numbers is something some autistic kids have, but not all. The thing about autism is it is a spectrum and every single child on the spectrum is unique and have their own quirky behaviors. ;) Everything that you described COULD be behaviors of an autistic child. MOST kids with autism do not make good eye contact- but here is something... REALLY pay attention to what he does- does he LOOK you in the eye when he speaks to you or you to him or does he glance then dart away or is he looking at your body, chin, neck, etc.? Kids on the spectrum are not necessarily not cuddly. Some don't like being touched, some don't mind. Some don't mind loud noises and some do. Every child is different, even every autistic child. If you feel like he needs to be evaluated, push for one. If you have the means, you shouldn't need a referral to go to a psychologist and pay cash (expect to pay anywhere from $500-2000) for an evaluation if you so desire. See if you have a local autism center (like Alliance for Autism or something similar) and ask if they do testing or who in the area does. HTH and good luck!

Candice - posted on 07/03/2012

It sounds like you have concerns that may or may not be indicative of other things going on, like an autism spectrum disorder. That being the case, yes, I would contact a developmental pediatrician for an appointment. Sometimes there is a 6 month wait for a screening and some doctors prefer to wait closer to a child's 3rd birthday. I guess the waiting time depends on where you live and how pressing the issues are at this point.

My son was diagnosed with PDD-NOS in March and he has displayed extremely picky eating habits since he was about 14 months old. He used to eat nearly everything I put in front of him, but now he's down to about a dozen and a half foods he'll actually eat. He enjoys eating the foods he likes, but he really isn't very open to trying unfamiliar food; he doesn't want it near him. However, he's quite interested in what everyone else is eating and will often ask what a particular food item or dish is.

I hope this helps!

Ashley - posted on 07/03/2012

@kristen I am not sure of the one i did before. but just now online i did the Mchat and it stated "The results of this screening suggest that there are some areas in which your child may not be developing like other children his/her age group. It is recommended that you make an appointment with your primary care Physician to review your child's M-CHAT findings and/or have a complete developmental assessment at your local Early Intervention Center."

Lisa - posted on 07/02/2012

@ Ashley ... what checklist are you speaking of? We completed the M-CHAT test at the doctors office and he passed it...the only thing we checked "no" for was the question "Does your child take an interest in other children? " (https://www.m-chat.org/mchat.php). he usually doesn't play with other kids unless he knows them really well. But other than that, he passed the M-CHAT test. Do you have a link or information on the checklist you did? I am wondering if there are different questions. Thanks, hoping to get some answers, too :)

Sharlene - posted on 07/02/2012

@Lana. Im also from Aust.

Nicole - posted on 07/02/2012

Always get a second opinion. Moms know when something isn't right.

Lana - posted on 07/02/2012

my son makes eye contact as well but only sometimes he is classed as high functioning. He will only eat toast with peanut butter and jam lately. and getting him to try something new I am still looking for answers on that as he has gone from trying everything to not even looking at something new. But I am in Australia dont know what the rules are in other areas

Ashley - posted on 07/02/2012

I am going through the same thing right now and lost. my daughter is two and has a deleyed speach. and picky isnt even the word. my daughter only wants plain starchy foods or carbs. plain white rice bread plain pasta chicken fingers or french fries... also all the foods are the same plain color? i heard children with autism do not like to be introduced to anything new. she showed signs of autism when i did the check list, the obnly thing is my daughter makes eye contact.

Lana - posted on 06/30/2012

My son was diagnosed Autistic last year after a change of doctors because like your doctor he said he shows you affection he does this or that. He is slightly delayed but nothing to worry about. We moved towns and had to find a new doctor who upon a half examination had him tested for Autism and came back as being high functioning. His affections are only aimed at his father and myself and always on his terms. He has recently started being picky about what he eats

Emma - posted on 06/28/2012

i found an answer to a similar question on a website where real doctors reply. hope this helps: https://www.healthtap.com/#user_questions/127784-is-it-common-for-a-child-with-autism-to-have-some-sort-of-eating-disorder
:)

Lisa - posted on 06/27/2012

I would recommend a second opinion. My son was just diagnosed with high functioning Autism (formerly known as Asperger's Syndrome) and scores high on all three criteria but he doesn't have some of the "typical" signs. He is a great eater (although hardly snacks - he prefers meals), started reading at age 3, talks all the time, sleeps at least 10 hours a night and only wakes up when he's sick, doesn't have clothes sensitivity, only hates certain loud noises. Our family doctor did not think he was autisitic and it was only because his preschool teachers had great concern that we got a referal to a pediatrician. She saw the signs right away and started the process of getting him officially diagnosed (we live in B.C., Canada and here there is a very specific process). Now that he has that official diagnosis, he will have a SEA with him from day one of kindergarten and I think will do great.

Even though he started talking early, reading early, if you actually focus on what he says, most of it is to himself. When he was your child's age, he rarely responded to direct questions and started talking in "scripts." Now, at age 5, he is much better at holding conversations although he still often speaks of himself in 3rd person. He was also listening all along because he tells us things we have said when we thought he was ignoring us. And he told his pediatrician that he likes her stethascope and asked her if she also has a lyrengiscope (he learned that from an iPod flashcard app). She was so blown away. And he was toe walking while he asked her.

Anyway, if you are worried, ask for an evaluation by someone who is more familiar with autism. I love our GP but she isn't an expert and she missed the signs. If we hadn't asked for the referral, Lyric would be entering kindergarten in September totally alone and unequipped for it. Now, he has a real chance of loving school and excelling in academics. And maybe even making a friend or two.

Deb - posted on 06/27/2012

So glad he's doing better eating...I'm with him though, in-laws at the table will always through your appetite for a loop...!

My J who is now 6 also was very cuddly and made great eye contact when he was younger; therefore, any autism "tests" came out negative...but we knew something was off (we have a 19 yr old and 21 as well) When he started to go to daycare, he also would play "alongside" kids, rather than directly with other children. Now that he just graduated (!) kindergarten, socialization remains one of his biggest issues.

J has come a long way though. He has lots of friends in his class, indeed he was able to ask some kids over for playdates this year all by himself (teacher overheard and told me) which is HUGE for someone with PDD-NOS. He has friends at his after-school program and a few friends in the neighborhood. But when we are out in public places, it sometimes remains very difficult for other kids to accept Jay. He can be somewhat overly exuberant and because of his ADHD, he sometimes can't focus to answer when other kids are speaking to him. Oftentimes the child will just walk away and J is left standing there wondering what happened to his "friend".

From one mom to another, NOTHING hurts more than your child hurting.

The moral of this story is to make sure your little one gets as much socialization as possible now so that he can benefit from it later when it really counts! And on and on as he grows, of course!

~Deb

Lisa - posted on 06/26/2012

thanks for your insight, Deb! Well, my son is doing better eating and I feel so much better. The in-laws were in town right before his birthday and I think that may have threw off his schedule and that may be why he was refusing food. He still eats very little and has issues at the dinner table. I had a phone consultation with a nutritionist today, she said that his height and weight were completely normal, another big relief. However, she is recommending us to an OT becuase he does have a few feeding issues that I mentioned to her. He only drinks out of one certain type of sippy cup. I have bought at least ten other types of cups and he will not even touch then and throws a tantrum until I give him his preferred cup. So today, I decided it was time to drink out of a big boy cup with no lid. Luckily we only tried water becuase it was everywhere! I even tried to assist him in getting the cup to his mouth and he just sealed his lips and water went down the front of him. He just didn't get the concept of holding the cup upright so it does not spill (he is like that with bowls too). We will keep trying. My son also has difficulty sucking through a straw and still needs assistance with a spoon (has a hard time getting food on the spoon but can get it up to his mouth just fine), but loses interest really fast with it and results back to hand feeding.

Great idea about getting him in preschool, since I am a SAHM. My friend is giving me some information about a preschool geared for 2 year olds. I hope it will help. I put him in daycare at the gym that I work out at and he usually goes over to his favorite car or asks a teacher to read to him, rarely plays with other kids (he does not mind being around other kids, just does not interact too much with them...probably the language delay).

Deb - posted on 06/26/2012

Hi Kristin. I don't think it would hurt if you were to take him to a pediatric gastroenterologist to see what's going on when he eats. This could set your mind at ease that there's nothing hurting him while he's swallowing... However, having said that, if YOU were tiny as a child and your husband was thin as well, that will definitely show up in your little one!

I agree with some of the other posts here...it sounds like he may have a form of Autism, such as PDD-NOS. It also sounds like he is very high-functioning, which is a blessing. Look into your states Developmental Delay sources and get him every service you can, while he's young. (such as play therapy, occupational therapy, socialization {a big one} and ABA. The more you do now for him, the more he will benefit from this when he enters Kindergarten. BTW, if you can, get him into preschool now if he's not already. That really helps with socialization! Good luck to you!

Jennifer - posted on 06/21/2012

My son was diagnosed as autistic on 2/21/2011. He sounds like your son in a lot of ways.

He is cuddly, always has been. I used to tell people how smart he was/is. He could finish puzzles, stack cups from small to big, point to letters of the alphabet when prompted, etc. He never ate very well. When I tried giving him new foods he would gag. He still only eats baby cereal, waffles, banana yogurt, and milk from a bottle (no juice).
My original pediatrician, the one I had for all 3 of my kids, totally missed it. I took Riley to see him 18 times for things like him sticking his hand down his throat to not walking by 18 months. The pediatrician never even mentioned Autism.
Go with your gut. Your mind is telling you SOMETHING, right? If you have to switch doctors, so be it. Always always always trust your instincts. Good luck!

Anaquita - posted on 06/19/2012

If he can understand what you're saying, responding, then he may, (no guarantee) like my son, flood you with talking around age 4. My son barely uttered a word until he was 4. He knew exactly what I was saying, and was obviously listening. But either for some reason couldn't, or didn't want too, talk until then. Once he started talking, he used words I thought was out of the usual scope of a 4 year old. And because of that the pediatrician's office never did consider it a true language delay. Where they not only don't talk on time, but they don't understand what you're saying too them.

Lisa - posted on 06/19/2012

yes, he understands what we say to him. He follows commands very well; he knows the name of many, many objects. He is very clever and seems pretty bright. This is just a mystery to me......

Anaquita - posted on 06/19/2012

One thing I've forgotten to ask. While he's not really talking, does he understand what you say to him?

Charmaine - posted on 06/19/2012

Hi Stacey,
It may be helpful for your child's development to take a couple of hours each day to just play with him in a calm manner. According to Dr Stuart Shanker who is a leading expert on autism it is important for the development of any child to calm the child down by taking notice of what stresses him and then helping arrange the environment so that he can learn how to calm himself down - it might be taking a shower, exercise such as jumping jacks or running, soft music, yoga, Tae quon do. It sounds like he gets very stressed at meal times. Apparently by spending as much time as you can playing with him this will help him develop his 'social brain' and help him cope with the stress in his environment. If you are stressing over his eating, he will too. Perhaps you should get his throat and mouth checked if he seems to choke in case there is something physically wrong. If he is fine, then see if you can let him lead as to what he likes to eat. I had two very fussy eaters and they did grow out of it. My youngest used to eat what we termed 20 cents worth - probably a dime's worth. I used to keep food around and let her graze all day. This might be less stressful for him. The more you stress about him, the more he will pick up on this and this may stress him more. Also, by spending time playing with him and slowing everything down - speak slowly, let him lead the play for several hours a day this will help him develop his brain and reduce his emotional anxiety.

Sharlene - posted on 06/19/2012

Hey stacey, Thats great get a dietitian ,but with pedisure its only happening here in Aust where its doubling in price so Im calling my dietitan to make up a prestripion for another doseage. There unware if its global as yet. let us know what happens with your little boy or like i said message me anytime .take care

Lisa - posted on 06/19/2012

Anaquita - that is what I was thinking - if there is the possibility of autsim in my son, I would think that he would be considered high-functioning just becuase of his great eye contact, his ability to cuddle, his ability to interact with other people, and his ability to name letters and numbers already. He LOVES spelling everything out -- passing by McDonald's he calles it "M". At the store, he points to letters and names them (gets them correct 100% of the time) and names the letters off cereal boxes, books, you name it. He also randomly sings the alphabet song, too. It's cute.



Pediasure is still on the shelves here in the States. I just bought some yesterday. I am also setting up an appointment with a nutritionist through his Early Intervention program, so I hope things get better!



Thank you ladies for all of your insight. My son is my one and only so far and sometimes I feel like I am doing everything wrong....first the language delay and now his eating issues.....I love my son so much and don't want it to seem to others as neglect....some people look at him and see that he is so skinny and I wonder if people think I starve him. He just does not eat :(

Sharlene - posted on 06/19/2012

yeah i know, Sorry If I sounded worried but when I saw you describe pedisure to stacy I thought to tell you. Im going to try to find out more see if its happening global and probably make it aware in some communities with other mums there children on pediasure. well Take care and i hope to see you around

Anaquita - posted on 06/19/2012

It's probably not going off the shelves in the U.S. More and more countries, however, are placing tighter restrictions on imports. Especially for food products. Which is likely what's happening to Pediasure in Australia.

Anaquita - posted on 06/19/2012

And Stacey, generally if they can't give you a diagnosis, if your son has it then it's likely a higher functioning form. (HFA, Aspergers, PDD-NOS) Meaning he could have autism, or just a developmental delay. They can mimic each other until they hit school age (around age 6+) where symptoms become more noticeable. Doctors are reluctant to give a label of autism when it's potentially just a delay; something they could honestly outgrow. When they get older though, things become far more obvious when it comes to the interactions with their peers.

That's what happened to my son. I actually had him evaluated at the age of 5, but that pediatrician didn't think he had any form of autism, despite the teachers concerns. But two more years of school, and a long list of observations, last summer (age 7) he was finally given a proper referral (by a different pediatrician) to a pediatric neurologist and given a diagnosis. And she's the one who explained why the pediatrician ignored it when he was 5. (Though he should have warned me to keep my eyes open the next couple of years)

Sharlene - posted on 06/19/2012

Thanks for getting back to me, I just found out today that there taking pediasure of the market here in Aus, There advising parents to stock up on it, Course going off around july I found out this by my daughters dietian . Theres another formula like pediasure called sustagen for kids its got the same nutrition info as pediasure. Im trying to find out if this is international.

Anaquita - posted on 06/19/2012

Nope. I'm from the U.S.

Sharlene - posted on 06/19/2012

Stacey and anaquita , Are u from Australia , I have major news.trying to find out more info about pediasure. bare with me

Lisa - posted on 06/19/2012

oh, and Sharlene - the pediatrician was the one who referred us to Early Intervention when my son was 18 months. At that time, doctor said that autism was not a possibility in our case nor was it mentioned at his 2 year check up last Thursday. Do doctors usually wait until the child is a little older before they diagnose autism just to make sure it is not something else?

Lisa - posted on 06/19/2012

Sharlene - no, he doesn't bang his head and is normally a well-mannered little boy. He signs "please" and "thank you" spontaneously. He follows commands really well. The only time we have issues with tantrums is when he wants something he can't have and when he doesn't want to eat. He has been in early intervention for about 6 months now for his speech delay and I sent an email to his EI teacher about his eating problem - I think that they offer OT for this type of issue.

Anaquita - I did buy some PediSure today....the doctor only wanted me to give him one a day because he says he needs to eat real food and doesn;t want to see him rely on liquid meals. And I can understand not giving in to letting him leave the table, but he just gets so upset, has actual tears and starts to act like he is choking in order to get down. I will just have to stand my ground, no matter how difficult it is for all of us.

Sharlene - posted on 06/18/2012

@ stacey. Thanks for further info, It sounds like it playing with light switches and does not show interest towards other children ,does he have behavior issues or banging of the head, really it does sound like it but Im no doctor but I do have some knowledge about special needs when I have three children with it. Get a second opinion and if it is push for early intervention that would help with his needs and help you and your family. If you ever want to talk message me anytime. take care

Anaquita - posted on 06/18/2012

Oie, I forgot to add, let him graze throughout the day, that may help him gain a bit of weight, while eating more.

And when it comes to staying at the table, don't give in. It may be hard, but standing your ground now, is far easier than when they get older. I stood my ground with my son on the rules when he was young, and let him know that whining was a foreign language I didn't understand. And that he had to calm down, to convey what he wants clearly where I could understand. It's made my life easier at age 8 where he tries to test his boundaries and give me a bit of sass.

Anaquita - posted on 06/18/2012

My son has Aspergers. Stereotypical Aspergers is a lack of eye contact, and while they are quite verbal, they supposedly come off as aloof, and unemotional. My son makes eye contact (unless really uncomfortable) and is a warm, loving little boy. Not as cuddly as he used to be, but I attribute that to being 8.

He also pointed to items, and played with toys. Though he didn't get into imaginative play until he was a bit older, and even then it's still not quite the same as other kids.

Keep in mind it's a whole spectrum. Tell the doctor your concerns, and demand a proper referral for testing.

As for eating, kids, on and off the spectrum are picky. Though if he's really upset about eating, it might be more of a sensory issue. (Sensory Processing Disorder is common for kids on the spectrum, and I've met at least one kid not on the spectrum itself, but has pretty severe SPD) Figure out the foods he actually really likes, and see if you can have a bit extra of that on his plate every night to get him caught up. And perhaps get something such as pediasure on hand for him to drink to get in nutrients and calories he isn't consuming otherwise.

Lisa - posted on 06/18/2012

oh, another sign he shows is that he is VERY independent and really does not like to play with other children. He also has an odd way of playing with his trucks and cars - he does not "drive" them. He puts all of his trucks and cars on our couch cushion, stares at them for a while, then transfers them over to the other couch cushion, and repeats this. sometimes he will line them all up on the floor, push each one about an inch forward and repeat this. He also seems to repeat the word "on" (pointing to light switches and ceiling fans)- not sure if that is echolalia? He did this at his doctor visit, but the doctor did not mention anything about it (if he noticed)...but when my son said "off", the doctor said he had good use of his "f".

Thanks for the article, too. I have seen this one before with all the research I have done, but I re-read it again. I am just so confused because he shows some signs of autism (listed in my earlier post and the additional ones above), but has GREAT eye contact, is very cuddly, will point to items and will use a lot of sign language to communicate. He signs for help and makes noises to get my attention and is great at following commands.

At this point, I am just so confused.....any insight would be great. Thanks.

Lisa - posted on 06/18/2012

Sharlene, the reason why I was worried about autism is becuase he shows a few signs of autism that I found on the internet: speech delay, likes spinning objects, fascinated with light switches, walks on tip toes sometimes, shakes when he gets excited, and the letter/number recognition thing (which I am not sure is true for autism), and now his feeding problem. I hope that it is just a phase, but if it is autism, I would like to know how it will affect him and how I can help him.

Sharlene - posted on 06/18/2012

read this , http://www.helpguide.org/mental/autism_s... or if you feel that strongly go and get a second opinion .good luck

Sharlene - posted on 06/18/2012

Can I ask why you think its autism, all kids are picky eaters and yes it can also be autism but all kids go through that stage where they become picky eaters. Does he have signs of autism. take care