May refuse food or have a restricted diet.

 

1. Try to offer a variety of different food, but don’t insist that they eat or drink certain things.

2. Try to introduce new foods very slowly.

3. Add small amounts of different foods on their plate as well as foods they are comfortable with.  If they cannot cope with new food on their plate, place them on the table instead.

4. Place food on the table buffet style and allow them to choose what they would like to try.

5. Add flavours gradually.  Start with bland/mild flavours and gradually introduce flavours one at a time.

6. Present food in different ways and try to make it fun (i.e. makes faces out of food).

7. Use positive reinforcements and rewards if appropriate but avoid using food as a reward.  Try rewarding for tolerating new food being around, tasting new food or eating new food.

8. Use DVDs/Books/Toys/Plates (with their favourite characters) to encourage eating.

9. Get them to help you cook the food (if appropriate).

10. Use Social Stories™ to explain why our bodies need food.

11. Use Social Stories™ to explain the different food groups and how each one functions.

12. Use Social Stories™ to encourage trying new foods.

13. Model trying new foods yourself.

14. Allow them to touch and play with new foods and textures.  This may take a while before this is tolerated.

15. Use visuals to add structure and predictability through a daily or weekly food planner.  This enables them to see what food is coming next.

16. Use visuals (PECS) to help the individual express their needs i.e. their food preference, likes and dislikes, emotions.

17. Allow them to eat in a different area if eating with others/in cafeteria is distressing.

18. Environmental Profile – Take notes to figure out if changing the eating area may help i.e. in a calm space away from others, allowing them to leave the table and return after a break (grazing).

19. Introduce a food diary to track what they are actually eating in a day.  You may find that they are eating more than you think.

20. Check that there are no medical issues that may be affecting their eating.  This may include anxiety, stomach issues, bowel issues, eating disorders etc.  Please see a doctor for further advice on these issues.

21. Check that there are no medicines that they may be taking that are affecting their appetite.

22. If they are refusing food or their diet is very restricted speak to a doctor to check they are getting enough nutrition.

23. If necessary a GP can refer to a dietician to support trying new foods.  They may also recommend supplements if they are not receiving adequate vitamins.

24. Avoid making a fuss if they are eating only a small amount or variety as this may reinforce problems.  If concerned speak to a GP.

25. See Sensory section for advice if refusal or limited diet is due to sensory issues.

 

May have a fear of food/food contamination.

 

1. If concerned speak to a GP who may carry out a medical assessment and give appropriate treatment if necessary.   This may include medications or they may refer to a qualified mental-health professional.

 

May have problems with choking/regurgitation/rumination.

 

1. Please see a doctor for further advice on these issues.  Your GP may carry out a medical assessment and give appropriate treatment if necessary.  This may include medications or they may refer to a qualified mental-health professional.

 

May over-eat.

 

1. Reduce food portions and use a smaller plate.

2. Encourage drinking more water as they may be confusing hunger for thirst.  Extra water will also help them feel fuller.

3. Use Social Stories™ to explain the different food groups and how each one functions.

4. Use visuals to add structure and predictability through a daily or weekly food planner.  This enables them to see what food is coming next.

5. Introduce a food diary to track what they are actually eating in a day.  You may find patterns to their over-eating.

6. Use visual ‘no entry’ or ‘stop’ signs to limit food.

7. You may need to show empty plates, pans etc to confirm that food has gone.

8. Don’t buy unhealthy foods and snacks.

9. Limit daily snacks.  Maybe try a snack jar which contains snacks for the day.  Once daily snacks are gone they are gone.

10. Use a visual snack timetable to show snack times during the day.

11. Limit access to foods.  If eating is extreme, this may include locks on kitchen cupboards.

12. Check that there are no medical issues that may be affecting their eating.  This may include stomach issues, bowel issues, eating disorders, Prader Willi.  Please see a doctor for further advice on these issues.

13. Check that there are no medicines that they may be taking that are affecting their appetite.

14. They may not have a feeling of fullness.  See Interoception in Sensory section for advice.

15. If necessary a GP can refer to a dietician to change eating habits.

 

May need physical help to eat.

 

1. See Fine Motor Skills section for activities that may help with holding cutlery.

2. An Occupational Therapist may be able to help with strengthening the individuals jaw muscles that are used to eat.

3. An Occupational Therapist may be able to help with the motor functions needed to move cutlery from plate to mouth.

 

May have PICA (eat non-edible materials such as grass/soil etc).

 

1. Chewellery such as chewigems enable them to chew as a distraction.  There are various types including necklaces, bangles and chubes (that can be attached to the strings of a hoody).

2. Oral stimulation such as chewing gum (if appropriate), blowing bubbles, drinking through a straw may help.

3. Access to different textured snacks such as crunchy carrots/breadsticks, chewy sweets, chewing gum, ice lollies etc.

4. Use Social Stories™ to explain the dangers of eating non-edible items.

5. Avoid access to non-edible items that they are attracted to.

6. Check that there are no medical issues that may be affecting their eating.  Your GP will be able to check if there are nutrient deficiencies etc.

7. If concerned speak to a GP, who may refer to a qualified mental-health professional/dietician.