It's a scene many parents are familiar with: it's been a busy day with work, school, and playdates. Dinner is finally ready, it's on the table, you just want to sit down to enjoy time with your family…and your child refuses to eat. Many kids on the autism spectrum have limited diets and eating is a common concern for parents of kids with autism. Some kids may avoid foods with specific textures, smells, or colors due to sensory processing difficulties in which certain sensory information (the smell of broccoli, the feel of yogurt, the intense color of watermelon) may be very overwhelming or unappetizing to a child. These difficulties can cause an intense reaction and refusal to eat the food. Some children avoid food because of picky eating, which is a developmental stage that many children go through of resisting new food. Whatever the reason, a child eating very few foods can be challenging and frustrating for parents.
As occupational therapists, we work with children to expand their food choices and become more comfortable with the sensory experiences involved in eating. In a future blog we'll talk about some of the techniques we use with challenging eaters and some tips for home, but first it's important to think about the steps that lead to a child eating a food. Believe it or not, we all went through these steps when first starting to eat new foods. For most of us the transition from one step to the next was fairly seamless, for children with autism each step and each transition may take a little more time. For at least a little while, our kids may need to go through these steps with each new food.
- Tolerating a new food: Before being able to touch or eat a food, we need to be okay with the food being around us. We have to be able to be in the same room as a food, then at the table with the food, and then have the food right in front of us.
- Interacting with a new food: Once we can tolerate the food being close to us, we need to be able to use a spoon or fork to touch the food, or pass a plate of food to someone else.
- Smelling a new food: After we can touch a container or utensil that has contact with the food, we can work on smelling it in the room, at the table, and on the plate.
- Touching a new food: After we've gotten used to the touch of a food, we want to get used to the feel of the food. We start by feeling the food with our fingers, then hands, then chin, nose, lips, teeth and finally tongue. This is a great time to have fun playing with your food!
- Tasting a new food: We start by touching the food to the tongue, without putting it fully in the mouth. We then move to biting and spitting out the food, then chewing and swallowing the food with a drink, and then chewing and swallowing the food by itself.
- Eating a new food: Hooray! We've made it to eating!
There are many steps to eating a new food, but with practice and exposure children can learn to eat more foods, making eating a more pleasant and relaxing experience for all.
From Kay Toomey, PhD, SOS Approach to Feeding