1 in 50
According to the 2019 Canadian Health Survey on Children and Youth, about 1 in 50 children and youth aged 1 to 17 in Canada had an autism diagnosis
In brief
Quick summary
- A clinician can assess food selectivity and discuss support options
- A qualified clinician can assess eating concerns and discuss support options
- OAP Core Clinical Services funding covers occupational therapy, SLP, and ABA-based feeding therapy
- Ask SickKids about assessment options for feeding concerns
General information only, not a diagnosis, treatment plan, crisis service, or individual estimate. Confirm your next step with the linked source or a qualified professional.
Medical Disclaimer
This page provides general information about autism and related therapies for educational purposes only. It is not medical advice. Every child is unique—consult qualified healthcare professionals (pediatricians, developmental pediatricians, BCBAs) to determine appropriate interventions for your child's specific needs.
Types of Eating Difficulties in Autistic Individuals
ARFID (Avoidant/Restrictive Food Intake Disorder)
A clinical diagnosis where food avoidance causes nutritional deficiency, growth failure, or significant daily impairment. Unlike picky eating, ARFID is not driven by body image concerns. In autistic individuals, it is almost always rooted in sensory processing differences.
- Nutritional deficiency or supplement dependence
- Fewer than 20 accepted foods in many cases
- Severe distress when presented with non-preferred foods
Sensory-Based Food Selectivity
The most common eating difficulty in autism. Driven by hypersensitivity or hyposensitivity to one or more sensory properties of food. The child accepts foods within a narrow sensory band and rejects others that exceed their sensory tolerance.
- Texture: refuses mixed textures, slimy, or crunchy foods
- Smell: gag response to strong or unfamiliar food odours
- Temperature and colour: rigid requirements about food presentation
Anorexia Nervosa in Autistic Women & Girls
Autistic women and girls are significantly over-represented in anorexia nervosa populations. The presentation often differs from neurotypical anorexia: it involves rigid rule-following about food, sensory aversions, and control-seeking rather than primarily body image disturbance. Many are diagnosed with anorexia before autism.
- Contact CAMH to ask about autism-informed eating disorder treatment
- Contact Holland Bloorview to ask about available assessment options
Anxiety-Based Food Avoidance
Distinct from sensory selectivity, anxiety-driven avoidance involves fear of choking, vomiting, or an aversive consequence associated with eating. In autistic children, a past negative eating experience can generalize rapidly due to heightened associative learning. CBT adapted for autism is the primary treatment.
- Often follows a choking or gagging incident
- CBT with graduated exposure is evidence-based
How Sensory Processing Drives Food Selectivity
Sensory comparison — source and verification date are listed for each row.
| Sensory Domain | Common Triggers | OT Intervention | Source |
|---|---|---|---|
| Texture (tactile/proprioceptive) | Slimy, mushy, mixed, lumpy foods; anything wet | Oral sensory desensitization; SOS approach food hierarchy | End The Wait Ontario page references · 2026-08-10 |
| Smell (olfactory) | Strong-smelling foods; fish, vegetables, spices | Graded olfactory exposure; nose-clip strategies during early exposure | End The Wait Ontario page references · 2026-08-10 |
| Temperature | Hot foods, cold foods, often only room-temperature accepted | Temperature grading; oral motor warm-up activities | End The Wait Ontario page references · 2026-08-10 |
| Colour / visual appearance | Green foods, mixed colours on plate, unfamiliar appearance | Visual grading; divided plates; consistent food presentation | End The Wait Ontario page references · 2026-08-10 |
| Sound (auditory) | Loud crunching sounds; noisy cafeteria environment | Quiet eating environment; ear protection during meals if needed | End The Wait Ontario page references · 2026-08-10 |
Evidence-Based Treatments for Autism Feeding Difficulties
First-Line Interventions
- Occupational Therapy (Oral Sensory), Addresses hypersensitivity and hyposensitivity in the oral sensory system. Uses graded exposure from tolerating food proximity to tasting and accepting.
- Speech-Language Pathology (Oral Motor), Targets difficulties chewing, moving food in the mouth, or swallowing. Oral motor exercises and food texture progression protocols.
- Sequential Oral Sensory (SOS) Approach, A structured 26-step food hierarchy from tolerating food in the room to eating it. Widely used in Ontario feeding clinics.
- ABA-Based Feeding Programs, Systematic exposure hierarchies using reinforcement. Covered under OAP Core Clinical Services funding when delivered by a BCBA.
- CBT (Anxiety-Based Avoidance), Adapted CBT protocols address fear of choking, gagging, or aversive food experiences. Effective for anxiety-driven rather than sensory-driven avoidance.
Nutritional Monitoring & Supplementation
A registered dietitian experienced in pediatric autism nutrition should assess for common deficiencies. Supplementation addresses nutritional gaps while feeding therapy builds the food repertoire, the two approaches work in parallel.
- Iron, zinc, and calcium, most commonly deficient
- Vitamin D, especially in northern Ontario due to limited sun exposure
- Omega-3 fatty acids, important for neurodevelopment
- Dietitian consultations covered through OHIP at community health centres
School Lunch Accommodations in Ontario
Schools are required under the Education Act and AODA to accommodate feeding differences documented in a child's IEP. Request these accommodations in writing at your next IEP meeting:
- Permission to bring specific safe foods regardless of school nutrition policy
- Quiet eating environment separate from the main cafeteria
- Extended eating time to allow for slow or ritualized eating pace
- Designated eating support aide if required
OAP Funding for Feeding Therapy
What OAP Covers for Feeding & Eating Difficulties
- Occupational therapy for oral sensory processing
- Speech-language pathology for oral motor feeding difficulties
- ABA-based feeding therapy delivered by a BCBA
- Parent/caregiver training in feeding support strategies
- Sensory integration therapy targeting mealtime regulation
What OAP Does NOT Cover
- -Nutritional supplements or specialized formula costs
- -Registered dietitian fees (covered through OHIP/community health centres)
- -Inpatient eating disorder program costs (separate OHIP coverage)
Ontario Feeding & Eating Disorder Clinics
SickKids Feeding Disorders Program
Ontario's primary specialist centre for complex pediatric feeding disorders. A multidisciplinary team, including GI, OT, SLP, psychology, and dietetics , assesses and treats children with autism and severe ARFID. Referral through your pediatrician or family physician.
Location: The Hospital for Sick Children, Toronto
Holland Bloorview Kids Rehabilitation Hospital
Offers integrated rehabilitation for autism including occupational therapy and SLP for feeding. Has an autism-informed eating disorder assessment stream. Accepts OHIP-funded and OAP-funded referrals.
Location: Toronto, Ontario
CHEO Feeding Team (Ottawa)
Children's Hospital of Eastern Ontario provides regional pediatric feeding assessment and therapy for Eastern Ontario families. Multidisciplinary team with experience in autism-related feeding difficulties.
Location: Ottawa, Ontario
CAMH Eating Disorders Program
For adolescents and adults with autism and anorexia nervosa or other eating disorders. Contact the program to ask whether it can support an autistic person.
Location: Toronto, Ontario
Frequently Asked Questions: Autism and Eating Disorders in Ontario
ARFID (Avoidant/Restrictive Food Intake Disorder) can affect eating, nutrition, growth, and daily life. A qualified clinician can assess eating concerns and discuss treatment options.
Yes. OAP Core Clinical Services funding ($6,600–$65,000/year) can fund occupational therapy targeting oral sensory processing, which directly addresses food selectivity. Speech-language pathology for oral motor feeding difficulties is also eligible. Behavioural feeding therapy delivered by a Board Certified Behaviour Analyst (BCBA) under an ABA program is covered. A clinician must document the connection between autism and the feeding difficulty when submitting for funding.
Picky eating is selective but does not significantly impair nutrition, growth, or daily functioning. ARFID is a clinical diagnosis where food avoidance causes nutritional deficiency, significant weight loss or failure to thrive, reliance on oral supplements, or marked interference with daily life. For autistic children, ARFID is often driven by sensory sensitivities to texture, smell, temperature, or colour, not dislike of taste. A clinical psychologist, developmental pediatrician, or registered dietitian can distinguish the two.
Ask your family physician or developmental pediatrician about local feeding-disorder assessment and treatment options. Contact each service directly to confirm its program, referral process, and availability.
Yes. Under Ontario's Accessibility for Ontarians with Disabilities Act (AODA) and the Education Act, schools must accommodate students with disabilities including feeding differences related to autism. Accommodations can include permission to bring specific safe foods from home regardless of school nutrition policy, a quiet eating space to reduce sensory overload, a designated eating support aide, and modified cafeteria expectations. These accommodations are documented in the Individual Education Plan (IEP). Parents should request an IEP meeting and involve the school's special education team.
If you have concerns about eating or an eating disorder, ask a qualified clinician about assessment and treatment options. Contact each program directly to ask whether it can support an autistic person.
Evidence-based interventions include: (1) Sequential Oral Sensory (SOS) Approach, systematic food exposure from a distance to tolerance; (2) Occupational therapy for oral sensory processing integration; (3) Speech-language pathology for oral motor dysfunction (difficulty chewing, swallowing); (4) CBT-adapted for autism to address anxiety-driven food avoidance; (5) ABA-based feeding programs with gradual exposure hierarchies; (6) Family-based feeding therapy. A multidisciplinary team approach, combining OT, SLP, psychologist, and dietitian, yields the best outcomes for complex cases.
Nutritional monitoring and targeted supplementation is often recommended alongside feeding therapy, not as a substitute for it. Common deficiencies in autistic children with significant food selectivity include iron, zinc, calcium, vitamin D, and omega-3 fatty acids. A registered dietitian experienced in autism and pediatric nutrition can conduct a dietary analysis and recommend appropriate supplementation. Always consult your child's physician before starting supplements, as excess intake of some nutrients can be harmful. OHIP covers registered dietitian consultation through community health centres.
Your child's health
Where the waitlist stands
Families navigating autism services in Ontario face a documented multi-year wait. Here is the Ontario data — and a two-minute way to push back, when you are ready.
- Ministry of Children, Community and Social Services: Spending Plan Review (2024). Financial Accountability Office of Ontario (2024)
- MCCSS Ontario Autism Program figures, May 13, 2026, obtained by the Ontario Autism Coalition under Freedom of Information. Ministry of Children, Community and Social Services (Ontario), obtained by the Ontario Autism Coalition (May 13, 2026)
Related guides
Guides and tools related to this page.
Sources on this page
The source chain stays visible.
Key claims are paired with their source, evidence tier, and verification date so readers can inspect the public record directly.
Facts3
Sources2
91,974
children are registered in the Ontario Autism Program
WHO recommends accessible, community-based early interventions for children with autism. Timely evidence-based psychosocial interventions improve communication and social engagement
Last system verification: 2026-08-10. Next scheduled update: 2026-11-05.
About this page
Check the author’s context, review method, and how to report an error.