[NOTE: My almost-five-year-old granddaughter, who lived with us her first few years, has had a lot of eating issues, including the need for a g-tube for a couple of years. She has received treatment from developmental pediatricians, gastro-intestinal specialists, nutritionists, OT therapists, etc. Thankfully, today her eating issues are mostly gone. There has been no magic bullet or wonder-cure or miracle therapy – just lots of worry, lots of trying all sorts of things, lots of professional care, and lots of love and praise.]
It is common for children on the autism spectrum to have eating issues. And there are things that we autism grandparents — even if we are not frequent caretakers of our grandchildren — need to know. And there are things we can do.
WHAT WE NEED TO KNOW :
Medical and/or dental problems can be a cause of eating issues. One research study (Buie & Krigsman) suggests that at least 50% of children with ASD have significant gastrointestinal symptoms such as GERD, chronic constipation, abdominal pain, etc.
It is common for parents to be blamed for their children’s eating issues, but such blame is not warranted when it concerns children on the autism spectrum. There are many, many, many causes for their eating issues. (We autism grandparents won’t be among those who blame our grandchildren’s parents.)
Autism professionals recommend and practice a diverse variety of feeding therapies and protocols – some that may be productive for our grandchild, and others that may be counterproductive. But whichever is selected, it should result from careful research of information provided by reputable third-party professional sources, and not simply from information provided by the practitioner.
It is common for children on the autism spectrum to have sensory aversions. This means that they respond negatively to specific smells or tastes or colors or textures (for example, they may like crunchy foods, but not smooth), or food temperatures (it is common for children with ASD to prefer foods at room temperature and be intolerant of foods that are either hot or cold), or noise level (e.g. lots of ambient noise during meals), or bodily sensations (e.g. chair too high or too hard, etc.), etc.
It is common for children on the autism spectrum to be extremely selective with foods. Some children with ASD eat mostly foods that are either sweet, sour, bitter, or salty. Some learn that all foods are better with certain condiments (such as catsup).
Other things can be issues, such as visual appearance (specific plates or napkins, location of food), socialization (whether or not other persons are there), transitioning from finger food to utensil food, etc.
Often children with autism don’t feel hunger pangs or exhibit signs of hunger or answer “yes” when asked if they are hungry. Therefore it is usually a good idea to serve food at regular intervals whether or not there are signs of hunger.
Feeding issues often get far less attention than other issues and challenges that confront children with autism. Thus we grandparents can be helpful with our attention to, and support for, progress regarding feeding issues.
As with most issues and challenges with autism, the focus should be on achieving and celebrating a series of tiny steps of progress. (For example, rather than an initial goal of eating a full helping of a newly introduced food, have an initial goal of simply tolerating the existence of that food on a separate plate during the meal.)
Parents of children with autism often hear, even from some medical professionals, words such as, “Don’t worry; she’ll eat when she gets hungry enough.” Or, “All children go through phases with food issues.” Such comments are not founded in a knowledge of feeding issues among children with autism.
WHAT WE CAN DO:
We can offer to our grandchildren’s parents that we can do research on feeding issues affecting children on the autism spectrum. Parents are sometimes so involved in daily tasks and challenges that they don’t have time for research. There is a wealth of information on the Internet, and we can offer to share with them what we learn. And we can be careful to give credence only to reputable sources. (The Internet world of autism – as with everything else – offers plenty of snake oil.)
When our grandchild is in our care we can refrain from scolding or being negative regarding feeding issues. We can be positive during meals (rather than viewing them as battles) and be liberal with praise for every bit of success.
When our grandchild is in our care we can see that our grandchild is involved with physical activity or exercise prior to meals. (Often such activity stimulates the appetite.)
When our grandchild is in our care we can try to make food and meals fun. (Making up songs or stories about food items, pretending with toy food items and dishes prior to the meal, allowing our grandchild to “play” with the food, etc.)
When our grandchild is in our care we can accept the possibility of tantrums, and can plan to ignore tantrum behavior (unless it is dangerous), and instead put emphasis on praise when warranted.
When our grandchild is in our care, we can eat together (unless socialization is off-putting) so our grandchild can observe and possibly mirror our actions.
When our grandchild is in our care, we can refrain from food “tricks” such as hiding vegetables in spaghetti sauce etc. (Once our grandchild recognizes a trick, he may decide not to trust any food.)
When our grandchild is in our care, we can keep a feeding journal and share it with our grandchild’s parents. Such documentation can often lead to a recognition of patterns of behavior that will enhance an understanding of our grandchild’s issues and thus result in strategies for progress.
There are many different strategies and therapies that are recommended by a variety of autism experts regarding eating issues. What works for one child may not work for another. But learning about current expert advice can help us autism grandparents better understand and empathize with the significance of this challenge for our grandchildren and their parents. And this knowledge can position us to provide helpful advice and suggestions — but of course only when truly welcomed and not viewed as interference. We grandparents can be a great source of love and positivity!