“My kid barely eats anything, they’re very picky,” is something I’ve heard commonly throughout my seven years in the  Applied Behavior Analytic (ABA) field. Parents can feel overwhelmed, annoyed or have completely given up on meal time behavior from their child with Autism Spectrum Disorder (ASD). Up to 89% of children with autism spectrum disorder (ASD) experience challenging mealtime behaviors (Ledford & Gast, 2006). This can include a child refusing to eat, only eating certain foods based on texture, color, smell or taste, refusing to sit or unable to partake in meal time discussion with family members.

While the behaviors surrounding mealtimes and eating patterns of children with ASD do not have a ton of research to go off of currently, there has been some progress on feeding techniques with children that have seemed successful thus far. Here are some strategies that may work for you meal times: 

• Take Data: According to best selling author and BCBA-D, Dr. Mary Barbera, speaks on she recommends taking 3 days of data collection on exactly what your child eats will help you be able to assess if your child needs more intensive therapy such as feeding therapy along with being able to look at the list of food they are eating and be more strategic about how you’re feeding them. Even if you can’t take all three, or it seems overwhelming to do so, start by taking data one time a day!

• Be strategic: Barbera also says that categorizing food into three categories can help you see what nutrients they are eating daily and how to meal plan around that. She recommends categorizing food by: Easy food (those that your child eats often and easily), Medium food (those that they eat occasionally throughout the month but not daily), and hard food (foods that you would like them to eat but they do not eat currently). This can help for a parent to actually know how much the child is eating of each item and the parent can adapt to feed more of the healthy items throughout each meal instead of allowing the child to fill up on filler foods and snacks. 

1. Limit snacks/drinks: these may fill them up but are not giving them the nutrients that they could get naturally in the foods they eat. For instance, if your child is only eating chicken tenders, skittles, goldfish and strawberries, you could focus on providing strawberries in the morning for fruit content and giving them the pizza in the afternoon or evening along with the snacks occasionally. This would increase the chances of your child being hungry enough to eat more of the strawberries or be open to trying new foods and drinks such as a strawberry smoothie or strawberry yogurt.  
2. Engage with children during meal times: Research by  Odar Stough et al. (2015) found that direct commands and parents physically feeding their child during mealtime were related to increased bite acceptance. Bite acceptance means that children were more likely to eat more food or new foods by their parents sitting with them, encouraging them and helping to feed them. 
3. Eat with your child: This goes hand in hand with the research above. Eating with your child will help them imitate the behaviors they see you do such as sitting at the table, accepting new foods, and eating different foods with different textures/colors/smells. 
4. Place a variety of foods on their plate: You might be thinking that you’ve tried this before or your child will just be wasting food but there’s a good chance that by putting yogurt and granola on the plate with their preferred strawberries will increase the likelihood of them trying the other foods on the plate. 

Hopefully these tips bring you encouragement and excitement that you’ve been looking for in  your family’s meal time. Remember, when in doubt, consult your child’s medical team to see if there is more that needs to happen for your child nutritionally.

Happy eating! 

Citations:

1. Am J Occup Ther. 2019 Jan-Feb; 73(1): 7301205070p1–7301205070p10.Published online 2019 Feb 5. doi: 10.5014/ajot.2019.024612
2. Barbera, Mary BCBA-D. (2018). How to overcome picky eating for children with Autism. Published online 2018 October 10. www.Marybarbera.com
3. Ledford J., & Gast D. (2006). Feeding problems in children with autism spectrum disorders: A review. Focus on Autism and Other Developmental Disabilities, 21, 153–166. 10.1177/10883576060210030401 [CrossRef] [Google Scholar]
4. Odar Stough C., Dreyer Gillette M. L., Roberts M. C., Jorgensen T. D., & Patton S. R. (2015). Mealtime behaviors associated with consumption of unfamiliar foods by young children with autism spectrum disorder.