My husband and I often call our son’s food preferences, “The Nursing Home Diet.” He prefers his food soft, bland, room temperature, and not much of it. But the truth is, up to 80 percent of children with autism spectrum disorder (ASD), like my son, have issues related to eating. This can be the result of numerous reasons such as sensory-related issues (aversions to flavors, textures, temperatures), side-effects of medications, fixation on rigidity and routine, and quite often the inability to recognize the symptoms of hunger.
Mealtime around our house gets very creative. If you think you’ll see our family all sitting around the table having meaningful conversations while we all enjoy the same wonderful dish like in a television sitcom, think again. I mean, that is a long-term goal, but there are numerous baby steps to us getting there. If you have a child with ASD who also struggles with restrictive eating issues, the following tips might help.
1. Find a motivator.
Our first opportunity in getting creative is getting the food into our son. We identified an extremely motivating reinforcer for him is praise. Our mealtime praise is called The Happy Dance! When my son is struggling to accept food, we offer him a choice. First, have a bite of food, then mom or dad will do The Happy Dance, which is when my husband and I run around the kitchen cheering, waving our arms and acting over the top. And honestly, we are that excited each time he eats! Find a motivating reinforcer to encourage your child to eat more. Maybe time on the iPad or a favorite movie as a reward. Initially, offer the reinforcer after each bite. So if it’s a favorite movie, pause the movie until a bite of food is taken, then increase to two bites, then three and so on. Use your judgement and increase the required number of bites for the reinforcer slowly over time. Keep data so you know if the reinforcer you are using is working.
For an observer, this may look quite different than the typical family mealtime, and it is. But parenting a child with ASD takes a ton of creativity! My son loves The Happy Dance and it does help increase the volume of food he eats. We have a long way to go before he’s eating sushi, but at least now he’s eating most of his mac and cheese!
2. Mealtime location.
When my older three neurotypical children were growing up, mealtime was at the table. Period. But raising a child with ASD means you must let go of what is considered “expected” and embrace what works! Transitions can be very challenging for children on the spectrum. If my son is thoroughly engaged in coloring or intently focused on a game, then requiring him to leave that activity and move to his highchair won’t go well. We must focus on what the goal is for that moment, which is getting him to eat. That may mean I go sit at his little table where he is coloring and feed him. That may mean bringing his plate to the floor where he is playing and feed him. That may mean (and this one is tough for me!) bringing his plate into the living room and letting him eat.
Often times children with ASD will eat more when the actual meal isn’t the focus of their attention. So letting them eat where they happen to be engaged in an activity may work better than forcing them to sit at a table with the meal.
3. It’s OK to have a limited menu.
Many parents get very hung up with the expectation that their child needs to eat a variety of foods to be healthy, or that they must eat what the rest of the family is eating. However, for most children with ASD, that isn’t going to happen. Early on when my son began to restrict foods, I started keeping data on what he would willingly eat. I took him to his pediatrician so she could review it and examine him to make sure he was healthy. She gave us a thumbs-up, said keep letting him eat what he eats, supplement with Pediasure and a multivitamin and he’s good to go. That doesn’t mean letting children eat only foods that are unhealthy. A diet of only doughnuts isn’t what I am talking about here. But if your child has limited their highly preferred foods down to a choice few, as long as they at least have something within every food group, you have to be OK with that.
While we continue to encourage my son to eat at the table and try new foods, we don’t worry anymore if he refuses. We let him eat what he will, supplement as prescribed and keep him under the watchful eye of his pediatrician. These tips and suggestions may seem counterintuitive to how parents are typically told to treat mealtimes with their children. Remember, your starting point for a child with autism shouldn’t be your end goal, but rather what is successful while you work toward the end goal.
“When you release expectations, you are free to enjoy things for what they are instead of what you think they should be.” — Mandy Hale