Part 1
About this series
Mealtimes are often painted as moments of joy and connection, but for many families, they can become a source of stress and uncertainty. This is especially true when neurodivergence enters the picture. Neurodiversity encompasses conditions such as Autism Spectrum Disorder (ASD), ADHD, sensory processing differences, and various learning and communication challenges. These conditions can impact a child’s relationship with food in complex ways, making mealtimes far from straightforward.
This blog series written by Laura Bottiglieri is designed to empower parents with knowledge, practical tools, and a compassionate perspective on all feeding challenges but especially for children who are neurodivergent.
You can expect to feel empowered, educated and informed to embark on the next phase of your neurodivergent child’s feeding journey. The topics covered should help you feel able to reframe your thinking and approach new strategies with confidence using the accompanying fact sheet as your guide.
What Is Neurodiversity?
At its core, neurodiversity highlights the natural variation in human brains and how they process information. This concept encompasses a range of conditions, including but not limited to Autism Spectrum Disorders (ASD), attention-deficit/hyperactivity disorder (ADHD), and sensory processing difficulties. These conditions are not deficits but differences, influencing how individuals interact with the world—including their experiences with food and eating.
For neurodivergent children, feeding challenges often extend beyond picky eating. They may involve sensory sensitivities to textures, tastes, smells, or even visuals—for example, some children may refuse to eat certain foods if they have been cut differently or if the packaging changes.
Additionally, routines and transitions during meals can be particularly challenging. Postural and motor difficulties may further complicate mealtimes, impacting a child’s ability to stay upright and use their hands to bring food to their mouth. For instance, if a child struggles to maintain an upright posture or control their arm and hand movements, the physical act of eating can become an overwhelming challenge. Communication delays can also affect their ability to express preferences or discomfort, further complicating mealtimes.
How Neurodivergence Impacts Feeding
Neurodivergence can manifest in feeding challenges in ways that differ significantly from typical fussy eating. Here’s how it might look:
Sensory Sensitivities
- Certain textures (e.g., mushy, crunchy, or slimy foods) may trigger aversions as well as mixing textures e.g. allowing beans to touch chips as this will change the texture of the chip making them soggy which can be a problem for some children.
- Strong smells or tastes can overwhelm a child, leading to food refusal.
- Visual preferences, such as food being separated on the plate, might dominate mealtime preferences.
Routine and Change Resistance
- Predictability is a comfort for many neurodivergent children. A sudden change in meal setup or food options can lead to distress.
- Familiarity with specific brands, flavours, or appearances of food is common. Even slight deviations might result in refusal.
Delayed Motor and Communication Skills
- Learning to chew or manage complex textures can take longer, especially if oro-motor skills are underdeveloped; often due to difficulties accepting foods or textures that can help these skills develop at the right time.
- Delayed motor skills such as the ability to use core strength to maintain posture whilst eating or the ability to use fine motor skills to manipulate and bring food to the mouth, can impact a child’s ability and attention during mealtimes” (for example if a child struggles to maintain posture and keep themselves stable and still at mealtimes they will lose concentration quickly and this may impact their interest in mealtimes.
- Communication barriers might prevent a child from expressing hunger, discomfort, or specific food preferences, leading to frustration.
Emotional and Sensory Regulation
- Mealtimes are multisensory events involving sights, smells, sounds, textures and social interactions. For a child with heightened sensory sensitivity, this can be overwhelming, triggering the survival response (fight, flight, freeze).
- Emotional regulation challenges, common in ADHD and ASD, can escalate during mealtime, amplifying resistance. Children with these conditions may feel overwhelmed by the sensory, social or environmental demands of a meal. When faced with such challenges, their ability to manage emotions and maintain composure can be limited, leading to frustration, anxiety, or even meltdowns. This heightened emotional response makes it more difficult for them to engage in positive mealtime behaviours and can reinforce patterns of food refusal or avoidance.
When to Seek Help
If feeding challenges persist despite implementing strategies, it might be time to consult a feeding specialist; more guidance on where to turn for this will be available later in this series. For practical strategies to try first, download our comprehensive guide available here.
Signs that professional input is needed include:
- Growth or weight concerns: If your child is not gaining weight, losing weight, or falling behind on growth charts, it may indicate that they are not receiving adequate nutrition from their current diet.
- Reliance on a limited range of foods: When your child consistently eats fewer than 20 different foods—often “beige” or highly processed options—with little to no interest in trying new foods, it may be time to seek help. If the number drops below 10 accepted foods, this may indicate a more severe feeding issue requiring prompt professional support. Significant mealtime distress or sensory aversions.
- Significant mealtime distress or sensory aversions: Persistent emotional distress at mealtimes, such as crying, screaming, or gagging, or strong negative reactions to specific food textures, smells, or colours may signal underlying sensory processing issues.
- Difficulty chewing, swallowing, or transitioning to age-appropriate textures: If your child struggles to manage foods safely in their mouth, frequently gags, coughs, or avoids solid textures entirely, professional support can assess and address these challenges.
What’s Next?
This is the first post in a series exploring neurodivergence and feeding challenges. The next blog will delve deeper into shifting the narrative around feeding difficulties, focusing on setting functional goals, building autonomy, and celebrating progress. Check it out here
About the Author & Contributors
About the Author:
Laura Bottiglieri is a feeding specialist and experienced Speech and Language Therapist specialising in Paediatric Dysphagia (childhood eating, drinking and swallowing difficulties) with a passion for supporting children and families on their feeding journeys. As the founder of Milk to Mealtime, Laura combines her professional expertise with her personal experiences as a parent to provide compassionate, practical, and evidence-based advice.
With extensive experience in managing complex feeding challenges, including Paediatric Feeding Disorder (PFD), dysphagia, ARFID, and feeding issues associated with neurodivergence, Laura takes a holistic and child-centred approach to care. She specialises in tailoring strategies to each child’s unique needs, ensuring that they feel empowered, safe, and supported at every stage of their development.
Laura’s work is driven by her belief in the importance of autonomy, family involvement, and celebrating small wins. She is committed to helping parents navigate feeding difficulties with confidence and fostering positive, sustainable mealtime experiences that benefit the whole family. Whether addressing oral-motor challenges, sensory aversions, or emotional barriers to eating, Laura is dedicated to making a meaningful difference in the lives of the children and families she works with.
In addition to her clinical practice, Laura actively shares her expertise through her website, www.milktomealtime.com, and on social media @milktomealtime, where she offers strategies, support, and encouragement to her growing community of parents and caregivers.
Key contributor:
Ellie Steer is an Occupational Therapist, Sensory Integration Practitioner, and founder of ‘Sensory Space UK Ltd’. Ellie has many years’ experience working with neurodivergent children, her special interest is in supporting children with sensory processing differences. She understands the challenges this world presents for children who have sensory processing differences, especially when exploring food and navigating mealtimes. Ellie offers specialist sensory assessments, advice consultations, training workshops to parents and schools, to better understand a child’s specific sensory profile and employ strategies to support children to engage fully in everyday activities. To access free sensory advice follow @sensoryspaceuk on Instagram or visit www.sensoryspaceuk.com for more information about the services Ellie provides and how to contact her.
Peer reviewed by:
Alexandra Sharp, Speech and Language Therapist & Autism Spectrum Disorders Diagnostician
Phoebe Kaspar, Clinical Psychologist & Autism Spectrum Disorders Diagnostician