AAP Voices Blog

Parenting, Practice, and the Many Ways Neurodivergent Children Experience Food 

“Can I have a cheese sandwich?” I asked one afternoon while standing in line at a fast-food counter. 
“Would you like tomatoes? Pickles?” 
“No tomatoes.” 
“Sure—no tomatoes, extra pickles.” 

The ease, the flexibility, the unquestioned acceptance of my preferences. I barely noticed it until I turned to my 8-year-old neurodivergent son beside me—eyes bright, pointing toward a drink on the display topped with a mountain of whipped cream. 

 “What would you like?” I asked. 
He said exactly what he wanted: “I want… whipped cream.” 

And just like that, I found myself juggling a request that didn’t fit neatly into any menu. 
“Could I just get whipped cream in a cup?” I asked. 
A pause. A confused look. 
“Wait—what? Sorry, we don’t offer that.” 

This wasn’t new to us and we got the same response many times. 

“Can I have only the hotdog—no bun, no sauce?” 
“Can I have cookies… just crushed cookies in a cup with only a little bit of ice cream (not a cookie ice cream shake)?” 
“Can you provide extra Nutella to add on my Nutella crepe?” 

Meanwhile, I ordered my own food exactly the way I liked it—extra pickles, no tomatoes, sauce on the side—and no one blinked. 

In that moment, staring at a table with extra ketchup bottles and extra bread and different kinds of sauces, I felt the familiar sting: Why is it so hard for my son to pick and choose what he wants, when everyone else can? The answer is both simple and complicated because the way he experiences the world is not the way most people do. 

For 7 years, I have been navigating life as the mother of a neurodivergent child with profound food aversions and severely restricted eating. We have worked hard together to find our place in the world of socially “normal” food experiences: family dinners, school lunches, restaurants, birthday parties, holidays. 

As a developmental behavioral pediatrician, I found myself living this journey from two perspectives, clinical and deeply personal. I had to learn and unlearn so much about how food experiences shape emotional and behavioral health, especially for neurodivergent children whose sensory worlds are far more intense and far less flexible than ours. 
I realized that meaningful support must begin with very simple things: permission, acceptance, and accommodation. Because when we understand a child’s sensory and feeding needs, we don’t just reduce stress—we reduce the isolation and exclusion that so many neurodivergent families quietly endure. 

As a society, we’ve grown tremendously in our acceptance of food preferences and substitutions. We can customize nearly anything with milk alternatives, gluten-free, keto bowls, “build your own everything.” And yet, somehow, we continue to overlook the individuals who experience food in a fundamentally different way. In their world, we are the ones using food “differently.” 

Food, for many of us, is comfort but for many neurodivergent children, food has become a chore because the world around them has not provided the necessary accommodation. Food is also connection, bonding, and relationship-building but for families of children with sensory-based food aversions, mealtimes can become a source of daily stress, anxiety, and disconnection. 

The stress trickles down. Every meal. Every outing. Every holiday gathering. It affects the entire family dynamic, siblings, routines, social participation, and even how welcomed or judged a parent feels in public spaces. 

We talk a lot about selective eating—but not enough about the full spectrum. We know sensory sensitivities, especially with texture, are massively overrepresented in neurodivergent populations. For instance, as many as 70% of children with autism make food choices based on how food feels in their mouth, compared to only 11% of neurotypical children. Even among children without neurodivergence, texture sensitivity is not rare: in one study, 16–22% of typically developing kids were identified as “texture-sensitive.” 

On the visual side, 58% of children with autism in parent report studies reject foods based on appearance (which includes properties like color), and smaller studies show preferences for certain colors (for example, some children only wanting white foods). 

Pediatric Feeding Disorder (PFD) is now finally recognized as a medical condition, yet resources remain limited and many families hit dead ends while seeking help. Avoidant/Restrictive Food Intake Disorder (ARFID) was only recently recognized, and awareness is still far behind where it needs to be. Families often find themselves alone navigating a maze with very few signposts. 

We are entering a season filled with food-centered celebrations. Apple pie. Turkey. Casseroles. Buffets. Crowded tables. 

 “Just take a bite.” 
“You won’t know until you try.” 
“Don’t be picky.” 

But what if we let go of the pressure? 

What if a child wants a bowl full of whipped cream for lunch, a single hotdog without a bun, or maybe their safe snacks brought from home—even in a restaurant? What if this holiday season, we choose acceptance over expectation? 

As adults, we freely modify our meals. We ask for substitutions. We build our plates the way we like. Why shouldn’t they? 

It doesn’t take much to make a child feel included but it does take awareness, understanding, and a willingness to see that their relationship with food is just as valid as ours. 

Let’s make it work to support families, to educate our communities, to provide necessary accommodations for children with restricted diets, to bring their own food to the restaurants and airports, to encourage restaurants to offer simple accommodations, to accept and not judge and to stop policing plates. 

Food is not only nourishment. It is identity, safety, culture, sensory regulation, and sometimes survival. Children with neurodevelopmental differences have their unique world of food, which is beautiful and deeply sensory, and sometimes, all they need to feel understood is a small request honored—just like: “Can I have whipped cream in a bowl?” 

This holiday season, may we all remember that inclusion often begins with something as small and as simple as saying: “Yes. Of course. Let’s make it work.” 

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.