Help my child won't eat

I'm new to the site and although my son George hasn't been diagnosed as yet with ASD i would like to talk to someone about the difficulties i am faced with.

George has seen many medical professionals over the past 4 years and no one seems to be able to explain his disinterest in food and failure to thrive. I attend a support group mon and fri mornings and it was while i was describing Georges strange eating habits that someone suggested he may have ASD. We are in the process now of getting this looked in to.

George was born 2 weeks premature and never gained weight properly once he was on solid food he used to chuck the whole feed up he couldn't cope with the lumps. Even now he tends to stick to certain foods and textures he won't try anything new and although many ppl say he is just testing me or its a

phrase he will grow out of it, i know there is a problem preventing him from eating. George won't eat food if it looks strange or dodgy as he likes to put it.

I have tried EVERYTHING

Special plates and bowls with every cartoon character imaginable on

Eating as a family

Turning the tv off and sitting at the table

cutting food into shapes or trying to disguise it

BUT NOTHING WORKS!!!!!!

PLEASE if there is anyone who visits this site that has a child that doesn't eat and they too are at their wits end message me.

I hope to hear from someone who understands very soon as then i won't feel so alone

When developing a plan for expanding the number and variety of foods a child will eat, it is important to be calm and not controlling. In fact the most successful experiences are when the child is given some control or at least they perceive that they do have some control. Struggles over eating most often make matters worse. Gradual exposure to new foods can be very important. Frequently, in despair, mothers will offer a different array of several new foods each day hoping that by chance the child might try something. The more choices the more chance of success, sounds like it makes sense, but not for a child on the autism spectrum.

Gradually introducing a new food will help the child to become desensitized to the smell, look and possibly feel of an unfamiliar food. If a new food is chosen that has highly desirable sensory qualities to the child, you will have a better chance at success. Start with a food that has the “best” sensory fit. Offer the food on a daily basis by putting it where the child will be able to desensitize to it. Think of how your child might best accept a new item in his/her space. Frequently a small separate bowl or plate in close proximity to the child’s seat will work. Sometimes a child can tolerate the new item on his or her plate as long as they understand that the only expectation is that it will just stay on their plate. Repeated exposure of the identical food item should be offered once or twice a day, at meals, with no expectations attached. Sometimes this technique paired with others in the family, especially a sibling, modeling the enjoyment of eating this new item, can make it easier for the child to try tasting it. You may try the same food item for two or three weeks. For children who respond to Social Stories (Gray, 2000; Gray & White 2003), information can be offered in this format, at times other then mealtime. In the Social Story, focus on the wonderful benefits of trying this new food. Sometimes, in the Social Story, describing a favorite character like Barney or Spiderman eating this particular food gets them interested enough to taste it.

If desensitization, modeling and a social story have not resulted in the new food being tried, the strategy of offering alternating small bites of a highly desirable food with a small bite of the new food is another option. As always, it is important that this technique not be made into a battle. The idea is to make trying a new food as pleasant and successful as possible. This is a common strategy that is used for all children. The information can be made visual (by putting the different bites in view on the plate) along with the instructions “First favorite food, then new/undesired food, and then favorite food.” An example might be “First macaroni, then peas, and then macaroni.” Both of these approaches for introducing new foods are positive and non-threatening to the child. The child can feel like s/he has some control.

Children do not want to be tricked. Tricks such as hiding “extra” vegetables in spaghetti sauce and or supplements in a child’s favorite drink do sometimes work but can also backfire. Sometimes, after detecting “additions” to familiar favorites, the child learns to be suspicious of all foods and will limit his/her diet even further. This strategy probably works best when the sensory characteristic the child is focusing on is the “look” of the food. If a child is more sensitive to the smell, taste or texture of a food, it may be harder to make “additions” because they are usually easier for the child to detect. Be cautious when using this strategy.

The auditory sense is generally not directly related to eating and feeding issues. Indirectly sounds can contribute to the comfort of the actual environment where eating and feeding take place. It is very common for individuals on the autism spectrum to get overwhelmed in noisy and crowded environments It is important to accommodate individuals’ needs so that the environment itself is not preventing successful eating because of sensory overload. The sensory issues can also be a partial reason for this difficulty. Sometimes adaptations are possible and appropriate such as allowing the use of plastic utensils instead of metal.

let me know what specific help you need

In addition to the sensory properties of foods and the sensory stimulus in the environment affecting the child’s ability to eat in a particular environment, a third common issue is the ability to sit at a table and eat a meal with others. There are a number of reasons why this may be difficult. Eating at a table with others is a social activity. Eating may not be a very motivating or rewarding activity in itself. Pair that with the social issues involved in eating with others and you may begin to better understand the situation from your child’s perspective. Additionally, many of our children are active and have a hard time staying still in one place no matter what the activity. There are several possibilities to address when looking at the issue of sitting at the table with others to eat.

Determining the reason your child is not able to sit at the table will help in deciding what to do to address your child’s needs. Some children need to organize their bodies with a little physical activity before they are asked to sit at a table. Sometimes a timer needs to be set to show more concretely that sitting is expected at mealtime, at least for a few minutes until the timer rings. The length of time a child is expected to sit may be gradually lengthened so success is built up slowly. Some children can sit and eat quickly at the table but will not be able to sit and wait for others before being served and/or after they have finished their food. This inability to wait can sometimes be addressed with special waiting toys or activities. Sometimes items to focus on while waiting are helpful. Even some older children and adults on the autism spectrum have a need to develop waiting strategies to use at mealtime while eating with others. In this situation, bringing something to read or a pocket sized game to focus on while waiting, is a positive coping strategy for older children and adults, too.

Eating and feeding problems can sometimes dominate family life. It is easy to get overwhelmed when eating problems are severe and are so closely tied to your child’s health and development. The fact that mealtime occurs at least three times a day, and families and children are not always able to eat at home, adds to the stress. Get help for any biomedical and behavioral concerns. After those areas are addressed, families’ can often tackle the environmental factors by calmly working to desensitize the child to new foods with structure and a non-controlling plan for trying a new food. The expectation to sit and eat at the table can be structured in small steps and paced so the child is successful. Patience with this process is also a key to success.My advice with children is feed them whatever they will eat when they hungry not when we think it is eating time just give him the available options. If he is not hungry enough to rise above his objections, he will be later on. If a human gets hungry, enough they will eat pretty much anything digestible. Whenever the child wants to eat give, him as much as he will eat (provided it is not totally "junk food.”) the thought that people are supposed to eat particular amounts of food at particular times of the day just seems impractical to me. If the child actually withdraws from eating for a dangerous length of time then something needs to be done.

The physical demands of a growing child should produce more than enough hunger to overcome any personal dislike of food.

Also try separating the food instead of carrots and peas mixed together, prepare and serve them separately etc.

Some children will develop cravings for foods they need, so as a parent all you really need to do is persuade your children to eat an amount of various healthy foods a few times so their bodies can learn then whenever the body gets low on certain nutrients, it will send a message to the brain.

Keep junk foods and sweets relatively unavailable (or as reward foods for not making you tear your hair out) and just feed them as much as you can of whatever they will eat. I have noticed that I sometimes make rules about food as a way of limiting decisions I will have to make later

Post edited by: spectrummum, at: 06/24/2008 09:32

Introducing a varied diet

A child's willingness to adopt a varied diet is directly linked to two main aspects: a) the child's sensory sensitivities and b) acceptance by people in their surroundings.

If a child is very sensitive to certain textures such as soft', 'slimy', 'squishy', then he will naturally tend to avoid foods such as some cheese and egg preparations, or dal and rice mixtures. Each child's sensitivity is different and we need to be aware of types of foods that may be bothersome.

Once we are aware, since we also know that it is a part of their autism and they are not just being difficult, it becomes very important to be accepting. It will also keep us form forcing the child to eat foods that he cannot tolerate. As the child learns to be comfortable at his eating place and can feed himself, then one can begin to introduce new foods.

New foods must be introduced in extremely small quantities along with a much desired food. For example, if the new food is half a segment of orange, and the desired food is a biscuit, tell the child, "Finish orange, then have biscuit". Similarly with other foods also you can use phrases like "one bite, then biscuit", or "eat orange, then biscuit, etc. With children whose ability to tolerate is very little, you can even begin by asking the child to "take one lick" or "taste once" and then promptly allow him to receive the favoured food. Each time the child tries even the smallest bit of a new food, cheer and praise him as if he has won an Oscar. Let him know that you feel proud that he has done so despite his difficulties.

The child may or may not try the new food. Sometimes he would rather skip the favoured food than consume a bothersome food. Don't let this discourage you. Keep trying again and again with different foods. If the child feels accepted and understood, he will make the effort to try a bit.

Another method of encouraging new foods is that at mealtimes put tiny pieces of undesired foods on the child's plate. There is always the possibility that he might try it. If he does, praise profusely. If not, make no comment, but try again some other time. Sometimes when the child does pick up and eat a new food it excites those around him, and he is immediately given more and larger pieces of the food. This is best avoided. Unless the child requests more, wait till the next mealtime to serve him more.

These methods need to be tried in many different places at different times so that the child learns to eat a varied diet, making mealtimes easy to deal with.

Teaching the use of spoon and fork

There are children who are unable to use their fingers to eat soft squishy foods. Many families in such situations, who in the normal course do not use cutlery, often provide cutlery for their autistic member. Additionally, families that make it a practice to use spoons and forks and knives during a meal will want to teach their children to use them. We move to teaching this behaviour only when the child is very comfortable feeding himself and has enough gross motor control to hold the spoon steadily. Initially the teaching will be hand on hand. Mould the child's hand over the spoon in the appropriate manner and then holding the child's hand, gently but firmly, maneuver the spoon to pick up a small quantity of food and move it to the mouth. Use foods that are not completely dry and that will not slide off the spoon. Repeat the action as often as required until you feel the child gripping and moving the spoon on his own.

Now you can slowly begin to fade your grip and just prompt the child to hold the spoon. With many children this prompting may even not be required. Again, plan and prepare the physical environment in such a way that the child is easily successful even in the mildest attempt to perform the task on his own. For example, pull the chair right up to the table, have the plate almost directly under the chin so that the food is closest to the mouth and a mess is avoided. Use a spoon that is a size appropriate to the child’s ability to manipulate objects, use plates that will not allow the food to spill over while being pushed around by the spoon. Also make sure that the sides are low enough not to obstruct the movement of spoon to mouth.

The use of a fork needs to be taught with a little more care because of its sharpness. Hence with younger children, a spoon is a better idea.

Again, as often mentioned, autistic people have difficulties in generalizing skills, i.e. just because a child can use a spoon at the table in his own home does not necessarily mean he will and can do so in restaurants, parties, other homes, etc. Therefore each skill taught needs to be reinforced in many different settings to help the child generalize the newly gained ability.

Dealing with undesirable behaviours

a) Eating too fast: Many parents say their children stuff their mouths with food or eat too fast. In such situations, explanations and demonstrations are not as effective as physical prompts. Sit with the child and place a hand gently over his during the times his mouth is full. If the hand is lifted before the food is swallowed, put gentle pressure on the hand to indicate a "wait" sign. This could be supported with a short instruction, "finish swallowing". Some parents have used 'stop' signs that they hold over the plate while the food is being chewed, some hold a written instruction in from of the child that says "finish swallowing before taking next mouthful". As a parent and caregiver, you know your child best, so try different ways and you are bound to find one that will work. Always remember to stay comfortable and accepting of the impairments of the child's social skills.

b) Overeating: This behaviour can easily be brought under control by structuring the physical environment in such a way that at all other times except mealtimes, food is out of sight and out of reach. In many homes, autistic children eat because they can't think of another way to occupy themselves. So apart from putting away food (locking cupboards and fridges, if necessary) leave items of interest around, like books, puzzles, etc available for the child to use when desired.

Aside from this, if the child during meal times finds himself unable to figure out when to stop, then that will have to be taught to him. Serve less food to start with. Have only enough for a certain number of helpings, i.e two or three for each person present and tell the child "You can take once more when you finish". When the child is taking his second helping, tell him, "This is the last time" and when he finishes, say "Finished, time to eat is over". Statements such as these must be followed through even if the child asks for more. Learning not to overeat is an important social skill.

c) Use a timer: Set the alarm for 10-15 minutes later, depending on the speed at which the child eats, and tell the child "when the bell rings, eating time is over". When the alarm actually goes off, gently and quickly remove the plate so that the child makes the connection between the two. Avoid reprimands. Reprimands only stress out the child and make it more difficult for him to learn.

d) Crying at such times: Some children may cry or show other undesired behaviour at such times. These attempts to get their way must be ignored completely and with comfort.

e) Eating only junk food: Junk food such as chips, Pepsi, crunchics, etc are high energy producers and are not good for any child. Thus to teach them to eat other foods, methods similar to introducing a varied diet may be used. In such cases of course, junk food may be used as a reward instead. Sometimes children are given a soft drink or a bag of chips while the family is busy or has visitors to keep the child busy and out of trouble. This is not a good idea; besides teaching the child that if he or she is disruptive enough when there are visitors he is rewarded with a bag of chips! Occupy the child in other ways using things that interest him.

f) Eating inedibles: Children with autism lack the social skills that refine eating habits as they grow older. At an early age all children explore tastes and textures orally. Due to developmental delays, this form of exploration lasts way beyond the expected time. After a certain age, parents and caregivers begin to get concerned with this perfectly normal aspect of development and try to stop it. The child learns that this behaviour is exciting attention and because he lacks the social skills to know appropriate ways of getting attention, he tries this behaviour.

To avoid turning this behaviour into one that is challenging, we need to comfortably ignore it right from the start. It will phase out if no attention is given. Some children may use this method of exploration for a longer period than others, but will definitely grow out of it sooner or later.

Sandra Dawson, Open Door

shell

BIG thank-you for your advice and for posting back so quickly i wasn't even too sure if i had posted my request properly.

I will try some of your suggestions and let u know how i get on!!

I watched a television programme last monday evening entitled Help my child won't end hence the name of my post. It followed 3 families for 6 months those children refused to eat certain types of food. There was a 12 year old girl featured that lived entirely off wotsits and cadbury chocolate fingers her parents had given up trying new foods and it took a couple of sessions with a feeding expert at Birmingham hospital for her to try toast, she was on the autistic spectrum.

George is so picky that i ask him what he would like for dinner and i dish it up and then he point blank refuses it.

We have been seeing dietician for sometime now but she must give the same advice to every parent whose child doesn't eat. Its difficult to know what the best thing to do is especially when everyone assumes it must be my fault that he doesn't eat!!

Do you know anyone on this site that has the same problem as George?

Zoe x

I only eat chips thats it sometimes I change slightly and that fad goes on for months years ,My non verbal five year old only eats toast my aspie only eats cereal and toast.

so yes we all have or had this problem at some point.

For me it is not only texture it is also smell also if i see where the food comes from I will not eat it.

shell

Post edited by: spectrummum, at: 06/24/2008 14:40

Post edited by: spectrummum, at: 07/01/2008 15:14