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Up to 70% of autistic children have significant food selectivity. ARFID, sensory-based food avoidance, and anorexia nervosa are all more prevalent in autistic individuals. This guide covers Ontario feeding clinics, OAP funding, school accommodations, and evidence-based treatments.
of autistic children have clinically significant food selectivity, compared to approximately 13-22% of neurotypical children
of autistic individuals meet full diagnostic criteria for ARFID, compared to less than 1% of the general population
of individuals diagnosed with anorexia nervosa are estimated to have undiagnosed autism — particularly women and girls
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.
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.
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.
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.
| Sensory Domain | Common Triggers | OT Intervention |
|---|---|---|
| Texture (tactile/proprioceptive) | Slimy, mushy, mixed, lumpy foods; anything wet | Oral sensory desensitization; SOS approach food hierarchy |
| Smell (olfactory) | Strong-smelling foods; fish, vegetables, spices | Graded olfactory exposure; nose-clip strategies during early exposure |
| Temperature | Hot foods, cold foods — often only room-temperature accepted | Temperature grading; oral motor warm-up activities |
| Colour / visual appearance | Green foods, mixed colours on plate, unfamiliar appearance | Visual grading; divided plates; consistent food presentation |
| Sound (auditory) | Loud crunching sounds; noisy cafeteria environment | Quiet eating environment; ear protection during meals if needed |
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.
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:
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.
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.
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.
For adolescents and adults with autism and anorexia nervosa or other eating disorders. CAMH has autism-informed treatment protocols recognizing the distinct presentation in autistic patients.
Whether your child has food selectivity, ARFID, or a more complex eating disorder, Ontario has specialized feeding clinics, OAP-funded therapy, and school accommodation pathways. Start with an OT assessment and a diagnosis referral.
This page is part of the Family Resources topic cluster. Support resources for families.
Commitment to Accuracy: Our data is independently verified against official government reports (FAO, MCCSS), peer-reviewed scientific literature, and accessible public records. Last updated: February 1, 2026.