Managing picky eating in children with autism spectrum disorders

Do understand why children have feeding problems

Oftentimes, parents can’t figure out why their child—who has been eating many different foods since age one—all of a sudden begins narrowing down his or her diet to only a few foods. While the direct cause of feeding problems is unknown, multiple variables play a role in food selectivity. Below is a list of several possible variables:

1. Experiencing pain or discomfort during mealtime. This can occur from a medical condition, such as reflux; deficits in oral motor functioning, such as an inability to properly chew food, which can result in gagging; or accidental choking.
2. Watching someone else have a bad reaction to a specific food. Examples of this include mom or dad expressing dislike for certain foods, or if the child witnesses someone choke or vomit from eating.
3. Children with ASD strive for routine and rituals. There is an insistence on routines and a resistance to change in the ASD community. Possibly attributed to language delays or deficits, children with ASD find it comforting to know the expected, and they seem to develop what could be equivalent to a phobia of trying new foods.

Do be sure your child takes 10 to 20 tastes of a food

Research shows that it takes 10 to 20 tastes of a food to determine preference. Consequently, it is a falsehood that if your child tries a food and does not like it, he or she will never ever like it. Remember that tasting a food means chewing it fully and swallowing it.

Do set a schedule for meals and snacks with no snacking between

This schedule will increase the motivation of eating foods presented during meal and snack times because your child will have time to build up an appetite. If your child is thirsty, offer water, not juice or milk. Anything other than water can become too filling and ruin his or her appetite.

Do tap into motivation

Many children who have feeding problems will not feel hunger or find food motivating or rewarding. For this reason, parents need to find other motivators in the environment–something that their child enjoys doing or playing–and reserve that object or activity until after your child follows your direction to eat.

Some examples of powerful reinforcers/motivators include iPads, TVs, DVD players, stickers and coloring. Each child’s reinforcers will be different, so it is important to pick the right one. Just remember, your child can’t have access to the fun toy any other time—or else motivation will be lost.

Do use a reward system

When using rewards, start out slowly. Make it very easy for children to earn their rewards since the goal is for them to be successful. This could be as simple as eating one bite of a new food in exchange for 30 minutes of their favorite iPad game or a piece of their favorite dessert.

Once you get successful bites, build on that success and increase the demand (e.g., 2 bites = 15 minutes of iPad time). Usually, the demand will need to be reduced when the next new food is introduced. It will feel as if you are starting all over again.

Do not assume feeding problems are all about oral motor skill deficits and sensory sensitivity

Although some children exhibit oral motor skill delays or oral sensitivity, which may have led to a reduction in food variety, there is often a behavioral component that needs to be addressed prior to working on desensitization and skill acquisition.

Do not underestimate the importance of minimizing distractions

Present meals and snacks in a location that is away from any distraction, such as toys and television. If your child is not concentrating on food and is constantly running around or engaged in another activity, he or she is less likely to eat everything presented and will be unreceptive to any interventions you may want to try.

Do not forget to model foods that you want your child to eat

When children see their parents eating certain foods, they are typically more willing to try these particular foods. Keep introducing your child to new foods whenever the opportunity is there. Don’t get stuck in a routine of putting the same food on your child’s plate each day because that’s what they want. Don’t let kids shape your behavior; instead, shape theirs.

Do not try starving your child

A common myth is that if parents withhold food from their child, the child will eventually come around and eat anything offered. However, children with ASD who experience feeding problems are not motivated by food and sometimes don’t feel hunger. Withholding food from a child is a very dangerous, inappropriate and ineffective strategy to fixing feeding problems.

Do not give in to tantrums

Many times, parents will ask children if they want to eat or what they want to eat as a way to avoid tantrums over foods. Some parents believe it is more important to keep the peace and avoid tantrums at all costs. But are you helping your child in the long run? Sometimes, parents must withstand a few tantrums to show their child that eating is a demand. And if kids comply with the demand–or follow your directions–they will get something fun.