Improving Mealtime Experiences

The table is set.  The enticing aroma from a meticulously-seasoned, mouth-watering, sizzling roast beef feels your entire home. As your family sits around the table to enjoy this wonderful meal, you cannot help but wonder…“will my child sit still today and have at least one bite of food this time?”

As many parents of children with Autism know very well, mealtime can be a rather difficult endeavor. Children will often fidget, be unable to sit still long enough to finish a meal, and ultimately get up from the table, forcing parents to chase them around the house with a spoon. Other times children will have a hard time trying out new foods and may gag and spit out food whenever they are presented with something they have never tried before. As time goes on, well-intentioned parents may find themselves frustrated, tired, and desperate to get any food inside their children’s bellies, whenever they are willing to eat it. The result is an irregular eating schedule with typically a very small menu of food items your child will accept. So what do you do?

Occupational therapists are professionals who work closely with children diagnosed with Autism Spectrum Disorder (ASD) who experience eating difficulties. Often times, children with Autism will have very different sensory needs than their peers, which may significantly affect their ability to eat a meal and perform other activities as well. In order to feel balanced or “at ease”, children may seek more or less of a specific type of sensory input. Once children meet their sensory needs, the result is what we call a state of regulation. To illustrate, imagine you are trying to study for a test at the library but the room is extremely loud. Would it be difficult to concentrate? How about if you are about to take a shower but the water temperature is too hot or too cold? We all seek a state of balance from the sensory information all around us (whether it is going to a quieter corner in the library to study or setting the water temperature just right before we jump in the shower)…and when we find it, it is easier to complete the tasks we are expected to do. Children with Autism often have sensory needs that are different than most of us. Does your child seem to be always “on the go” (e.g., climbing furniture, running around the house tirelessly for prolonged periods of time?). Perhaps your child engages in those activities in an attempt to reach a state of balance or wellbeing that most of us take for granted. The most important thing to remember is that once a state of regulation is reached, it is easier to engage in the activities we want to do or are expected to do.

Let’s go back to our opening story now that we’ve learned how sensory needs affect us. What would be some important points to have in mind or even practical, easy-to-implement strategies that could improve your meal time experience? Consider the following points next time you plan to have a meal with your child:

• Know your child’s sensory needs. Every child has different sensory needs, and it is very important to be able to identify these needs in order to improve your mealtime routines. Is your child consistently active and has difficulty sitting down for prolonged periods of time? Providing your child with opportunities to engage in moderately-intense physical activities prior to mealtime may help improve concentration and overall sense of well-being. Take your child to your local park an hour before mealtime. Climbing, running, and jumping are great ways for your child to self-regulate and reach a sense of well-being. For children with oral sensory issues, it may be challenging for your child to accept various types of tastes, textures, and/or temperatures. Knowing and respecting what your child accepts is the first step in helping them improve their repertoire of food. Avoid forcing your child to eat any non-preferred foods. Instead, allow your child to freely explore novel foods with his or her senses at their discretion (e.g., looking, smelling, touching with their fingers, etc.).  Gradually introduce small samples of new food in a corner of your child’s plate as a supplement to already-accepted foods. It is okay if your child does not eat the new food right away.  It takes an average of 10-12 attempts before a child will begin trying a new food.  So be patient!

• Adjust your environment. Sometimes it is difficult for a child with sensory needs to sit still for a meal at an unfamiliar place (e.g., restaurant, church cafeteria, etc.). Under these circumstances, it is a good idea to modify your environment to suit your child’s needs. Take a small inflatable seat cushion with you if your child has difficulty seating still. Bouncing gently on a cushion may help meet your child sensory needs. Fidget toys (i.e., small balls that can be squeezed, rubber toys that stretch, etc.) can also be useful tools in assisting your child to self-regulate. For children who appear to be “picky eaters”, it is beneficial to plan eating out ahead of time. Consider restaurants that incorporate menu items which your child accepts. If needed, take small preferred snacks, sauces, and/or condiments with you to a new restaurant in order to help your child transition as smooth as possible into this new feeding environment.

• Take Baby Steps. This is perhaps the most powerful strategy to improve your child’s mealtime experience. No matter what type of oral sensory difficulties your child may be experiencing, taking small steps towards a desired outcome (e.g., whether it is to incorporate a new food item into their repertoire of limited accepted foods or to decrease gagging episodes when introduced to new foods) is one of the most fundamental and effective tools used in therapy today. Children are more likely to comply with a small request rather than a large one, especially if a much-desired reward awaits. Asking your child to “kiss” a non-preferred vegetable like broccoli is much easier than asking to eat it altogether, right? One of the benefits of taking small, consistent steps over time is becoming acclimated (or desensitized to) a particular stimulus. Thus, breaking a seemingly difficult undertaking (such as swallowing a piece of broccoli) into smaller, more-manageable tasks (i.e., touching, smelling, kissing, biting) is a great way to help your child incorporate new foods into their diet.

Sharing a meal together with family is one of the most enjoyable experiences in day-to-day life. It allows us to unwind and connect with our loved ones. It brings us joy and helps us build lasting memories. I encourage you to put these simple yet fundamental concepts into practice next time you plan your meal. They will not only help your child eat better but will most definitely enrich your time together as a family.