Nutrition Counseling

Counseling Adults With Autism

Autism spectrum disorder (ASD) is a complex developmental disability with a defined set of behaviors. A diagnosis of ASD now includes Asperger syndrome, autistic disorder, and pervasive developmental disorder not otherwise specified. ASD affects individuals differently and to varying degrees. Scientists have yet to figure out what causes ASD and why those with ASD communicate, behave, learn, problem-solve, and interact differently. In its most recent study (2012), the Centers for Disease Control and Prevention estimates that 1 in 68 births in the United States have a diagnosis of ASD.

I’ve worked with ASD patients for more than three years. It has been humbling, challenging, and rewarding. When I was approached by a local community resource organization to provide nutrition services to adults with ASD, I had very little experience counseling them.

After completing autism spectrum training, I realized that my approach to nutrition education with ASD patients would have to be more simplified and detailed. These patients also interact differently. For example, once I started meeting with ASD patients, I quickly learned that even though they may not be making direct eye contact with me, they’re fully engaged and listening intently.

As mentioned above, while patients with ASD may not have unique nutrition needs, they have unique counseling needs that require strategies different from those an RD would use with adults without ASD. The following are some tips for effectively counseling patients with ASD.

Know their history. ASD patients deal with emotional, social, and physical challenges. Some have dealt with hardships that most likely have led to their weight gain, eating disorders, or other health issues. Obtaining the patients records of past medical history and current health status is critical for creating the right nutrition care plan.

Be mindful of medications. ASD patients sometimes are on antianxiety and antidepression medications, and these can increase or decrease their appetite, depending on the drug. Accounting for these medications may involve adjusting the timing of their meals and snacks as well as extending dates for meeting nutrition goals.

Keep plans simple. ASD patients prefer to make small modifications to their eating habits. Encouraging them to strive for one or two easily attainable goals within a three- to six-month period is ideal for patient compliance. Incorporating too many modifications at once can lead to patients feeling overwhelmed. If meal plans are provided, they should be budget friendly, patient specific, and easy to follow, and should contain just a few ingredients.

Celebrate progress. Positive motivation is key. For example, when patients reach their first goal weight or they start eating a healthful, balanced breakfast five out of seven days of the week, celebrate their achievement. They may choose a fun day trip to a museum, an amusement park, or zoo. At my office, sometimes we enjoy a healthful lunch together as a reward. Recognizing their efforts and applauding them for trying is important for success.

As a nutrition professional and business owner, I continually try to improve the way I operate and communicate within my practice. Working with ASD patients has enhanced my teaching and organizational skills and has led to a more simplified way of providing nutrition care plans tailored to each individual’s needs.

Some of my patients have eaten out of cans and boxes their entire lives. Others are trying fruits and vegetables for the first time in their mid-20s. When patients create their own meal plans with nutrient-dense foods such as baked sweet potatoes, black bean burgers, grilled salmon salad, and homemade guacamole, it feels like Christmas morning in my office. No matter how big or small their progress, my experiences with ASD patients have been beyond rewarding.

To learn more about ASD, visit

— Helen Agresti, RD, is founder of Professional Nutrition Consulting, LLC. She’s credentialed by the Pennsylvania Bureau of Autism Services and educates children and adults with autism spectrum disorder on a weekly basis. Helen has educated the public on healthful eating for nearly 20 years. Her passion is to convey the importance of eating real food and exercising regularly. Her current initiative is encouraging families to cook healthful meals at home, while dispelling the myth that doing so is difficult and time consuming. Helen lives in Erie, Pennsylvania, with her husband and their five children.

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