Improving your autistic child’s diet is a challenge for so many families!  

The pediatrician says “Only offer what the rest of the family eats.  They’ll eat when they get hungry enough.”

Your mom says you went through a picky phase and now you eat everything so not to worry.

But you know that every meal time is going to be a struggle.  

Every meal time you have to chase them down and try to get a few bites in.

Or you just give them what they will eat – an applesauce pouch, granola bar, and goldfish crackers.

I covered a lot of information over the past month to help you set the stage.  Today I’m giving you 3 strategies you can use to help your autistic child eat new foods.

Make sure to read about medical issues around eating, how to get rid of some common mealtime behaviors, and how to set up a mealtime schedule BEFORE you decide on a strategy. 

You can pick a strategy that sounds great to you, but it’s going to be hard to do if you haven’t tackled these other factors first.

Disclaimer:

As I’ve mentioned in my previous posts, I am not a feeding expert.  I cannot assess oral-motor skills or other physical/medical factors that influence your child’s eating skills.  I am qualified to discuss how to set up mealtime routines and schedules, decrease challenging behaviors, and give strategies on how to introduce new foods.  However, if your child is showing any of the symptoms listed in this post or is showing extreme behaviors, you need to contact medical and behavioral professionals that are familiar with the specific needs of your child and family.  This is also necessary to make sure your child is safe to eat foods you want to introduce and is physically supported when sitting to eat.

Learning to Eat New Foods is a Skill

The goal of any strategy you choose is to get your child to eat new foods so they have a more balanced diet.  

Your child will eat several foods from each food group.

You know they’ll be able to eat some of the foods offered at home, school, daycare, and restaurants.

As a 40 year old adult, I still lock into what I like and stick with it.  But, there’s enough variety in my diet that I can usually find something I like wherever I go.

Your child may stay more of a cautious eater, but we want them to have somewhat of a variety so you don’t have to panic if that one particular brand of cheesy chips isn’t at the store that week.

And remember – this is going to take some time like learning any other skill.

We didn’t learn how to walk, talk, tie our shoes, do algebra, etc. in a day (or even in a couple of weeks).  

Be patient with yourself and your child and appreciate the small wins!

Before Focusing on Eating New Foods

One of my favorite books about feeding is Broccoli Boot Camp by Keith Williams and Laura Seiverling.  Before getting started on any intervention, they suggest thinking about several factors first.

Your Life Right Now

• How much time do you have right now?  Changing your child’s diet takes patience, time, effort, and consistency.  The strategy that you start with needs all of that in order to be successful.  Additionally, if you have other big life changes happening right now or very soon (new baby, moving, potty training, sleeping through the night, etc.), making other big changes may be difficult.  Of course you want to improve your child’s diet, but if you just moved into a new house or had a baby a couple of weeks ago, it’s ok to give yourself (and your child) time to adjust to these changes first.
• Do you have help?  It’s going to be really helpful if your spouse, partner, mom, etc. is available to help you.  It’s not a must, but it’s great to have someone supporting these changes and helping you follow through.
• What have you tried before?  Can you think of some reasons that your child’s eating seemed to improve before?  Did anything work previously?  Did it work for a while and then stopped?
• Have medical issues been addressed?  If your child has any chronic medical conditions, these can definitely affect eating.  Talk to your child’s pediatrician and other professionals involved with your child’s care to help address these.

What to Have Established First

• Is your child drinking water?  All of the strategies that we’ll discuss will limit access to drinks other than water and foods in between meals.  It’s important that your child will drink water (flavored water is ok) so they stay hydrated and you don’t have to worry about constipation.
• Can your child sit at the table to eat?  Decide where you want your child to eat and keep foods and drinks limited to that area.  
• Have you set up a meal time schedule?  If your child is used to grazing and drinking juice and milk throughout the day, they don’t ever feel hungry.  If they don’t have an appetite, it’s going to be very hard to get them to try new foods.
• Choose what works for your family.  There is not a one size fits all for eating.  You are the expert on your child and you know your life!  You’ll need to make changes to your current routines in order to change your child’s diet, but pick what works best for you!

Option 1:  New and Preferred Foods Offered

This is a great place to start and is one that families usually feel comfortable with.

It’s also nice for kids that are new to sitting at the table and having to tolerate new foods near them.

Here’s what’s involved:

• Foods and drinks (other than water) are only offered during your set meal/snack times.
• Meal and snack times happen in a designated area.
• Set a time limit for meals and snacks (start with a shorter time and increase as your child can sit at the table for longer periods of time).
• Offer a couple of foods your child already likes and 1-2 that you want your child to try every time your child eats.
• Start with a very small portion of the new food (size of grain of rice or large crumb).
• Eat the new foods in front of your child and talk about how they taste.
• There’s no requirement for your child to taste the new foods.  
• Ignore fussing, whining, and other minor behaviors.
• Praise your child for tasting the new food.
• Let your child be done when the timer goes off.

The downside of this plan is that your child might only ever eat the foods they like, however, it’s a good starting place.

Option 2:  Small Changes to Preferred Foods

This plan has some of the same components of the first option, but it’s geared more towards kids that are REALLY locked into what they like and how it’s presented.

Here’s what’s involved:

• Foods and drinks (other than water) are only offered during your set meal/snack times.
• Meal and snack times happen in a designated area.
• Set a time limit for meals and snacks (start with a shorter time and increase as your child can sit at the table for longer periods of time).
• Choose 1-3 of your child’s favorite foods (or other routines) and decide on a small change to make.
• Examples: 
  • Same juice, different colored cup (apple juice in a blue cup instead of red)
  • Different brand, same flavor of yogurt (vanilla yogurt but different brand)
  • Same food, different person preparing the food (dad gets food ready instead of mom)
  • Same food, offer with a dip (chicken nugget offered with ketchup)
  • Same food, different flavor (Cheddar chips instead of plain)
  • Offer two foods your child likes at the same time (tortilla and beans)
• Praise tasting the foods/drinks in the new way.
• There’s no requirement to eat or drink the new food.
• Ignore minor inappropriate behaviors.
• Let your child be done after the designated time is up.

Our big goal is that your child will eat several foods from all of the food groups, not 17 different kinds of chips.

However, if you know your child needs time to adjust to even small changes, start there.  

Once a new small change or two is tolerated, move on to another 2-3 small changes.

Option 3:  New Food + Reward

In order for kids to taste and like new foods they have to have repeated exposures.  

It’s common for us to give a bite of mashed potatoes and, when our kid spits it out, we say “Oh, well, they don’t like mashed potatoes.”

However, many of our kids (especially those with feeding difficulties), may need 15-20 exposures before they are comfortable enough to put something in their mouth.

In Broccoli Boot Camp, the authors use “taste sessions.”  

Some of the components are the same as the first two strategies:

• Meal and snack times happen in a designated area.
• Set a time limit for meals and snacks (start with a shorter time and increase as your child can sit at the table for longer periods of time). 
• Praise tasting the foods/drinks in the new way.
• There’s no requirement to eat or drink the new food.
• Ignore minor inappropriate behaviors.
• Let your child be done after the designated time is up.

However, with this plan there are some changes:

• Taste sessions are short (maybe 5-10 minutes) and are offered throughout the day.
• Make sure your child hasn’t eaten for at least one hour before a taste session.
• Choose 3-5 items that are very motivating to your child right now (foods, toys, activity, song, etc).
• Write down up to 15 foods you’d like your child to eventually eat.
• Choose 2-3 foods from that list to use during your taste session.
• Cut those foods into very small pieces (big crumb or grain of rice size).
• Your child can pick up the food with their fingers or with a spoon/fork.
• If they taste a bite of the new food, they immediately get the reward you’ve chosen (bite of favorite food, watch 5 seconds of a video, etc.)
• If they don’t take and eat a bite of the food, that’s ok!  They don’t get access to the reward, but you’re not forcing or demanding them to try.
• Keep this up for 5 minutes or so (whatever your child can handle).  
• When the timer goes off, the session is done.

This is a good option for kids that are doing well sitting at the table and understand the meal time schedule, however, they aren’t eating any of the new foods presented to them.

As your child starts eating some of the newer foods, you can gradually increase the size of the portion offered.  You might go from a grain of rice to the size of a pea and so on.

Rotate through your list of foods you want your child to eventually eat.

This option can be a little time consuming since you do it multiple times during the day, but it’s a great structured option and works well for some families.

Some Do’s and Don’ts for Eating New Foods

• Do

  • Start when you have time to focus on your child’s feeding.
  • Make small changes.
  • Use specific praise when your child eats a bite (“Wow!  You ate the banana!  That was great!”)
  • Sit with your child and model how to eat the new food.
  • Pick one strategy and stick with it for at least 2 weeks before changing.
  • Bring preferred foods when you’re out of the house.  Make sure your child has something they’ll eat at the restaurant, grandma’s house, etc.

• Don’t

  • Make big changes.
  • Be sneaky about changes (the changes need to be small but obvious to your child).
  • Threaten, beg, or demand your child try the new food.  
  • Make comparisons about your other kids (“Your brother always eats his carrots.”)
  • Beat yourself up!  Things are going to happen.  Certain days won’t be perfect.  Be consistent with your schedule and routine.  Provide new foods and/or taste sessions on certain days.

Wrapping Up Feeding

Feeding is complicated and there isn’t a one size fits all rule.  

Additionally, it’s something that takes time and patience and a team.

Always rule out medical issues for your child’s pickiness first!

Then move onto setting up your mealtime schedule and teaching your child where they are supposed to eat.

Get rid of grazing!

At this point, you’ve already got several huge wins!

When you’re ready, these three options can help increase the amount of variety in your child’s diet and help them move towards eating more balanced snacks and meals.

Questions about any of the strategies?  Leave a comment below!