About a year ago, Alex suddenly became a picky eater.
Typically, children with autism do not eat a variety of foods, but Alex had
always been good about trying new foods and eating well. In fact, the only food
he refused to eat was popcorn. We knew we were blessed that he had such a
healthy appetite and were thankful this was one problem of autism that was not
a concern for us. Knowing that Alex goes through phases, we truly believed that
within a few days or weeks, he’d soon tire of eating the same few foods and go
back to his more expanded diet and healthy appetite. We were wrong.
According to the online article, “Mealtime and Children on the Autism Spectrum: Beyond Picky, Fussy, and Fads,” by Marci Wheeler on the Indiana Resource Center for Autism website, children with autism often have medical, behavioral, and/or environmental issues that cause them to have problems eating. [To read this excellent article, please click here.] She notes that medical concerns must be addressed first, and resolving those health issues is crucial to getting the child to eat properly. Specifically, she explains that some children with autism may gag or choke while eating, and others have food allergies or gastrointestinal disorders that affect their eating habits. In addition, some children with autism cannot feel or detect hunger, causing them to have no interest in eating. For that reason, allowing children with autism to wait until they feel hungry enough to eat, which is sometimes suggested for picky eaters, is a method that should not be used since they might never feel hunger pangs. Therefore, children with autism need medical evaluations to see what health conditions may be behind their poor appetites.
For Alex, we know what triggered the sudden change in his appetite. A mild virus that was going around last spring seemed to take away people’s desire to eat for about a week. Once that week was over, however, Alex still had little interest in eating. We soon discovered that he had also developed thrush, an overgrowth of yeast in the mouth and throat, probably because the virus had weakened his immune system. Yeast overgrowth has plagued Alex over the years, as it does many people with autism, but he typically responds well to antifungal medications. The thrush would also explain his decreased appetite because it causes his mouth and throat to be sore; hence, he doesn’t feel like eating. While this case of thrush was especially virulent and required repeated visits to the doctor and several rounds of antifungal medication, the yeast eventually was under control. Nonetheless, Alex’s lack of appetite continued.
Not only did Alex have little interest in eating, but he also developed anxiety issues around mealtimes. He would have panic attacks when it was time to eat, manifested in his body shaking, caused by adrenaline surges. While we had addressed the medical problems, then we had behavioral concerns about eating appear. Working with his behavioral therapist, we discussed ways to help Alex deal with his anxiety about eating. While we knew we had to encourage him to eat, we didn’t want mealtimes to be stressful for him. Consequently, to get him to eat, we allowed him to eat healthy foods that appealed to him instead of what we were having for dinner, permitted him to leave the table as soon as he was done eating, and let him eat lunch in his bedroom, as he requested. So long as he ate, we were willing to compromise our usual mealtime routines. However, this might not have been the best approach because his picky eating was not getting any better, even though his anxiety about mealtime did improve.
The third type of feeding issue in autism discussed in Marci Wheeler’s article is environmental, specifically sensory concerns. She explains that for many children with autism who have sensory issues, the look, feel, smell, taste, and even sound of food can be problematic when eating. For this reason, she recommends that parents assess their child’s eating patterns, considering what, when, with whom, how, and where their children prefer to eat. Once these preferences are established, parents can work with their children to encourage them to eat foods that are similar in taste, temperature, texture, and color to those they will already eat.
Since Alex’s current preference is for foods that are soft and smooth, especially applesauce and strawberry smoothies, I did an online search of foods recommended after dental surgery. Because we have ruled out any problems with his teeth and gums by taking him to the dentist twice in the past year, I suspect that he prefers these foods because they are quiet. After looking over the recommended foods, I made a list of those I thought Alex could try again, such as cranberry jelly, green beans, bananas, coconut milk yogurt, dairy-free lemon pudding, and turkey. Even though he has maintained his weight and takes vitamin, mineral, and protein supplements to make up for what nutrients his limited diet may be lacking, I knew we needed to expand his palate to make him more willing to eat the variety of foods he used to enjoy. Now I was ready to implement the excellent strategies outlined in the article about picky eaters.
In this article, Marci Wheeler offers not only tips for getting children with autism to eat but also explanations of why these approaches are crucial to success. A summary of her suggestions includes the following:
According to the online article, “Mealtime and Children on the Autism Spectrum: Beyond Picky, Fussy, and Fads,” by Marci Wheeler on the Indiana Resource Center for Autism website, children with autism often have medical, behavioral, and/or environmental issues that cause them to have problems eating. [To read this excellent article, please click here.] She notes that medical concerns must be addressed first, and resolving those health issues is crucial to getting the child to eat properly. Specifically, she explains that some children with autism may gag or choke while eating, and others have food allergies or gastrointestinal disorders that affect their eating habits. In addition, some children with autism cannot feel or detect hunger, causing them to have no interest in eating. For that reason, allowing children with autism to wait until they feel hungry enough to eat, which is sometimes suggested for picky eaters, is a method that should not be used since they might never feel hunger pangs. Therefore, children with autism need medical evaluations to see what health conditions may be behind their poor appetites.
For Alex, we know what triggered the sudden change in his appetite. A mild virus that was going around last spring seemed to take away people’s desire to eat for about a week. Once that week was over, however, Alex still had little interest in eating. We soon discovered that he had also developed thrush, an overgrowth of yeast in the mouth and throat, probably because the virus had weakened his immune system. Yeast overgrowth has plagued Alex over the years, as it does many people with autism, but he typically responds well to antifungal medications. The thrush would also explain his decreased appetite because it causes his mouth and throat to be sore; hence, he doesn’t feel like eating. While this case of thrush was especially virulent and required repeated visits to the doctor and several rounds of antifungal medication, the yeast eventually was under control. Nonetheless, Alex’s lack of appetite continued.
Not only did Alex have little interest in eating, but he also developed anxiety issues around mealtimes. He would have panic attacks when it was time to eat, manifested in his body shaking, caused by adrenaline surges. While we had addressed the medical problems, then we had behavioral concerns about eating appear. Working with his behavioral therapist, we discussed ways to help Alex deal with his anxiety about eating. While we knew we had to encourage him to eat, we didn’t want mealtimes to be stressful for him. Consequently, to get him to eat, we allowed him to eat healthy foods that appealed to him instead of what we were having for dinner, permitted him to leave the table as soon as he was done eating, and let him eat lunch in his bedroom, as he requested. So long as he ate, we were willing to compromise our usual mealtime routines. However, this might not have been the best approach because his picky eating was not getting any better, even though his anxiety about mealtime did improve.
The third type of feeding issue in autism discussed in Marci Wheeler’s article is environmental, specifically sensory concerns. She explains that for many children with autism who have sensory issues, the look, feel, smell, taste, and even sound of food can be problematic when eating. For this reason, she recommends that parents assess their child’s eating patterns, considering what, when, with whom, how, and where their children prefer to eat. Once these preferences are established, parents can work with their children to encourage them to eat foods that are similar in taste, temperature, texture, and color to those they will already eat.
Since Alex’s current preference is for foods that are soft and smooth, especially applesauce and strawberry smoothies, I did an online search of foods recommended after dental surgery. Because we have ruled out any problems with his teeth and gums by taking him to the dentist twice in the past year, I suspect that he prefers these foods because they are quiet. After looking over the recommended foods, I made a list of those I thought Alex could try again, such as cranberry jelly, green beans, bananas, coconut milk yogurt, dairy-free lemon pudding, and turkey. Even though he has maintained his weight and takes vitamin, mineral, and protein supplements to make up for what nutrients his limited diet may be lacking, I knew we needed to expand his palate to make him more willing to eat the variety of foods he used to enjoy. Now I was ready to implement the excellent strategies outlined in the article about picky eaters.
In this article, Marci Wheeler offers not only tips for getting children with autism to eat but also explanations of why these approaches are crucial to success. A summary of her suggestions includes the following:
1. Parents must remain calm and not make mealtimes a
struggle. Instead, eating should be a pleasant experience for the child, and
the child needs to feel a sense of control.
2. To help the
child desensitize to sensory issues, children need gradual exposure to foods.
Too many new foods at once can overwhelm the child. Moreover, offering a food
similar to one the child already likes is more apt to be successful.
3. Sneaking other foods in preferred foods is not a good
idea, as the child with autism is likely to detect the hidden food and may
refuse to eat anything after that, fearing being tricked again.
4. Eating with
others is a social activity that needs to be encouraged, especially since
others can model positive eating behaviors for the child. The time of sitting
at the table may need to be increased gradually, and a timer may be helpful for
the child to know how long he or she has to sit at the table.
While we had not pressured Alex to eat for fear of intensifying his anxiety about mealtimes, I knew we needed to be a little more encouraging. In addition, once I had come up with “new” foods similar to those he already likes, I decided to offer them gradually, list all their positive attributes, and praise Alex enthusiastically for trying them. (Knowing how keen Alex’s senses are, I have never tried to sneak any foods into him, fearing that he not only wouldn’t eat but also that he wouldn’t trust me about other issues.) Finally, this week, I changed the mealtime setting for him. Instead of eating lunch in his bedroom, as he preferred, he now must eat lunch at the kitchen table. Amazingly, he took my new directive quite well and didn’t balk at this change. In addition, I told him that he must sit at the dinner table with his dad and me, even when he is finished eating, so that we can have nice conversation. Again, he has taken this change remarkably well and seems to enjoy chatting with us while we eat. I’m also hopeful that we are desensitizing him to sensory issues while he sits there seeing, hearing, and smelling the food we are eating.
Although we have only just begun to implement the new feeding plan, we are hopeful that we are on the right track to helping Alex regain his healthy appetite. I’m thankful for the suggestions and explanations presented in the article because they have given me ideas about how to encourage Alex to make positive changes. We’re also pleased that Alex seems to be responding well to the changes, trying some different foods successfully, cooperating with our requests to eat at the table, and showing no signs of anxiety around mealtime. Most of all, we’re grateful to God, who guides us as we try to help Alex be happy and healthy. Hopefully, Alex will continue to increase the number of foods he will eat so that he can enjoy all the foods he once happily savored.
While we had not pressured Alex to eat for fear of intensifying his anxiety about mealtimes, I knew we needed to be a little more encouraging. In addition, once I had come up with “new” foods similar to those he already likes, I decided to offer them gradually, list all their positive attributes, and praise Alex enthusiastically for trying them. (Knowing how keen Alex’s senses are, I have never tried to sneak any foods into him, fearing that he not only wouldn’t eat but also that he wouldn’t trust me about other issues.) Finally, this week, I changed the mealtime setting for him. Instead of eating lunch in his bedroom, as he preferred, he now must eat lunch at the kitchen table. Amazingly, he took my new directive quite well and didn’t balk at this change. In addition, I told him that he must sit at the dinner table with his dad and me, even when he is finished eating, so that we can have nice conversation. Again, he has taken this change remarkably well and seems to enjoy chatting with us while we eat. I’m also hopeful that we are desensitizing him to sensory issues while he sits there seeing, hearing, and smelling the food we are eating.
Although we have only just begun to implement the new feeding plan, we are hopeful that we are on the right track to helping Alex regain his healthy appetite. I’m thankful for the suggestions and explanations presented in the article because they have given me ideas about how to encourage Alex to make positive changes. We’re also pleased that Alex seems to be responding well to the changes, trying some different foods successfully, cooperating with our requests to eat at the table, and showing no signs of anxiety around mealtime. Most of all, we’re grateful to God, who guides us as we try to help Alex be happy and healthy. Hopefully, Alex will continue to increase the number of foods he will eat so that he can enjoy all the foods he once happily savored.
“Taste and see that the Lord is good. Oh, the joys of those
who take refuge in Him!” Psalm 34:8
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