Many children with and without autism are picky eaters, and some even have serious feeding disorders, which need to be treated by medical professionals. In these circumstances, a thorough evaluation at a feeding clinic may be needed, but there are a lot of kids that can be helped at home or at school, so today I’m going to give you 7 picky eating strategies to help picky eaters start to eat better.
Each week I provide you with some of my ideas about turning autism around. So, if you haven’t subscribed to my YouTube channel, you can do that now. Before I was a Behavior Analyst, I got some training on feeding from top experts at Children’s Hospital in Philadelphia when my son Lucas attended a 10-day outpatient feeding program there for his extreme picky eating that ended up being a feeding disorder. In the past two decades, and after becoming a Behavior Analyst in 2003, I’ve had many clients with picky eating, and some with eating disorders. This enabled me to get a lot more training in this important area.
What do autism eating problems look like?
I had a client one time, I’ll call him Zach. He was six years old. I saw him at school only. He had some basic early learner skills, such as manding and some imitation and touching body parts. He was potty trained, and I saw him eat some food in the classroom. I saw him eat corn chips and in the cafeteria, I saw him eat french fries. His mom came in to meet with me, and we were going over some of the issues he was having at home. When I asked about his food intake, she told me that the only way she got any fruits, vegetables or protein into him was through baby food. Remember, he’s six years old at the time and can chew and swallow fine because I’ve seen him eat corn chips. I tried not to act shocked. I’m like, “Oh, okay. How much baby food are you giving him?” She said, “52 jars a week.” This was shocking.
I also had several two-year-old clients over the years with problematic eating. One boy who only ate gluten-free crackers and drank almond milk out of a bottle. That’s it, morning, noon, and night. And another two-year-old, who was okay with finger foods, but screamed with anything mushy that was presented on a spoon. Lucas and all of my clients with significant problem eating also had something else in common. They all had problems talking. Both of the two-year-olds I just mentioned, the boy with the bottle and the gluten-free crackers, and the boy who couldn’t tolerate mushy food being on a spoon, were both completely non-vocal.
You may be wondering what you should do to help a child with picky eating, so I’m going to give you seven strategies now. But if your child or client is not growing or gaining weight normally, has trouble chewing or swallowing, and or cries during meals, even after you implement some of these easy strategies, you’ll need to get professional help to complete an individualized assessment and plan. The following seven strategies are just skimming the surface of a comprehensive ABA program that needs to include a full assessment and a plan in all areas, not just feeding, which I cover in my online courses. These seven strategies may help picky eating, but should not be considered professional behavioral or medical advice.
Strategies to improve autism heating habits
Strategy #1: The first step in changing any behavior is to do a baseline assessment. That might sound scary if you’re a parent, but all it means is for three days, write down everything your child eats. If it’s 10 chips, if it’s four ounces of 2% milk, write it down and be as specific as possible. This assessment may also help you determine if you have a more serious feeding issue on your hands that will require more professional assistance.
Strategy #2: During your assessment period, also make 3 lists of foods your child will eat consistently. If your child eats only certain brands but eats them consistently, write that down in the left-hand column and we will call those easy foods. In the middle column, write down foods your child has eaten in the past month or two but doesn’t eat consistently. We’ll call these medium foods. They may be different brands of the same easy foods on the left. And in the right-hand column, write down the foods you would like your child to eat, but they have no ability to eat at this time without fighting. Those are hard foods. For now, I would feed your child only things from the easy list.
Strategy #3: Your child should eat all the snacks and meals at the table. No sitting on the sofa eating cereal or grazing on food while walking around.
Strategy #4: Switch snacks or meals to increase nutrients as much as possible. Obviously, one cup of vegetables would have more vitamins and nutrients than two cookies, but if your child has any vegetables on the easy list, we would want to be offering these very frequently within meals and snacks throughout the day.
Strategy #5: Limit snacks between meals, especially one hour before and one hour after meals. Remember, those snacks need to be at the table too.
Strategy #6: In addition to serving food at the table only, don’t allow your child to walk around having access to juice or milk in a bottle or sippy cup, and allow only water throughout the day. Drinks with calories will fill children up, and they won’t be interested in food, especially food that isn’t highly preferred. You want to limit juice or milk and serve only at the table in a regular cup or a cup with a straw. Eliminating sippy cups, bottles, and pacifiers may be a necessary step to use this strategy. I did a blog about getting rid of bottles and pacifiers a few months ago, so you may want to check that out now.
Strategy #7: gradually start presenting medium foods in between the easy foods and then eventually weave in some harder foods as well.
In summary, to overcome picky eating in children with autism, I would recommend doing a 3 day assessment, making easy, medium, and hard lists on one sheet, having all meals and snacks and drinks with calories, except for water, at a table. Making snacks and meals as nutritious as possible, and working with your child to ease in harder foods along the way. Also remember that if your child is having feeding problems, he’s probably also having issues with other oral motor skills such as talking, following directions, imitation, play, and maybe having a lot of problem behaviors too. All of this needs to be addressed, and the best way to start is by downloading my free three-step guide now. If you’re watching this video blog anywhere other than MaryBarbera.com, hop on over there, leave me a comment, give me a thumbs up, and share this video with others who might benefit. To download that free guide go to MaryBarbera.com/join, and I’ll see you right here next week.