Open Society

We can’t stim, are subject to rules around when we can go to the bathroom and forced into chafing uniforms that are, frankly, a sensory hell.

If you've declared your child a "picky eater," you've probably heard a particular refrain from well-meaning family and friends: "When they get hungry enough, they'll eat." The danger with this? Actual food aversion is a neurobiological response that cannot be persuaded, giving that piece of advice the potential to do a lot of harm.

Food aversion can tip into ARFID if food intake doesn't keep the body nourished enough for growth.

"[Food aversion is] safety-based ... Your brain is telling you, 'Don't eat this. You may get sick, and you may die,'" Broberg-Moffitt shares. But instead of getting curious, they explained, parents often default to slapping a "picky eater" label on their kids and calling them difficult. In all actuality, our kids might be in distress with no way of communicating it.

Food aversion is very similar to a subcategory of ARFID called sensory avoidance, which is when a person has issues with food tastes, textures, temperature, and smells. What avoids the slip into ARFID is the quantity of food a child consumes. As long as a child has enough "safe foods" to find the nourishment their body needs, they remain food averse and not ARFID. Many children, especially autistic children, struggle with this. In fact, food aversion is common with autism, Broberg-Moffitt says, and can also be an indicator for the undiagnosed.

Food aversion is neurobiological. "If you're biting into something and it's not what you're expecting, your brain is going to start sending you signals," Broberg-Moffitt tells me. And for neurodivergent children, especially those with sensory processing disorder, those signals are so much stronger. "They can't tune them out." A child might be feeling like, I should not eat this. I cannot eat this. This is bad. Yet, Broberg-Moffitt explains, their loved one is telling them, 'No, go ahead eat it.'" According to Broberg-Moffitt, forcing a child to eat when they're reacting strongly to food could create a schism. While someone they love is telling them to eat something, their body and brain are telling them it's a hazard. Ultimately, says Broberg-Moffitt, "They cannot physically do it."

I asked Matthew what they see children choosing as "safe foods." They listed things like chicken fingers — "things that don't have much variance to them." Such things fall under safe foods because "they know what to expect when they bite into it." If your child is eating enough food that provides a sustaining amount of calories and nutrients, it's OK if they only eat five foods, reassures Broberg-Moffitt. (Yes, really!)

Keeping "safe foods" on hand ensures that, if your child rejects what you offer, you have a better shot at ensuring they're still getting the calories and nutrients they need. The saying is true: Fed really is best.

Neurodivergence has been established as associated with a significant number of co-occurring physical conditions, particularly for autistic individuals who are at risk for increased pain, hypermobility (including Ehlers-Danlos Syndrome) and gastrointestinal problems. However, data, so far, has been focused on adults and generally limited to discussions of condition prevalence alone.

It is clear from current evidence there is a co-occurring physical health disparity in neurodivergent adults. For example, neurodivergent adults display a higher expression of joint hypermobility and pain compared to neurotypical adults (Csecs et al., Citation2020). Furthermore, autistic women with generalised joint hypermobility (GJH) experience higher immune- and endocrine-conditions than autistic women without GJH (Casanova et al., Citation2018). However, it is vital to understand physical health in neurodivergent CYP (aged up to 25 years (National Institute for Health and Care Excellence (NICE), Citation2020)). Neurodivergent CYP experience worsened physical health conditions than neurotypical CYP (McLeod et al., Citation2019).