My son Andrew has a healthy appetite but doesn't like textured foods and is highly selective about what he eats. He has eaten the same peanut butter and banana sandwich daily for years.  For autistic children, restrictive eating is very common.

Dr. Sharon Smile, Division Head of Developmental Pediatrics, Sunny Hill Centre at B.C. Children's Hospital says feeding difficulties, such as food selectivity, can emerge as early as one to two years of age and are often parents' top concern. Transition periods can be the most challenging, like starting solids or going to daycare or school for the first time. Many autistic children gravitate towards a narrow range of foods, causing distress and anxiety for caregivers.

Moira Pena, occupational therapist and Autism Programs and Projects Team Lead at Holland Bloorview Kids Rehabilitation Hospital, echoes this concern. She notes that up to 90% of autistic children experience atypical eating. Many strongly prefer sameness, including colour, texture and temperature. Other common concerns include

Staying seated at the table for more than a few minutes
Refusing to eat
Grazing during the day rather than eating meals at specific times
Only eating a particular brand of food or at a specific restaurant rather than at home

Many autistic children have expected weights and heights, making it difficult to tell if they are undernourished simply by looking at them. 30% or more can be overweight or obese from eating all those calorie-dense...