Faddy diets are a common feature of autism and a potential source of anxiety among parents and carers. How can parents vary the limited menu a child will tolerate? We put this
common query to our panel of experts.
Clare Jones is a Nutritional Therapist based in Manchester.
Autistic children very often restrict the number of foods they eat and find it hard to make changes to their diet. A number of possible factors may be involved:
• A heightened sense of taste and smell, making some foods unpalatable
• A dislike of the texture of some food or the temperature at which it is served
• Digestive problems or food allergies
If digestive problems or allergies are an issue, your son may fear an unfamiliar food may give him tummyache or other unpleasant symptoms. If you want to encourage your son to try
new foods, start by making sure that the foods you want to introduce are not likely to contribute to any allergic reactions: this is a complicated area so it is advisable to get professional help with it. Any changes should be introduced slowly: only one new food at a time and don’t lose heart if it is rejected at first.
Julia Dyer is an independent physiotherapist and advanced sensory integration practitioner
based in Clitheroe, Lancashire. For details look up www.juliadyer.com or call 07752 365 487
Many children with autism have problems processing sensory information and this may be
contributing to your son’s restricted diet. Fussy eaters with sensory based feeding problems restrict their diet as a result of their difficulties with processing sensory information. For
example, a child who is over responsive to touch may not like the feel of a spoon in their mouth or the texture of food. Children may be over responsive to the smell of food or the taste of food or they may be under responsive in certain sensory systems.
These sensory problems can then lead to the child having a very restricted diet.
The first step in forming strategies is to discover if this is a sensory based feeding problem and then to identify the sensory systems involved. Sensory strategies can then be put in place to
address the sensory issues. For example, I worked with a young boy who was over responsive to tactile input and his diet was restricted to three dry foods (toast, crisps, crackers). By
addressing the sensory problem, through therapy and a sensory diet at home, he is now extending the types of food he will eat.
Dr Luke Beardon is a Senior Lecturer at the Autism Centre, Sheffield Hallam University
There are two main possibilities here (possibly both) that may be at play: a powerful inherent (and logical) drive not to steer away from the familiar and sensory hyper and/or hypo sensitivities.
In the first instance it is often best to go for an extremely gradual exposure to new experiences taken at a pace suited to the individual. One additional pea a week is fine! And one pea followed by nine mouthfuls of a favourite foodstuff is better than no peas at all. Golden rules – eating is necessary to survive, but a restricted diet is not the end of the world – it’s a balance between potential distress (mental health) and the perfect diet (physical health). The former is just as important as the latter, if not more so. Sensory issues are about perceptual reality. Just
because you can’t taste colours, for example, it doesn’t mean someone else can’t. Check out
literature on synaesthesia* for more info. Also think about whether food is touching other food, what shape it is, what texture it is, what temperature it is – most people assume it’s all about taste, but think of all the other senses as well.
And, the bottom line – if you find food that is accepted, great – it doesn’t matter if the range is
nowhere near as much as other people’s. Sometimes, variety sucks.
*Synaesthesia could be described as a joining of two or more of the senses. For instance, experiencing colours when hearing or seeing
Katie Moizer is a Chartered Clinical Psychologist who provides specialist services to children with autism and their families both for the NHS and independently.
It may be reassuring to hear that on many occasions I have been surprised to hear that children manage to take in enough essential nutrients despite having a restricted diet, but this is something that should be explored with a trained professional, like a paediatrician or dietician.
Your GP is the best person to see in the first instance.
Assuming that there are no medical or physical causes for your child’s restricted diet, in my clinical experience there are a number of commonly occurring explanations for restricted diets in children who have autism - sensory issues, dislike of change or increased attention to detail.
It might be helpful to make a list of all of the foods your child will eat happily and then have a think about any similarities between them, like whether they are similar in colour, texture, smell and whether your child has a preference for hot or cold food, to using cutlery or his hands to eat, or to one particular method of cooking.
Mealtime diaries can be excellent ways to spot trends in your child’s existing eating habits. Make a note of the date, day and time your child ate; where he ate and whether anyone else was there; what the environment was like; how the food was presented; what they ate and how much.
Try hard not to get stressed and do not punish your child for not eating what you offer! Your approach and attitude to mealtimes can have a huge impact on your child’s inclination to try new foods. It’s really important that your child associates mealtimes as pleasant and relaxed experiences.
Children are more likely to try something new if it’s familiar to them. It’s important that he sees others handling and eating that food. You might start by shopping for the food with your child, showing it to them and naming it on a few occasions. You could then involve him in preparing meals with you. Then you could serve it up for family members to eat and when someone does eat it, praise them for doing so.
Try to make sure that the ‘conditions’ around mealtime (e.g. using preferred cutlery, preferred
background noise etc.) are right for your child before introducing him to something new. Your
diary entries should help you to do this.
If you suspect that the appearance or presentation of food is very important to your son, always keep this in mind. Gradually introducing your child to a new food is another option. You could start by just having a small piece of food on the table and when he is
able to tolerate this, move the food a little closer to your son’s plate. Then you could try putting a small piece on his plate without asking him to do
anything with it. If he manages to do this for a number of days, ask him to touch it, then to smell it, then to put it to his lips etc.
Reward charts can motivate your child to try new things, provided they are able to understand their purpose. Targets should be worded in a positive way and be short and to the point e.g. to keep a little bit of carrot on your plate. The reward should be given as soon as the child achieves the target.
This way they know exactly what it is that they have done that was so great and are more likely
to do it again.
FURTHER READING
Just take a bite! Easy effective
answers to food aversions and
eating challenges.
Author: Lori
Ernsperger
and Tania
Stegen-Hanson
£15.95 excl. vat,
available through
the NAS website
at www.nas.org.uk