More Lindsey Biel Tips

Autism Asperger’s Digest March-April 2011 issue
Column: Sensory Smarts www.AutismDigest.com

How To Diversify a Diet When A Child Has a Significantly Limited Food Repertoire

Do not withhold the few foods that are acceptable. If you take away that one brand of mac n’ cheese, you’re taking away one of the few sources of nutrition for your child, even if it is a poor one. Pizza can be healthy if you buy or make it with high-quality ingredients.

I start by identifying one food the parent would like to add to a child’s diet, typically a fruit or vegetable. If possible, the child selects the particular fruit or vegetable.

Here’s how we approached a similar situation with a client your daughter’s age. She and her mom identified bananas as a food she would consider eating “when she is older.” For about 10-20 minutes each session, we worked on bananas. Session 1: We made a collage of banana pictures. Real bananas were within sight. Sessions 2-4: she learned to slice bananas and fed them to her mother, in a playful, unpressured interaction. She smelled and felt the banana and observed her mother enjoying it. Sessions 5-8: She touched one banana slice to her lips before either feeding it to her mom or throwing it away. Sessions 9-12: She touched the banana slice with her tongue and threw it away. Sessions 13-14: She nibbled on the banana slice and then spit it onto a napkin. On the 15th session, she swallowed the nibble. Sessions 16-17: She ate one slice of banana. Session 18: She ate half a banana. Now she loves bananas and has selected sweet peas as a vegetable she will eat when she is older.

While you do want to “work on” just one food at a time, don’t give up introducing new foods. When it’s dinner time, go ahead and serve her favorite food but also make other food available on the table. One exception is if your child cannot bear the smell of a food such as brussel sprouts, which may be so nauseating that she will be unable to eat at all. Remember that it may take dozens of introductions before a food becomes familiar enough to try. Here are a few other ideas:

* Combine acceptable foods with new foods. While your sensitive child will immediately detect when you’ve snuck some peas into her mac n’ cheese, you may be able to get her to dip a “tree” (broccoli) in the cheese sauce. Many kids are willing to try new foods if they can dip them into a favorite sauce such as ketchup, tahini, or salad dressing.
* Try introducing a food that is similar to another food the child already eats, such as a different and healthier brand of frozen pizza or chicken nuggets. Remember, you may have to introduce the new food dozens of times. Change accepted foods slightly to present new textures, shapes, and colors. Break crackers into four pieces instead of two, cut bread into a funny shape. Experiment with food temperatures. A child might try frozen blueberries or snow peas for the novelty of it.
* Avoid empty calories. Don’t let your child fill up on high-sugar fruit juice during the day or snack on high-calorie junk foods like chips. Keep treat portions small. Rather than give a full bag of Veggie Booty (which doesn’t count as a vegetable), serve a small
bowlful.
* Provide “oral comforts” that help normalize mouth sensation. These nonfood items are safe to suck and chew on and come in a variety of shapes and textures. Some favorites include: Chewy Tubes, Chew-Eaze, Dr. Bloom’s Chewable Jewels, and Kid’s Companion Jewelry. You can find these in most therapy catalogs and on the sensorysmarts.com website under Toys & Equipment/Oral Comforts.

Above all, avoid food battles. Mealtimes are social time, not therapy time. Serve food you know your child will eat when your family sits down for a meal and focus on having a pleasurable family experience.

You may need to work with a feeding specialist (usually an occupational therapist or speech language pathologist) especially if your child has significant oral sensory issues, oral motor weakness, muscle tone problems, or extreme reactions to food. The feeding therapist will evaluate your child’s issues and implement a therapeutic program with a home component. Also investigate supplements such as multivitamins and essential fatty acids to make sure your child is getting the nutrients he or she needs to stay healthy.

Find more on eating difficulties and other sensory challenges in Raising a Sensory Smart Child and at sensorysmarts.com. You may also want to check out these books: Just Take a Bite (by Lori Ernsperger, available in bookstores and online) and Happy Mealtimes with Happy Kids (by Melanie Potock, available at MyMunchBug.com).

Got a question? I’d love to hear from you. Please email questions to Lindsey@sensorysmarts.com.