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Autism, ADHD, and Learning Differences at Family Meals

Posted on: August 17th, 2022 by Bri DeRosa


Autism, ADHD and learning differences can impact every part of a person’s life, including family meals. Neurodivergent family members might have different experiences at mealtimes than typically developing family members. That’s to be expected! Challenges like sensory eating issues or mismatched expectations about behavior might make shared meals frustrating for everyone. How parents and caregivers adapt and respond to create a more welcoming environment can make all the difference.

The research on the benefits of family dinners – and shared meals in general – is compelling, but just eating together doesn’t necessarily mean that every member of the family can access those benefits. The most important ingredient in a family meal is connection; if sitting down to eat together doesn’t feel like a positive experience, at least most of the time, it’s much less likely that the people around the table are going to experience improvements in mental and emotional health, physical well-being, and family bonding. But nearly everything about the traditional family dinner could feel uncomfortable for a child with autism, ADHD or another neurodivergence. Sounds, smells, tastes, having to sit in a specific chair for a specific length of time, turn-taking, following family rules about manners, picking up on social cues…all of these things, and all at the same time, present a minefield of challenges!

We talked about family meals and autism, ADHD, and learning differences with a number of experts in the fields of child psychiatry, family therapy, nutrition and feeding therapy, occupational therapy, and special education. While each of our experts stressed that no two people, and no two families, are exactly alike, they provided some insights into the ways different types of neurodivergence can impact family dinners.

How Autism, ADHD, and Learning Differences Impact Family Meals

Although each person’s experience at mealtimes is unique to them, there are some common challenges that often come up for people on the autism spectrum, ADHD or other kinds of neurodivergence.

  • Sensory processing differences are one of the most common and frustrating dinnertime challenges for families. Sensory differences can impact the way a person experiences taste, smell, touch, and hearing, but also how they interpret their own body’s signals around cues like hunger and fullness (interoception), how they experience the way their body is positioned in a chair or relative to other people and objects (vestibular), or their sensations around motor control (proprioception).
    In children with sensory processing differences, everything from the food that’s served to the feeling of the chair they’re sitting in can make family dinners uncomfortable. Jennifer Stornelli, a Pediatric Occupational Therapist and head of the Pediatric Feeding Program at Spaulding Outpatient Center for Children in Lexington, clarifies: “When I work with sensory differences at mealtimes, I stress that we are all different sensory beings. There is a huge range of how much we can tolerate noise, how much movement we need, how we manage our impulses…we are all on a continuum.”
    Because the way a child behaves is so closely related to how they’re interpreting sensory information, a lack of understanding about the things that trigger sensory responses at mealtimes can quickly lead to what looks like “misbehavior” or “acting out.” In reality, a child who’s under- or over-stimulated by sensory input can’t control the impulses that then lead to refusing food, gagging, shutting down, lashing out, fidgeting, spinning, acting impulsively, or any number of other behaviors that parents might notice.
  • Transition and Attention Difficulties are another big cause of mealtime conflict and tension for many families. For many people on the autism spectrum, for example, shifting between one activity and another can feel disruptive or overwhelming. Doing so on someone else’s schedule can be particularly upsetting – like when a parent abruptly announces “Dinner’s ready! You have to come to the table now.” For a child who struggles with transitions, having to summon the self-control to stop whatever they’re currently doing in order to switch gears and enter another activity can cause anxiety or emotional upset. Unfortunately, a parent might interpret that as “being difficult,” noncompliance or stubbornness, leading to a power struggle that makes everyone unhappy before the meal has even begun.
    Once at the dinner table, the ability to sustain attention and follow the “flow” or routine of the meal can also be difficult. Some kids might try to rush through eating in order to get back to a preferred activity (or away from an overwhelming environment). Others might struggle to remember rules and routines that govern table manners and family expectations, or have trouble integrating into conversations. Adjusting expectations to more closely match what’s realistic for that child can be helpful in diffusing the tension, as can using supports like visual prompts or timers to help keep things on track.
  • Behavior Challenges are one of the most common complaints parents bring up when talking about family meals. Of course, what families mean by “behavior” can vary widely, and the way a child behaves at dinner is likely to be their way of trying to communicate their own needs. Some of the most frequently discussed “behavioral challenges” parents mention are things like fidgeting or not being able to sit still or “sit nicely”; interrupting frequently or monopolizing conversation; disruptions like touching other people or their food, or “playing” with food and objects on the table; making too much noise; and “noncompliance,” like refusing to eat as directed, not cooperating with requests to sit up or pass dishes, or continually offering silly/rude/inappropriate responses to conversation despite being asked to stop.
    All of these behaviors, and others, are likely to be symptoms of a child’s discomfort, not “bad behavior” at all! “Children communicate through their behavior. If they melt down during dinner, what are they telling us?” asks Naureen Hunani, RD., a pediatric and family dietitian who specializes in neurodiversity and weight-inclusive practices. “Maybe there are unmet needs during the school day and when he sits down to eat there are more demands, and that is why he has a tantrum.”

Family Dinner Can Feel High-Pressure

When families are struggling with mealtimes, “it’s often a conflict of expectation,” says Bob Cunningham, Executive Director for Learning Development at Understood.org and former Head of School of the Gateway School. “Some of the challenges are related to the particular idiosyncrasies of the child, some are based on the parents’ upbringing or particular experiences with meals or manners, what’s acceptable or not.” But, he notes, the way the adults in the family were raised and the expectations they have around meals and manners may not be attainable for a neurodivergent child. “Kids with ADHD, for example; their lives can be pretty taxing because they are doing things that are hard for them all day. Often, they are coming home from school exhausted. Family dinner puts a strain on frustration, using language, being nice. Often, you’re having the kids sit down (at the table) and you are talking at them for 40 minutes, and that is going to cause a conflict.”

Naureen Hunani points out that in many cases, the frustrations parents have around mealtimes are a reflection of their own sense of pressure. “We know that food and eating are supposed to be social,” she says. “For autistic kids and kids with ADHD, eating in a social environment can cause a lot of anxiety because of the extra demand to socialize in a neurotypical way. But the social function is something that parents are concerned about.” That internal struggle many parents feel around making meals an opportunity for social growth can be in direct conflict with a child’s need to simply get their physical and nutritional needs met, without the burden of interacting or communicating in particular ways.

And it’s not only internal pressure that impacts the way a family might feel about mealtimes. External pressures, too, can add stress to the whole experience. For example, in a family where one or more members receive services for autism, ADHD or learning differences, the daily schedule might include extra hours devoted to activities like therapy and tutoring. Not only do those additional hours put time pressure on the parents to get meals on the table at a reasonable hour, but as Cunningham notes, they can add to a child’s sense of being stretched too thin by dinnertime. “Their afterschool time is taken up with learning specialists and therapy, and they just want to hang out with their parents,” he says – without additional demands to behave a certain way or conform to anyone’s vision of a “perfect” family dinner.

He also points out that tutoring and therapies can reduce a family’s opportunity to create a regular dinner routine. “The number of kids who eat while being tutored or in the car on the way to therapy is high.” While that kind of eating on the go is sometimes unavoidable, it can also lead to further complications when parents then expect kids to integrate seamlessly into sit-down dinners on other nights of the week. The expectations parents may have for behavior and interaction when a child eats a meal in the backseat of the car are often totally different from what’s expected when the whole family gathers at the table for a shared sit-down dinner. For a child with ADHD or a person on the autism spectrum, that switch between expected behavior while eating in two different settings can be jarring. Parents may need to consider letting go of some of their expectations for the sit-down meal, or finding ways to bridge the two different experiences. Maybe the child has gotten used to listening to music in the car while eating, and not having to carry on a conversation. Or maybe the child is more comfortable eating with their fingers from a divided lunchbox tray, as they do in the car, and providing that kind of experience at the dinner table relieves some of the pressure to have specific table manners.

Ultimately, one of the easiest solutions to a mismatch between parent and child expectations for mealtimes is one that often gets overlooked. “Talk to the child and see what they would like,” suggests Megan Mayo, a Board-Certified Behavior Analyst who specializes in sensory, behavioral and feeding challenges. While a parent might be fretting about the limited amount of time the child spends at the table or their lack of input into family conversations, “the child may be content with their participation.” Making adjustments that are comfortable for the child, rather than expecting the child to conform to the parents’ vision for mealtimes, is more likely to result in a compromise that works for everyone.

Mealtime Struggles are Normal, and they’re Okay

“We need to normalize difficulties with mealtime routines,” says Mayo. That doesn’t mean that families have to keep struggling, or that parents should throw all boundaries and expectations out the window because their child is neurodivergent. But, Mayo says, parents need and deserve “emotional regulation support to help them remain calm, maintain their limits and avoid power struggles.”

“If you have parents who work hard,” Cunningham adds, “like moms who hold down two jobs, and they want to keep dinnertime sacred…but the parent is exhausted, and the kid has special needs, it’s very taxing.” Adding to the list of demands on parents and kids, he points out, is an often overwhelming amount of homework and the constant feeling that there aren’t enough hours in the day to get everything done. Then, when parents hope to make mealtimes a refuge where they can relax and talk about the day, exhausted kids might spiral out of control.

Ultimately, Hunani says, it’s crucial for parents to understand that mealtime struggles aren’t necessarily their fault. “Families will come to me thinking that they are creating the problem. Maybe I’ve accommodated the problem and therefore created it. Maybe I shouldn’t have given so much mac and cheese and now he isn’t eating anything. My child isn’t eating enough or is eating too much. But every family is unique. The important thing is that parents feel safe and confident—then they can show up for their kids and help remove shame and stigma.”

Get more help with family meals for ADHD, autism, and learning differences through our Welcoming Table initiative.