Struggling With Meals

It is normal for a child to go through a stage during which food does not appeal as much as a parent would like it to. According to a study conducted by the American Association of Pediatrics, eating problems are common in toddlers and associated with normal growth. Notably, it states that drinking too much milk may be the cause of a lack of appetite during mealtimes (Wright et al., 2007). However, in children affected by an Autism Spectrum Disorder (ASD), a loss of appetite is more than a stage of selective eating.

Autism is a complex disorder that is accompanied by sensorial problems (Ackerman, 2003). Children affected by this disorder manifest restricted and repetitive patterns of behavior. Nutrition deficiency is a common problem in children affected by ASD. According to studies, children with ASD had significantly more mealtime problems than their siblings living in the same social environment (Nadon et al., 2010). A good example would be a child throwing a tantrum because his meal was not served in the usual blue plate his meal has always been served in, or a child refusing to eat because his usual “crunchy fried chicken” was not crunchy enough. Autism also causes restricted choices in food. Your child may want to eat foods that are sweet and reject all other taste forms. These examples demonstrate breaks in a child’s routine and, as a result, bring about outbursts of unpleasant behaviors.

Behavior analysis shows that children with ASD (Linscheid):

• have increased anxiety associated with new food, and become phobic of that food;
• are more likely to cry and scream when new food is presented, because that behavior is rewarded by anxiety reduction; and
• are less likely to be offered new food by their parents because they do not want to see the child distressed.

Bringing nutrition to your child’s daily diet can be challenging but here are some strategies you can use to alleviate picky eating in your child with autism:

• Observe and record when and what your child eats the most. This includes tracking the time your child is most hungry, type of food consumed, the temperature of food, food presentation, the texture of food, and taste (sweet, salty, sour, bitter, spicy) of food.
• Try and incorporate nutritious food such as vegetables into your child’s favorite food. Placing vegetable bits in spaghetti is an example. But be very careful in doing this, because when your child notices the difference he or she might refuse to eat altogether – worse, your child will suspect all food and will not eat even his favorite food.
• Gradually introduce new food to your child by:
•  Placing different kinds of new food in small bowls in front of your child – a bowl of apples, carrots, peas, potatoes, and so forth – and observe what your child eats the most.

• Trying to introduce new food with the same texture your child prefers in his food. If your child consumes more liquids than solids, try and introduce healthy shakes to your child, such as carrot shakes.

• Presenting new food in fun ways, such as cutting carrots in different shapes or making car shapes out of vegetable pieces.
• Using video modeling, social stories, and picture cards. Having your child watch Barney eat vegetables or talk about fruits may help encourage him or her to eat more healthy food.

References:

Ackerman, L. (2003, September). Picky kids, eating, and autism. Retrieved April 22, 2011, from http://www.tacanow.org/family-resources/picky-kids-eating-and-autism/

Wright, C., Parkinson, K., Shipton, D.,  & Drewett, R. (2007, October). How do toddler eating problems relate to their eating behavior, food preferences, and growth? Pediatrics, 120 (4). Retrieved April 22, 2011, from

Nadon G., Feldman D.E., Dunn W., & Gisel E. (2010). Mealtime problems in children with autism spectrum disorder and their typically developing siblings: A comparison study. Autism 15 (1), 98-113.

Linscheid, T. (n.d.). Pediatric Feeding and Swallowing Center. Picky eating in children with autism and how to treat it. Retrieved April 23, 2011, from http://www.chop.edu/export/download/pdfs/articles/pediatric-feeding-and-swallowing/picky-eating-in-autism.pdf

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