Many children with autism have behavioural issues relating to food, diet and healthy eating.
—Avoidance of unfamiliar foods
—Food preference according to visual appearance (colour, shape)
—Difficulty with sensory processing (avoidance of particular tastes/textures)
—Difficulty with oral motor control
Particular eating patterns
—fear of contamination (foods touching on plate)
—crumbling food before putting in mouth
—hand/ fingers in mouth while
With these considerations in mind, a ‘Fun with Food Committee’ was established with representatives from various disciplines—nursing, social care, school staff, speech and language therapy, play therapy and the head chef.
The goal of the committee was to promote a positive and enjoyable healthy eating experience for those with food behavioural issues. Emphasis was placed
on supporting each child’s individual needs by developing tailored eating plans.
General intervention strategies
The committee kept in mind recognised best-practice intervention strategies,
— Oral play activities known to have potential in developing oral processing
and oral awareness in a nonthreatening manner. Activities involved sessions on blowing bubbles, blowing out cheeks, blowing musical instruments, funny facial expressions with emphasis on mouth gesturing, cheek and chin massage, kissing
— Creation of a positive, calm and relaxed atmosphere
— Contingent positive reinforcement (preferred foods contingent on consumption of refused foods).
— Non-edible rewards, e.g. a favourite activity/toy and praise.
— Mealtime routine—small groups with familiar peers sitting at table as a means to model behaviour, inclusion and sociability. Eating at table (family all together) is actively encouraged.
Consideration to seating comfort and height to maximise vision and access to the food. ‘Own place’ for sense of security and routine is also addressed.
— Consideration to the child’s likes and dislikes in terms of favourite colour, themed cutlery and crockery are important.
— Small portion size on plate to discourage over-eating, over filling of mouth and for visual acceptability
— Engagement of the child in grocery shopping and healthy food choices, with the aim to create anticipation and enjoyment of meals.
— Making gradual food changes, e.g. gradually thickening, changing texture, and increasing variety.
— Awareness of the child’s hunger cues and not insisting on a ‘clean plate’
approach. Even babies who turn away from the breast/bottle send signals that they are full.