My husband and I often refer to Barclay’s food preferences as The Nursing Home Diet. Barclay 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 Barclay, are selective eaters. This is the result of numerous reasons such as sensory-related issues (aversions to flavors, textures, temperatures), side-effects of medications, and often a hypo-sensitivity to even being able to recognize the symptoms of hunger as a result of an under-functioning interoceptive system.
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.
Our first opportunity to getting creative is actually getting the food into our son. We identified an extremely motivating reinforcer for Barclay is praise. Our mealtime praise is called The Happy Dance! When Barclay 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. The Happy Dance is when my husband and I run around the kitchen, cheering, waving our arms, and acting pretty crazy. And honestly, we are that excited each time he eats!
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! Barclay loves The Happy Dance, and it does help increase the volume of food he eats. Eventually, we will start to require two bites before praise, and then three until finally, we can phase the reinforcer out. 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!
Our second opportunity in being creative at mealtime is where Barclay eats. When my other three neurotypical children were growing up, mealtime was at the table. Period. But raising a child with ASD means you have to let go of what is considered “normal” and embrace what works!
Transitions can be very challenging for children on the spectrum. If Barclay is thoroughly engaged in coloring or intently focused on a game, requiring him to leave that activity and move to his high chair won’t go well. We have to focus on what the goal is in that moment. The goal isn’t setting him up for an opportunity to transition, although that is something we continuously work on. The goal is to get him to consume calories. 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.
Our third opportunity in being creative at mealtime is what Barclay eats. We are struggling with this one. Currently, he has limited his diet down to just a select few foods. Over the last few weeks, I have been keeping a log of what he eats, what time, and how much. Soon I will be working with his therapists to develop a Food Introduction Plan.
Update: August 2020 – Barclay continues to struggle with an extremely limited diet despite attempts to introduce new foods. He has been cleared by his pediatrician as healthy, prescribed several supplements and we continue to work to introduce new foods without much success. At this point, a limited diet is lower on the priority than other challenges so as long as he is healthy we are focused on the quality and quantity of food rather than the variety.
In general my children refuse to eat anything that hasn’t danced on television. – Erma Bombeck