“Our 7-year-old son has Asperger’s, and he eats constantly. When we try to talk to him about it, he gets very upset. We try controlling what he eats and getting him outside. But he sneaks food, and it’s so hard to get him away from the television.”
This week’s “Food for Thought” answer is by (left to right) child psychologists Michelle Spader, Rebecca Hellenthal and Jonathan Wilkins. They work within the Autism Speaks Autism Treatment Network at Nationwide Children’s Hospital, in Columbus, Ohio.
Thanks so much for your question. We get it a lot. Helping any child learn better eating habits can take hard work. It can be especially challenging for children with autism. We hope the suggestions below – some of them autism-specific and some of them more general – prove helpful.
Develop a daily schedule
Many children with autism do best within a structured daily schedule. Help your son develop one and include set times for meals and snacks.
TV viewing can be a part of this schedule. Just make it a defined part – say, an hour of television after your son has spent active time outdoors. Rather than leave it up to your son to decide what to do outside, we suggest brainstorming some specific activities he finds enjoyable. Walking the dog? Going to the neighborhood playground? You can also include outdoor chores such as raking leaves or shoveling snow.
We know that many individuals with autism have difficulty following ordinary schedules. At the same time, many have a natural strength in visual processing. You can use this strength to address the challenge. In particular, we recommend creating a visual schedule. (Download the Autism Speaks ATN/AIR-P Visual Supports Tool Kit here.)
Visual schedules use pictures or objects to represent each transition and new activity. You can swap out pictures as needed for each day’s events. For tomorrow’s schedule, for example, you might have a picture of raking leaves in the spot for outdoor time. On the following day, it might be a picture of swinging at the neighborhood playground.
Emphasis on physical activity
All children need daily physical activity. Besides burning calories, it promotes cardiovascular health and clear thinking.
But we know it can be challenging to inspire a child who has fallen into the habit of sitting in front of a TV. It may help for your child to join a structured activity outside the home. If your child is receiving behavioral, physical or occupational therapy, ask his therapist to help you identify some options in the community. And definitely discuss options with your child to find the best fit.
As mentioned above, it can help to schedule one of your child's favorite activities to occur immediately after a scheduled period of physical activity. For example, allow a healthy snack after exercise.
Replacing food with fun!
Are there particular times during the day when your child is most likely to snack mindlessly? Try scheduling some fun activities during these times. Are there favorite games your child enjoys playing with you? A craft you can learn together?
Choosing healthier foods
No one likes to feel hungry. So be sure to have lots of healthy and relatively low-calorie foods available for when the munchies strike. You can help your child learn about smart choices with a visual system such as the “Red Light, Green Light, Eat Right” program.
You can create a visual aid that includes pictures of “green-light foods” such as fresh fruits and vegetables and lean sources of protein. Let your child know that he can indulge in these freely. “Yellow light foods” are less nutritious and to be eaten in moderate, measured amounts. For example, a cup of tortilla chips or a low-sugar cereal. You might want to restrict these foods to scheduled snack times.
“Red light foods” include high fat or sugary foods with little nutritional value. They’re to be eaten in small quantities on special occasions like a birthday party or holiday.
In teaching healthy eating, we recommend that you openly discuss such topics as hunger and satiation. It’s important for your child to be able to express his feelings around food – especially uncomfortable feelings such as hunger. You might want to talk about true hunger versus boredom eating.
In addition, your child’s school may have a healthy eating curriculum. Ask his teacher and/or counselor about what programs or lessons they use. This will allow you to tap into some common themes.
Restrictions and rewards
Outside of a “green light” bowl of fresh fruits and vegetables, you may need to physically remove food temptation from your child. This may require making the kitchen off-limits or putting locks on cabinets and the refrigerator.
Another possibility is to eliminate or minimize the availability of unhealthy snacks from the house. Obviously this would affect other members of the family – but with potential benefits for everyone's health.
We also recommend that you and your son develop a reward system that encourages physical activity and following the daily schedule. You might want to include “staying out of the kitchen” in this reward system as well. However, we strongly recommend non-food rewards such as a favorite activity or small purchase.
Behavioral therapy can help
It can help to work with a behavioral therapist or psychologist in implementing these strategies and manage problem behaviors such as tantrums that may result when you limit food. You might also create a safe zone where your child can go to calm down when you hit one of these bumps in the road.
We wish you and your family all the best. Please let us know how you’re doing.
Need more help with issues around food, eating or special diets? Send them to foodforthought@AutismSpeaks.org.
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