Children on the autism spectrum are much more likely to present eating difficulties than neuro-typical children. They may struggle with a range of sensory issues (well, food is all about the senses: it has smells, textures, colours, and tastes as well as different temperatures!). They may struggle with change and require a strong routine that includes eating the same food day after day. They may overeat or even eat non edible items ( PICA).
This can be extremely challenging and stressful for parents, who may find themselves very lonely and worried about nutritional and growth outcomes for their child. The dinner table may become a constant battlefield and the anxiety levels may be very high for all involved.
Since children are diagnosed in average at the age of 4, parents may have already established a feeding relationship in which they have adapted the best they can to their child’s refusals or habits. It’s worth revisiting this relationship on the one hand and exploring options to improve the range of accepted foods on the other hand. Here are my top 10 tips to help you expand your child’s range of food.
1-Always check for underlying causes that may trigger pain or difficulties. Misbehaviour is often rooted in physical pain so it is important to eliminate any Gastro-Intestinal (GI) issues, chewing and swallowing difficulties. Recently I saw two children with chewing difficulties, and one with a swallowing issue.
2-Take the time to reassess your feeding relationship. On a scale of 1 to 10, rate your stress, your worry. Try to narrow it down to what’s really at the back of your mind when you sit your child down for a meal. Is it causing stress to your child in return. Are you coercing, cajoling, rewarding for eating? Can fun become part of the meal routine?
3- Trust your child’s appetite: there is no evidence that children on the autism spectrum can’t feel hunger or satiety, more research is needed though since some children seem to overeat. Making sure that meals are offered when your child is hungry can only help. For further adapting to overeating situations it’s better to talk to a professional first, as these strategies warrant an assessment of your child’s food intake.
4- Reduce anxiety by offering certainty, use cards or charts to spell out the routine. What is the routine before the meal, during the meal, after the meal. What is on the menu? Routine has to allow for some degree of flexibility eventually. I have observed the capacity that children have to increase their accepted range when routine is present and stress is reduced.
5-Use a french style of family meals serving: the food is varied, nutritious and your child can choose what he wants to eat from your offerings.
6-Present new foods on the table, move them closer to your child as time goes by, increase familiarity.
7- Integrate a new food to a liked food, to slowly change the texture, the taste, or the colour, depending on what the refusal is about.
8-Use food dyes to gradually improve acceptance of food that are not of the accepted colour, or to slightly change the colour of foods that are liked.
9- Improve familiarity with food by having non-eating activities that involve preparing and cooking food.
10- Seek professional help. I am of the view that a most pressing issue is to help you in your home (including via the internet) to optimise your feeding relationship with your child, reduce stress and allow for growing flexibility and food acceptance. This can be done conjointly whilst working with other professionals such as speech or Occupational Therapists.
Remember we eat 3 times a day at least for the duration of our lives, so this activity should become as normal and pleasant as possible for all children on the ASD and their families.
Contact me so we can get started to open the range of foods your child will eat.
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