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How To Help a Selective Eater

How To Help a Selective Eater

If you have autistic kids you probably know the location of every McDonalds within a twenty mile radius of your house.

Maybe you’re an expert at making a meal out of only white foods or your pantry is stocked high with a particular type of cracker. You’re tired of throwing away uneaten meals, and if you see one more article about how many serves of vegetables your kids need in a day you’re going to scream.

Yep, autistic kids can be selective and restrictive eaters. It’s common for their diets to consist of a small number of foods - and by small, I mean tiny. There was a time when Max only ate crackers for every meal.

Note that I didn’t say they can be picky, fussy or finicky. These words imply that there are options, and lead to all kinds of dangerous and useless advice like ‘hungry children will never starve themselves’ and ‘if you give kids a new food seventeen times eventually they’ll try it’. No. Make no mistake about it, selective and restrictive eaters are not just being fussy.

They are trying to survive.

Imagine that you’re lost in the Amazon jungle and stumble across a village. You’re hungry - no, more than that - you’re starving, your stomach hurts and all you can think about is food. Just when you think you’re going to go mad with hunger, the villagers hand you a bowl of white goo. You tentatively take a sniff. Hmm, seems okay. You taste a little - it’s warm and sweet. In fact, it’s delicious! You gulp it down and happily the gnawing in your belly finally goes away. Every day the villagers come to you with a bowl of white goo and you feel happy. Yay! The yummy okay stuff that makes me feel good! Everything is going to be okay.

Then one day they hand you the bowl and inside is a spiky black sea urchin. What the? Give me my white goo, stupid villagers! You push it away but they push it back. Eat! They look kind of angry. One of them has a spear. Desperate for them not to yell, you bite into the hard black shell and a spike scrapes the roof of your mouth - ouch! And what the hell is that horrible smell? Your tummy growls. White goo! Please, just give me my white gooooo!

Hunger is such a fundamental urge, one that we’d do almost anything to satisfy. That’s all these kids are doing when they insist on eating a particular food or freak out when they don’t get it - trying to satisfy that urge in the safest (or only) way they know how. They’re trying to avoid the spiky black sea urchins.


So instead of wondering why these kids can be so fussy, the question should be why are so many foods uncomfortable for them?

Why do selective eaters prefer particular foods?

Sensory modulation

Eating can be one of life’s great pleasures. All those delicious sensations - the sweet taste of an apple, the smell of onions frying, the smooth silkiness of custard on your tongue or the satisfying crunch of fresh celery. Your senses are on fire every time you eat.

But what if it hurts when your senses are on fire? What if every taste, smell, sound or texture was amplified? Well then I’m guessing that you’d do anything you had to do to get white goo instead of spiky black sea urchins. You’d want the foods that were bland, didn’t smell and were soft to avoid all that loud crunching and rough scraping of your mouth. You’d want foods that weren’t cold or hot. You might not like it when other people cooked or ate loud, crunchy, smelly foods either.

Conversely, what if none of your senses were on fire when you ate? What if your reduced sensitivity to taste and smell made food boring and unpalatable? What if soft foods didn’t provide any pleasant sensations, in fact they made you gag? Your white goo would look a bit different - crunchy, hot, cold, spicy, intense flavours.

A lot of autistic kids have exactly these kinds of sensory disruptions, so it’s no wonder that they can have strong preferences when it comes to the texture, flavour and temperature of their food.

Need for routine

To autistic kids who are selective eaters, the McNuggets or bread or chocolate milk are safe, known foods that are always the same and never hurts them. Everything else is a spiky black sea urchin. The foods that these kids will eat are often the ones that are the same every time they eat them. And I’m not talking ordering-spaghetti-at-different restaurants kind of same, I mean exactly the same - identical shape, colour or size.

A large part of the reason they want nuggets is that they’re exactly the same no matter which McDonalds you get them from. Tell a kid he’s getting nuggets and he knows exactly what they will look, taste and feel like. He knows that he likes them and they will make him feel good. Zero surprises. Chicken strips on the other hand? They don’t always look the same. They might be a different size, number, taste... for some kids that’s just too much risk.

Focus on details

Kids who are great at noticing details see that tiny brown spot where the meat has been overcooked or the tiny corner of the cheese that’s missing. They notice the shapes and colours of food, and these distinctive features make each into a completely different food for them.

Rigid and literal thinking

Autistic kids can have trouble distinguishing between the essential and non-essential components of the food experience - the last time they ate that really yummy cereal, it was in the red bowl. They also find it tough to generalize from one food experience to another, so when you say ‘pasta’ they picture that one specific type of pasta you gave them the last time you said that word. Giving them a different shape of pasta isn’t ‘pasta’, it’s a completely different food.

Resistance to change

It’s understandable that someone who finds new things scary would try to keep everything the same, especially food since it’s one of our most fundamental comforts.

Cause and effect confusion

A large part of our food preferences comes from the emotional memory of having eaten a food before. We get excited when we see a big plate of crunchy bacon because we remember how nice it felt to eat and how good it makes us feel to taste it. But if your body isn’t great at telling you how it feels, or you have trouble connecting that response to the thing that triggered it, the emotional memories will be less strong. This can make it harder for you to remember which foods you like.

Communication difficulties

Ever tried ordering food in a foreign country where you don’t speak the language? You know what you want to eat but don’t know how to ask for it, so you try the best you can and they bring you something completely different. It might taste great, but you’re too scared to try because it looks unfamiliar and you’re not sure whether you’ll like it. You’re hungry and desperate, so you end up ordering the one thing that you do know the word for just to be sure that you’ll get something you can eat.

How can you help?

Rule out medical causes

Food aversions can result from problems like gut issues, allergies and intolerances, so it’s a good idea to rule out these issues first.

Relax

Selective eaters are already anxious about food. Tensing up every time they eat only adds to that anxiety, so make meal times a happy thing. Don’t get upset if they want the same thing they’ve eaten all week instead of that new food you’re trying. For now it’s important to make them feel safe and satisfy their needs in a way that’s less stressful for everybody. They spend all day trying to cope with the unpredictable and confusing world around them,  so let eating be one time when they can chill out. And reducing the anxiety surrounding food will help them to relax, which will open a window for you to start working with them on adding new foods.

Forget what you know about food

Start with a clean slate. Ignore that some foods are considered delicious and others boring, that pasta of the same shape tastes the same. Imagine that you know nothing about these foods. Get rid of expectations about what we should enjoy eating, or which properties of foods make them appealing. It’s incredibly hard to do, but if you can put yourself in this place mentally then you have a better chance of looking at your kid’s food selections with an open mind.

Keep a food diary

Write down all of the foods that you try over a few weeks - what they looked like, how they were served, whether they were eaten. Look for patterns in the foods that they ate, and try to figure out why they’re appealing. Is it a texture thing? Temperature? Routine? Communication issue?

Take small steps towards new foods

Once you’ve figured out what’s appealing about the foods they do eat, use that to segue to new stuff. If they like soft foods, try a pear instead of an apple. If they like all white stuff, sneak in some parsnip. Try the same food in a slightly different shape or colour. Serve the foods they do like at different temperatures. Edge your way towards new foods slowly, making small changes at a time.

Aim for variety not quantity

Don’t obsess over the number of different foods your kids will eat, concentrate instead on covering the food groups. A kid who eats only one food from each food group is probably better off than one who eats fifty kinds of fruit but no protein.

Time it right

Try introducing new foods at the least stressful times of the day - in the morning when they’re rested or set up a picnic while they’re playing outside.

Don’t offer only new foods

Selective eaters may never choose to eat a new food even if there’s nothing else to eat. Kids who don’t get reliable feedback from their bodies don’t always recognize that they’re hungry, and that new food might not even seem like something edible to them. So always make sure that at least one preferred food is available.

Experience food outside of meal times

Learning about food doesn’t just happen when you eat. You can read books about new foods, play games, sing songs... introducing the idea of different foods will make them more familiar when the time comes to actually try and eat them.

Make meal times comfortable

Try and eliminate any surrounding sources of anxiety when eating. Reduce sensory demands for hypersensitive kids - dim the lights, cut back on cooking smells, don’t bang cupboards or pots and pans, avoid clinking cutlery. Have a meal time routine to make things more predictable - wash hands, sit down at the table. Let them be involved in choosing what you’re going to eat or how it will be prepared.

Be inclusive

Instead of getting frustrated that your selective eater won’t eat what everyone else eats, go the other way and try to think of meals for the whole family that include one or more of the foods that your autistic kids prefer. If they like plain tortillas, make burritos that everyone can assemble themselves. If they’ll eat cubed cheese, baby carrots or crackers you could make up a dip platter for the table that they can serve themselves from. Making them feel involved in the family meal will not only validate the food choices they make for themselves, but it will also expose them to a wider variety of foods and more opportunities to try them.

 

The bottom line

Life with a restrictive eater can be really, really frustrating. But as long as they're eating something, does it really need to be at the top of your list of things to tackle?

I know that when I let go of my own anxieties about what Max was eating, it freed up a lot of energy for me to cope with other stuff. Deciding that we had bigger fish(sticks) to fry was very liberating for all of us... and with the reduced tension Max made some huge leaps forward, including trying new foods.

Life's weird like that.

This article was first published in October 2012.

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