For many of us, the evening meal is often a pleasant experience. It’s an opportunity to reconnect with family members, catch up on the day, and enjoy each other’s company. Preparing appealing, nutritious foods and getting everyone to come to the table at the same time can be a challenge, but it’s usually worth the effort.
If you have a child with developmental disabilities, you know that dinnertime may be much more complicated than planning menus and coordinating schedules. Autism spectrum disorder (ASD) and related disabilities can impact many activities of daily living, including eating.
Researchers at Emory University School of Medicine have found that children with ASD are five times more likely to have mealtime challenges such as tantrums, extreme food selectivity, and ritualistic eating behaviors. It is no surprise, then, that your son or daughter’s food selectivity issues and problem behaviors can turn dinnertime into an unpleasant ordeal for everyone involved, including your child.
The good news is that there are steps you can take to increase your child’s participation in family mealtime and minimize the negative effect that his or her disability may have on this “together time.” The strategies you work on will also increase your child’s chances of having more successful experiences related to eating outside of the home.
Food selectivity refers to a child’s preference for a narrow range of foods or certain types of foods. In some cases – when a child refuses to eat a large enough variety of foods to accommodate his or her nutritional needs – food selectivity can lead to medical or health issues. If this is the case with your child, you may need to enlist the help of a nutritionist.
Unless your child has an intensive program coordinated by a professional, it may be most beneficial to focus on strategies to keep his or her food selectivity from getting worse. These strategies can include introducing and offering new foods regularly and repeatedly. The simple repeated presentation of a particular food item may increase your child’s preference for it. Keep in mind that tastes and preferences can change, so introducing different foods more than once over time may increase the likelihood you will find something new that your child may like.
To ensure that your child continues to eat the foods that he or she currently finds “acceptable,” make sure to serve these foods regularly. Rotate these items often, and if your child has been requesting the same foods for several days, change the meal for a night or two before returning to the old favorites.
Part of what children with developmental disabilities may find difficult about mealtime is that they have to stop doing something they enjoy and go to the table and eat. A visual schedule can help your child “see” and understand when a meal will occur (e.g. after a favorite television program). Having a weekly schedule and menu of meals will give you the opportunity to offer your child a choice of various meal options for different days. Providing choices may make it more likely that your child will comply when it comes time to eat the dinner he or she has selected (even if the choices you provide are not his or her very favorite foods). It is important to note that there should be at least one or two foods that your child has eaten before included in the options for the day.
If you want to increase the amount of time your child spends at the dinner table, it is important to evaluate how long he or she stays there now. Then, set a goal for increasing this time and encourage your child to take small steps to reach that goal.
Give your child a “reinforcer,” or small reward, for completing each step successfully. You might start by requiring your child to end an activity for a certain length of time before giving him or her a reward. Slowly increase the number of things your child needs to do, or the amount of time he or she needs to do them, in order to earn a reward. Move on to the next step only when your child has successfully mastered the previous step.
Mealtime improvements may take time and, for some parents, feel like an endless battle. However, the potential rewards for your entire family make the effort worthwhile. If mealtime seems to be too difficult a task to tackle on your own, a behavior analyst should be able to aid in developing a program that will work for your child.
By Sarah Helm, M.A., BCBA, LABA
May Institute is an award-winning nonprofit organization with more than 65 years of experience in serving children and adults with autism spectrum disorder (ASD) and other developmental disabilities, brain injury and neurobehavioral disorders, and other special needs. May Institute operates four schools for children and adolescents with ASD and other developmental disabilities, including one in West Springfield, Mass. For more information, call 800-778-7601.