“Our grandson, who has Asperger syndrome, has difficulty getting food neatly into his mouth. No matter what we say, he seems oblivious when it ends up on his face. And it gets him teased and avoided at school. How can we help him?”
Today’s “Food for Thought” answer is from child psychologist Lauren Elder, Autism Speaks assistant director for dissemination science, and occupational therapist Alison Wheeland, a University of Southern California doctoral student completing her residency with Autism Speaks.
This is a tricky situation! We definitely don’t want him getting teased when he could learn to eat more neatly. This is an important skill, especially as he gets a bit older and starts to think about dates and job interviews. It may take some time, but here are some tips that may help.
1. Use a mirror. When he’s at home, have him eat in front of a mirror. This can help him become aware when food’s on his face – as well as when he’s eating neatly.
2. Try a nonverbal cue. This strategy can help your grandson when he’s in public and a mirror isn’t appropriate. Sit where he can see you while he’s eating. Each time food ends up on his face, gently tap your face to indicate where it is. Let him know that this is his cue to wipe his face. When you’re not around, a parent, sibling or trusted friend can provide the cue.
3. Make it easier to eat neatly. Encourage your grandson to take smaller bites. If you’re packing his lunch, pack less-messy foods like a dry turkey sandwich and carrot sticks. This isn’t a long-term solution since you want him to learn to eat all foods neatly. But it can reduce the teasing at school while he’s learning to be neater.
4. Instill a routine. Until your grandson masters eating neatly, encourage him to use a napkin to wipe his face at regular intervals. Make it specific – such as a wipe every five bites.
5. Help him understand. At this point, your grandson may not appreciate why eating neatly is important. Try writing a social story that explains why it’s important. Include a picture that includes someone with food on his or her face. The story might continue with the person learning to take smaller bites and regularly wiping his or her face with a napkin.(For help with writing social stories, see the Autism Speaks ATN/AIR-P Visual Supports Tool Kit.)
6. Provide motivation. Consider a reward system, where your grandson gets a small reward for eating neatly. Make sure to set small, achievable goals. For example, begin by providing the reward when he remembers to wipe his face or eats a meal even a little more neatly than last time. You can up the ante over time.
7. Gently “wake up” the sense of touch on his face before he eats. Many individuals with autism are under-responsive to touch. If you grandson doesn’t mind you touching his face, make a game out of the following exercise: Use the base of your palms to apply gentle but firm pressure to the top of both cheeks, then slide your palms down toward his mouth, making a “squishy face. Your grandson can learn to do this himself, but make sure he understands that the routine is something he does in private. You don’t want it to result in further teasing. Also, don’t push this routine if he finds it uncomfortable.
8. Keep a log. You may gain insights into your grandson’s eating issues by taking notes of when he gets particularly messy and when he tends to eat more neatly. Does he get messier when he’s tired? Anxious? Starving? Around his friends? Does it carry over to other activities, like brushing his teeth, or cleaning his hands? Does it just happen around the mouth? His entire face? His hands and body too?
It may be that he’s really not noticing when food’s on his face. Or he may have trouble aiming his hand at the right place to wipe it off? Once you start noticing patterns, you may come up with more strategies to help him. If your grandson sees an occupational therapist, your log can also help the therapist identify sensory-processing and motor-coordination issues and help your son address them.
Thank you again for your question, which we know is a common one. We wish you and your grandson all the best.
Need more help with issues around food, eating or special diets? Send them to foodforthought@AutismSpeaks.org.
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