“I don’t like it.”
It’s not uncommon to hear kids say that when they aren’t interested in trying a new food. But for children with autism spectrum disorder, there’s a higher chance of resistance, says Kristin Hustyi, a Board Certified Behavior Analyst and the Network Director for Autism Home Support Services – Michigan.
In fact, she says, “Research shows that the prevalence of feeding problems in general can be as high as 90 percent in children with ASD.”
Some of these food aversions are due to chronic health issues, including gastrointestinal difficulties and oral motor problems, while others are simply a resistance to change, Hustyi says.
“Many kiddos are selective by texture,” she adds. “They may like soft, smooth textures and not crunchy ones or vice versa. Alternatively, they may be selective by type of food, color, brand or appearance.”
The reasons vary from child to child but can be frustrating for parents who don’t know how to overcome this obstacle. That’s where a Board Certified Behavior Analyst, or BCBA, can help. Here, Hustyi discusses how tasting sessions during applied behavior analysis (ABA) therapy help encourage finicky eaters on the spectrum to expand their palates.
Introducing new foods to children with autism is a gradual process. “One of the strategies that I really like to use with picky eaters that I work with is implementing a tasting session,” Hustyi says. “This really takes the pressure off mealtime.”
During a tasting session, Hustyi is trying to teach the child that if he takes a bite of something new, he gets a reward. If he doesn’t take a bite, he doesn’t get a reward.
It seems easy, but it’s a process that requires several attempts at trying a new food. Simply presenting food to a child isn’t sufficient; the child must taste the food.
“We know that children develop preferences for foods by repeatedly tasting them,” she says. “That can take 10, 20 or 30 bites before we would consider a food ‘mastered’ during a food intervention,” Hustyi says.
There are a number of ways to introduce new foods.
“One way would be to mix or blend new foods with preferred foods. For example, you might start with 75 percent preferred food and 25 percent new food blended in and then adjust the ratio over time.”
Or pair a new food with a preferred food together, like cheese on a cracker or a new vegetable on pizza. It can also help to start your food intervention with foods that were previously accepted but the child no longer eats, Hustyi says. “I also ask parents, ‘What was the child was eating three months ago that he’s decided he’s no longer into?'” she says. If he ate it before, there’s a chance he will eat it again. And that’s a good place to start.
“During a tasting session, rather than changing the way we present the food, as with mixing or pairing with preferred foods, we focus on motivating the child to taste the new food.”
Start small – with one bite – then gradually work your way up to more bites of that food. Use a preferred item or food as to reinforce or reward the child for consuming that new food.
“This really gets into the principle of positive reinforcement,” Hustyi says.
It may be helpful to set a time limit during a tasting session. During that set time – 10 minutes, for example – a child may watch a video he or she loves for a short time; then, in an ABA session, a therapist will pause that video, and present a bite of food.
“As soon as the child takes a bite, we praise the child and immediately turn the video back on for about 15 seconds. When they stop eating, we pause and repeat,” Hustyi says.
Once that 10 minutes is up, the tasting is done. Do not exceed that set time or switch your expectations.
“It’s important not to increase the demand because the child is doing well,” she says. “It’s important not to decrease the demand because the child is not doing well.”
The end goal, after the child has tasted the food repeatedly, is always to work toward generalizing or incorporating the new foods into regular mealtimes.
For parents interested in learning more about food interventions, Hustyi suggests reading Treating Eating Problems of Children with Autism Spectrum Disorders and Developmental Disabilities: Interventions for Professionals and Parents by Keith E. Williams and Richard M. Foxx. This book, which is written in two parts, provides insight for teachers, parents, caregivers and professionals on how to solve a child’s resistance to eating.
General guidelines for parents
While you should consult your child’s BCBA before implementing any of these food tastings on your own, there are some things you can do at home to help your picky eater try new foods.
1. Look at how much your child is snacking each day. “Too much snacking can teach your child that avoiding mealtime is OK,” Hustyi says, “and it also decreases motivation to try new foods.”
2. Examine how much and what types of fluids are consumed. A child could be consuming a large number of calories simply through what he is drinking. Limiting the amount of milk or juice may be a consideration, depending on the child’s age. Check with your child’s pediatrician to make sure the amount he or she is drinking is appropriate for his or her age.
3. Get on a schedule. “Teach your child to follow a consistent schedule that includes mealtime, snack time and bath time.”
4. Create a good environment for mealtime. Parents should model good habits. Eat the same foods your child is eating, and focus on the meal in front of you. Avoid distractions.
5. Expect resistance. “There will most likely be some problem behavior, some resistance,” Hustyi says. “I would urge parents to be prepared to that.” Be sure you’re providing attention when your child is meeting expectations and when they are doing what you want them to be doing – and do your best to ignore inappropriate behavior like negotiating.
For more information on Autism Home Support Services, visit autismhomesupport.com.