Fussy Eating or Something More? Understanding Feeding Challenges in Neurodivergent Kids

You’ve heard it before: “It’s just a phase.”
“They’ll eat when they’re hungry.”
“All kids are fussy!”

And yes — fussy eating can be a completely typical part of development. But what if your child’s eating behaviours feel bigger than that? What if they’re not growing out of it, or the list of accepted foods is shrinking instead of growing?

As a paediatric dietitian who works with neurodivergent kids and ARFID (Avoidant/Restrictive Food Intake Disorder), I want to walk you through the difference between developmentally normal fussy eating — and when it might be something more. 

🌱 The Fussy Eating Phase (and When It’s Just That)

Most kids go through a fussy eating phase. It usually starts between the ages of 2 and 3, right alongside a developmental desire for autonomy. Suddenly, your toddler who once ate curry with their fingers now only wants white toast. Welcome to the age of “I do it myself!”

During this stage, kids might:

• Reject previously loved foods

• Become more sensitive to food textures or presentations

• Assert control over what, how, and where they eat

💡 Hot tip: Fun presentation can go a long way. A sandwich cut like a dinosaur or snacks served in a bento-style lunchbox can make food feel less threatening and more engaging.

But here’s the key: Fussy eating typically resolves over time. Kids still experiment, even reluctantly. They might push back on broccoli, but they’ll lick the corner of a cracker they’ve never had. You see movement, even if it’s slow.

🚩 When It’s More Than Fussy Eating: Understanding ARFID

Some kids aren’t just selective — they’re stuck. Their list of accepted foods isn’t just short; it’s getting shorter. New foods spark anxiety, not curiosity.

This could be ARFID — a serious eating disorder often missed in neurodivergent children.

Unlike other eating disorders, ARFID isn’t about body image. It’s about:

• Fear of the sensory experience of eating

• Rigidity around food brands, packaging, or preparation

• Distress when safe foods aren’t available

• Avoidance of food due to anxiety or traumatic experiences

🔍 The Sensory-Autonomy-Food Triangle

Neurodivergent kids — especially those with autism or ADHD — may experience differences in:

• Sensory processing: Food may feel “too loud,” “too spiky,” “too wet.” The texture, smell, or colour can be overwhelming or even physically distressing.

• Rigidity and routines: The “right” brand of nuggets or a sandwich cut diagonally becomes non-negotiable. Any variation can feel unsafe.

• Interoception: The brain-body connection that helps us sense hunger and fullness might be muted or confusing.

These challenges can lead to:

• ✖️ Avoidance of new or unfamiliar foods

• ✖️ Anxiety around mealtimes

• ✖️ Low appetite due to stress (and stress hormones override hunger signals)

• ✖️ Reduced food variety and missed nutrients

• ✖️ Isolation from social events involving food

It’s a domino effect. What starts as “quirky eating” can spiral into nutritional deficiencies, stunted growth, and profound family stress.

❗️Red Flags: When to Seek Support

If your child is showing any of the following signs, it’s time to consider professional help.

According to the DSM-5 diagnostic criteria and supported by Eating Disorders Victoria, red flags for ARFID include:

• ⚠️ Significant restriction in food intake leading to:

  • Weight loss or failure to gain expected weight

  • Nutritional deficiencies (e.g., low iron, zinc)

  • Dependence on supplements or formula

  • Impaired social functioning (e.g., avoiding food-based activities)

• 😨 Fear of negative consequences from eating, such as:

  • Fear of choking, vomiting, or pain

  • Intense anxiety about unfamiliar foods

• 🚫 Not related to body image or weight concerns — unlike anorexia nervosa or bulimia, ARFID is not driven by a desire to be thin.

Other common signs include:

• A shrinking list of accepted foods (often <20 items)

• Distress or meltdowns when preferred foods aren’t available

• Avoiding social events where food is present

• Strong preference for specific brands, textures, or preparation methods

• Sensory sensitivity to taste, smell, texture, or appearance

📚 Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA.

👉 For a more detailed overview, see the Eating Disorders Victoria ARFID factsheet.

💬 The Bottom Line

Fussy eating is normal.
ARFID is not.

The difference lies in persistence, distress, and impact on health and development.

Whether your child is just starting to show signs of picky eating or you’ve been managing feeding challenges for years, support is available. You don’t have to navigate this alone.

👩‍⚕️ Why Paediatric Dietitians (and Feeding Therapists) Matter

When a child is struggling to eat, it’s rarely about willpower — and rarely something they just “grow out of.” What they need is a team that understands how neurodivergence, sensory processing, and nutrition intersect.

As a paediatric dietitian and feeding therapist, my approach bridges medical nutrition therapy with behaviourally informed, child-centred care.

At Diet Physics, I offer:

• Feeding therapy that respects a child’s sensory profile and autonomy

• Food School — a gentle, exploratory setting where kids can learn about food without pressure

• 1:1 parent education and coaching — helping you feel empowered and confident at mealtimes

• Personalised support for nutrient gaps, iron/zinc deficiencies, and meal planning for ADHD and ASD

If this blog sounds familiar — if you’re living in the space between “just fussy” and “something feels off” — know that you’re not alone. And you don’t have to figure this out by yourself.

🎁 Download my free ARFID Survival Guide to take the first step in understanding your child’s eating and what gentle, effective support can look like.
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