There are ways to support picky eaters and children who refuse new foods. I’m back with Dr. Dolezal further discussing feeding challenges for children with Autism Spectrum Disorders (ASD). The first post explored why children with Autism have challenges with eating (almost 90% do). I often say that a typically developing child will not starve with a full refrigerator, but this advice just doesn’t hold up with ASD children. I love Ellyn Satter’s advice and mission in helping adults and children be joyful and confident with eating. Her resource and guidance inspires a “division of responsibility” that basically a parent’s role is most simply to provide great healthy food and a child’s job is to choose what and how much of it to eat. But we have to acknowledge that parents to children with ASD need more information about challenges and often far more support. Here are Dr. Dolezal’s 6 tips to help a child with autism, or any child who choses to eat only a few, certain foods, eat better.

Children who graze are really not open to trying new things. — Dr. Dolezal

6 Tips To Help Your Child With Autism Eat Better

  1. Create a big team for your child. A team can conduct good assessment surrounding your child’s feeding struggle. Your child’s team should include your PCP, Pediatric Dietitian, Occupational Therapist/Speech and Language Pathologist (OT/SLP), and a Child Psychologist or Behavior Analyst. Help your team work together if they are not all under one roof. Sounds like a lot of people (!!) but after learning with Dr. Dolezal, I can’t endorse getting multiple people to help enough. You’re not overdoing it when you do this. You’re not…
  2. Get in a class for feeding support! Here at Seattle Children’s there are parent classes at the Autism Center specifically for feeding disorders in which expert team members go more in depth about the factors that contribute and maintain feeding issues and next steps to take for treatment. These are offered monthly and available to parents if they choose. Some are even available online. If you’re not in the Seattle area, ask your pediatrician what center is near you with similar resources.
  3. Get a psychologist to support your child and family. There are many excellent OT/SLPs in the community, but this phenomenon in sameness and feeding challenges have a strong psychological thread that also needs to be examined and treated by mental health professional trained in challenging behavior and anxiety. Please consider adding a psychologist to your team to help evaluate your child and think on interventions for what is next.
  4. Constipation. About 88% of children with Autism Spectrum Disorders and feeding difficulties struggle with chronic constipation. Dealing with the frustration of constipation and the challenge in treatment is a marathon, not a sprint. If your child also struggles with stooling issues, please work with your PCP for regular follow-up and management of this struggle. If you have ever been constipated you know eating is not high on your priority list, let alone trying new foods. Children with constipation will not have as big of a drive to eat. Treating the constipation (likely for months) will help increase interest in food exploration!
  5. Work with what you got. In other words; keep your children on a regular mealtime schedule with meals being spaced 2.5 to 3 hours apart. Also think about balanced combinations of foods you offer and rotate through your children’s preferences. For example, offer a protein/carb entrée with a side of fruit/vegetable. Consider your fats and proteins to help your child make it from one meal to the next to prevent grazing. Children who graze are really not open to trying new things.
  6. Start where your child is.  Dr. Dolezal emphasizes in the podcast and in her work that you start where you are and then stretch slowly and in small increments from there celebrating each new occurrence of flexibility and growth. Praise new foods and new habits! She wants you to have support in your family to begin to conduct “adventure bites” at home with increased structure and use of positive reinforcement. This can help tremendously to expand diets. Keep encouraging more and more adventure bites as time goes on and don’t give up on them even when children stutter in their progress.

Nourishing our children is one of the most joyful things we do as parents and this can be enormously challenging and emotional when it doesn’t go well. Seek extra support if you’re struggling in helping your child eat and do know you’re not alone in this challenge. In time, and sometimes with lots of help, this will and can get better for you all…

Please leave comments or questions if we can help you.