Neurodivergent Space

By: Seasoned Mom, a mom to two children with autism, ages 13 and 9. She is also the spouse of someone on the spectrum. Her education background is with teaching birth to third grade children with an emphasis on special education, specifically autism. 

The most difficult obstacle faced by parents of children with autism is feeding. There are many different factors that play a role in picky eaters, this blog post will highlight some obstacles we faced as well as some resources on things to consider. 

Many children with autism have issues with textures of foods. Some children with autism have no issues with textures, but have difficulty with identifying fullness or hunger. I will focus on children with texture issues in this blog post. 

According to Autism Speaks, children with autism are five times more likely to have mealtime challenges. They offer steps to consider with food aversions where Total Care ABA offers the steps we took during our food therapy journey. 

Some signs to look for when your child is a picky eater include aversions to particular foods, smells and textures, difficulty chewing and swallowing, vomiting and/or gagging, pocketing the food in their cheeks instead of swallowing, and unexplained behavior outbursts. It is important to discuss these with your pediatrician, as there could be a medical condition causing picky eating. 

The biggest culprit of texture issues are vegetables. Vegetables can be mushy, soggy, crunchy, chewy, stringy, or bitter. The best approach to have is to offer a vegetable cooked with different methods. Examples of cooking methods listed in order of most mushy to most crunchy are slow cooking, boiling, sauteing, baking, grilling, air frying, steaming and raw. Some children prefer soft, mushy textures while others prefer hard, crunchy textures. The goal for the parent is to find the perfect texture for their child. 

But first, your child might need help learning how to eat a food that they might not like. For us, our children would gag and vomit while having a vegetable on their plate.  We spoke with our pediatrician and we were referred to food therapy. There, our child worked with an occupational therapist to learn how to explore foods. 

The end goal is to desensitize the child to food aversion, and to do so, you must start at the very beginning. After an evaluation is completed, you and your child will attend sessions with an occupational therapist. There, a selection of food is made and offered at each session. For example, for our oldest daughter, her chosen food was a constructed taco. Soft shell, meat, lettuce, sour cream and a serving of a red pepper and a slice of bacon on the side. Her first step was to interact with the food. The first step is to observe the food. What does it look like? What does it feel like? What does it smell like?  Using her body language as cues, the next step would be to place the food to the lips and return it to the plate. 

This slowly progresses through placing it in the mouth but not biting, taking a bite but not swallowing, and taking a bite, chewing and swallowing. Eventually this works up to being able to eat a whole slice of red pepper. One important thing to teach is the appropriate size of a bite. Some children will take “mouse bites” which are tiny nibbles. Some children will take “alligator bites” which are too large and make chewing more difficult. The goal is to take a bite that is in between the two sizes. 

Another component of feeding therapy is how you serve the food. Children with autism don’t always like their food to touch, even if it is a food (like a taco) that should touch. It is perfectly acceptable for a child to eat a meal that is deconstructed and separated. Offering a divided plate can help. We did not need to make adaptations to dinnerware or cups, but an easier to use dinnerware or cup should be considered. Using just their fingers to eat is also acceptable, eating with a fork or spoon shouldn’t be the focus until eating is no longer an issue.

Pick your battles. If the child takes one step towards trying one averse food at the beginning of mealtime, that’s huge. Let them eat what they will eat, but do not force them to eat something they don’t like. The environment should always be a positive experience at mealtime. Always provide one food you know they love and introduce one food you’re working on learning to eat. It is important that parents model eating averse foods with the child as well. 

Make it fun and make the whole family do it together!

Lastly, reward, reward, reward! Positive reinforcement is the best way to build new skills! Some examples of tangible reinforcement rewards at our house include ice cream, Dum Dum suckers, a cookie, extra one on one time with mom playing their preferred activity, which is a tablet game called Roblox! Remember, tangible means something that is a physical reward, so use your child’s interests and hobbies as ideas on rewards!