“What is it about autism and food? It seems to provide our son with such comfort. But his narrow focus becomes an obsession that leads to meltdowns.”
This week’s “Got Questions?” answer comes from psychologist Emily Kuschner, of The Children’s Hospital of Philadelphia, a member of the Autism Speaks Autism Treatment Network. With the support of an Autism Speaks research grant, Dr. Kuschner is developing and testing a cognitive behavioral treatment program that addresses the complex reasons behind narrow food choices in many individuals with autism.
Research has backed up what you’ve experienced firsthand. Food overlaps with many aspects of life that challenge the coping skills of individuals with autism spectrum disorder (ASD). These can include extreme sensitivity to change and sensory stimuli, as well as an intense focus on details.
For instance, many children and adults on the spectrum are extremely sensitive to not just flavor, but also the color, smell and texture of foods. Many also have strong preferences for a narrow selection of foods. Some even feel compelled to have certain foods in the same place on the plate or to use the same plate at each meal.
Of course, we all have food preferences and most of us find food comforting. However, these natural tendencies can become exaggerated for a person with ASD. In other words, your son’s focus on food – like his other special interests – may be particularly intense.
On top of this, many individuals with autism have difficulty describing what they like or dislike about certain foods. So it can be difficult to determine what it is about a certain food that’s so important – or upsetting – to your son. And that increases the risk of meltdowns.
Research also tells us that many individuals with autism tend to have strong preferences for carbohydrates and processed foods, while rejecting fruits and vegetables. This, too, may reflect an aversion to strong tastes and textures. Unfortunately, it can lead to nutritional deficiencies and excessive weight gain, especially if exercise is limited.
The need for sameness that is common in ASD may also make it difficult to introduce new foods to your son’s diet. Just as a substitute teacher can prove extremely upsetting for children with autism, so can unexpected foods on their plates!
Put it all together, and meals can become emotionally loaded for everyone in the family. So let me offer a few tips.
In general, it’s important to avoid making food a chronic source of conflict. When you sense a food-related meltdown approaching, try to defuse the situation as you would any other potential meltdown. Use your tried-and-true coping strategies. For example, a deep breath and a break from the conversation. You might make a visual schedule to establish a plan for mealtime or negotiate a reward that could be earned for completing a task such as trying a new food.
When introducing a new food, remember that a touch of consistency can help keep things calm. So include one or two old favorites in every meal along with any new introduction.
Go softly in introducing new foods. You can try the age-old “try one bite,” or start with asking your son to just smell or lick the food the first time it’s offered.
You can also build on a preferred food to gently expand a diet to include similar choices. So if your son insists on, say, Honeynut Cheerios, try offering him a similar cereal such as Multigrain Cheerios. It will help to have your child’s “buy-in” for this. So try making the new choice together at the supermarket when you’re both calm and away from the dining-room table.
Finally, try to encourage flexibility around trying new foods. Away from mealtime, discuss how his favorite food can be his “Plan A” choice for mealtime, but that it may not always be available. So he’ll need a “Plan B” that he agrees will be acceptable. (These types of strategies can be found in Unstuck and on Target: An Executive Function Curriculum to Improve Flexibility for Children with Autism Spectrum Disorders.)
Also see my previous blog on autism and food aversions, “Encouraging Picky Eaters with Autism to Try New Foods,” and psychologist Jennifer Bass’ presentation on feeding plans at Autism Speaks 2013 National Conference for Families and Professionals.
I hope these insights and tips prove helpful. Best wishes to you and your family.
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