Twelve-year-old Kevin has autism and only eats five foods. When one of the foods he likes isn’t served in exactly the way he likes it, a meltdown is usually the result.
This food selectivity makes mealtimes stressful and overwhelming for everyone. Often, the family eats separately because Kevin’s behavior at the dinner table is so upsetting to his dad and siblings. Kevin’s mom spends hours coaxing, bribing, and even threatening Kevin to try to get him to eat.
Kevin’s food selectivity has taken a terrible toll on this family.
Therapists who address food selectivity hear cases like this all the time. One of the first things we can address during treatment is how the family can enjoy mealtime again, and these tips will help facilitate this goal.
1. Envision the Ideal Family Meal
By the time the family is in feeding therapy, mealtimes have probably become completely overwhelming. As therapists, we can help them step back and envision the ideal meal for their family. Sometimes, we need to broaden the focus—moving away for a moment from what the child is eating to helping the family enjoy being around each other again.
Dinner table games can help accomplish this. These games might include:
- Two Truths and a Lie
- Guessing games (“Guess my favorite animal/color!”)
- Name That Food (“It is crunchy, sweet, and healthy to eat!”)
- Would You Rather (“Be able to fly or be invisible?”)
- I Spy
Refocusing on connection during meals can reduce anxiety and encourage healthy relationships. Plus, playing games together is fun!
2. Rebuild the Family Mealtime Routine
The family meal should be a time for connection between members as well as nourishment of the body and spirit. Developing a clear and consistent mealtime routine can bring peace back to this important time of the day.
Part of this routine can include encouraging the child with food selectivity to participate in meal preparation. They can plate food, stir, pour, and, if appropriate and safe, chop and cook. This allows the child to assert some control over what they eat. In addition, through interaction with food, they can prepare their body and mind for the sensory experiences of eating.
Also, visual tools can clarify mealtime expectations and reduce anxiety for the family. For example, a visual timer can be used to communicate how long each member will spend at the dinner table. Alternatively, the child with food selectivity can place a “no eat” card over foods that are particularly scary and know that his parents will not force him to eat these foods.
Getting creative with visual cues can help both children and parents reduce anxiety and solidify the mealtime routine.
3. Celebrate Small and Meaningful Changes
While we work to establish a peaceful and enjoyable family meal, we can also slowly start adding new foods to the child’s diet. It is important for caregivers to realize that this will be a gradual steady process.
Incorporating these general principles can help the caregiver successfully partner with their child to add foods to the child’s diet:
- When offering a new food, make sure the portion is very small and non-intimidating.
- Exposure and progressive interaction with food is key. The parent and the feeding therapist should determine which rung on the food interaction hierarchy the child should practice with new foods.
- Encourage the child to alter preferred foods in small ways. Maybe they put their favorite color food coloring into their mac and cheese or sprinkle parmesan on their spaghetti. The feeding therapist and parent will work together to determine the one small change that can be made with preferred foods.
- Never trick or sneak a non-preferred food into the child’s favorite foods. This can break down trust, which is essential for greater food acceptance to occur over time.
As families start to tackle food selectivity with their feeding therapist, these tips can get them started in the right direction. Soon, the family will be able to connect and share the ups and downs of life during the family meal and be nourished both physically and emotionally by this positive time spent together.