Parent’s Guide to Feeding Behavior in Children with Autism
Trying to introduce a child with autism who is a picky eater to new foods or transitioning from pureed foods or a bottle can be difficult and frustrating (for both the parent and the child), but can be accomplished.
Now, I would not call myself a feeding therapist. However, with my experience as a Registered Behavior Technician for over 10 years, I have had the opportunity to attend many seminars, trainings, and workshops led by some of the top feeding therapists around. I have learned excellent techniques which I use on my clients who are all on the spectrum and I have a very high success rate. Majority of the clients I provide ABA services to tend to have feeding issues. The clients I am speaking of DO NOT have any problems with chewing or swallowing. I only do this for children who have a very limited diet.
There are quite a few techniques, but the two I use regularly are: Rewards and Planned Ignoring. They go hand in hand.
Rewards are exactly what they sound like. In the beginning, I reward my students for every little thing they do that pertains to only trying the food. That could be just picking up the fork/spoon or just opening their mouth and acting like they are going to try it (even if they close it back without any of the food going in) or just sitting at the table. I reward every little thing! I do this because the more they see that I am rewarding them for their appropriate behaviors, the more they begin to feel comfortable with me. Eventually, they trust me and finally open up and allow me to put the food in their mouths. When I put the food in, I do it quickly and put a small amount (this is done to avoid overwhelming them). I put just enough for them to be able to taste it. The rewards I usually use are their favorite toy or my personal favorite—exaggerated praise! That consists of tickles, high fives, screams of excitement, etc.
I use planned ignoring when the child is having a tantrum (more than likely, to get out of the feeding). I do not react to the meltdown. I keep the child at the table, confirming they are safe, and let them cry and scream. Often, children with autism engage in screaming and/or crying in order to get out of something they do not want to do. I know the child is in no harm, so I ignore this behavior. I keep the fork, spoon, or my hands with the food near the child’s face. Yes, sometimes I need to use my hands to get the food in the child’s mouth, as a fork or spoon may not be convenient.*
And, of course, when they eventually stop and/or just allow me to get the food in their mouth, I will reward them.
As you can see in the video, the child is not having a meltdown, but she is trying hard to avoid the food. It is also a great idea to pair the new food with something they currently eat. In this case, the child enjoys eating chicken nuggets, therefore I paired the new food with chicken nuggets. I also chose to give her control of the spoon, even though I still held on to it. Letting her hold the spoon allowed her to have a sense of control over the feeding process. She was able to smell the food which also gave her a chance to explore what she was about to eat. I did not want to overwhelm her with too much food on her fork, which is why I took some off. When I took some off, she was willing to try more. I did not reward her for every try because we had been working together for quite a while, so I knew she would eventually try it. I did give her praise with hand claps and tickles which she loves, and I gave her an Oreo, which is her favorite snack. Even if she did not finish the food, I would have still given her the rewards just for trying.
Feeding can be very challenging, frustrating, and time-consuming. You as a parent may also want to have a meltdown but please hang in there. These behaviors do not usually last long. Again, your child has developed a habit of getting out of things they do not want to do by having meltdowns. As soon as you learn to ignore those meltdowns, while ensuring your child is safe, you will begin to gain more control over your child and will become more successful with increasing their compliance and cooperation. Crying is okay, as long as the child is not in any pain or danger. Allow yourself a great deal of time when teaching your child to try new foods. You could even allow your child to explore the food by letting them touch and play with it.
Please be patient and do not give up. You can get through this!
*Sometimes, the utensil itself is scary to children therefore it may be better to use your hands for feeding purposes…of course, you must use your better judgment at that moment to determine what works better for your child.
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