Jemma Swales has developed this workshop organised by SHINE for Autism with the intention of educating parents/carers about Food Issues.

 

Eating a varied diet is good for your health, but many people don't achieve this.  Some autistic people have a restricted diet, eating only a limited range of food.  Others may over-eat.  

 

Problems to look out for:

 

In children, rigidity around foods is very common, not just for those on the autism spectrum.  There’s no need to be too concerned if the person is eating foods from each of the main food groups, and if a child, is growing well.

 

Get advice if the person is:

 

          -accepting fewer than 20 foods

          -refusing all foods from one or more food groups

          -constipated – constipation can have a huge impact on appetite and may require medication

          -suffering from tooth decay as a result of their diet

          -losing weight or not growing well

          -gaining weight excessively

          -displaying behaviour, e.g. tiredness or pica (eating non-edible items) that might indicate a                          vitamin or mineral deficiency (e.g. iron deficiency anaemia)

          -missing school due to eating problems

          -coughing and choking while eating, or has recurrent chest infections, especially if they have                  developmental delay or physical disabilities

         

Finding the cause

 

Start to take note of what is eaten and when.  Sometimes, a food diary can be reassuring – you may in fact see that the person eats a wider range of foods than you originally thought.

 

Here are some examples of what to include:

 

          What time of the day did they eat? – 11.05

          What did they eat? – Salt and vinegar crisps

          Where did they eat? – In the living room

          How much did they eat? – Two bags

          Who was there? – Mum, brother

          How did people around respond to the person eating the particular food? – Mum praised,                         brother had no reaction

          Were there any environmental factors? – Radio was on in the background

 

This could reveal some causes of the eating difficulties, whether over-eating or restricted eating.  Try to work out whether it is the amount, type or range of food being eaten which is the core issue, and then what underlying problems, or sensory issues, may be involved.

 

General pointers: communication, rewards, exercise, modelling

 

Communication

 

With any approach, it is important that you communicate in a clear, consistent and calm way.

A social story could help someone to understand why we eat and the function of food, e.g.:

 

• food provides us with fuel/power, which enables us to do things we enjoy.

• eating food from all the food groups gives us energy.

• missing out food groups can make us tired.

 

Presenting information visually can also help.  You could:

 

          -produce clear daily and/or weekly menus of foods -display the time of next meal in a                                prominent position

          -provide visual tools to help the person express and recognise their needs, feelings and                              preferences, such as stress scales, hunger and fullness scales, or happy/unhappy face pictures

          -have a food group chart, with a rule that they must have at least one food from each group each              day.

 

Try not to categorise foods into healthy and unhealthy, or good and bad.  This can sometimes be taken too literally and can cause further problems.

 

Try to be very specific when talking about food, or using pictures of food.  For example, apples look and taste different, but we call them all apples.  It's possible that the person likes golden delicious apples, and dislikes brae burns, but is confused by you showing them a picture of a green apple, then bringing them a red one.

 

Rewards

 

Using reward systems can be effective.  However, avoid using a preferred food as a reward for trying a new or non-preferred food.  It could make the preferred food even more attractive, and the new food appear like a chore.  Also, ensure the emphasis of the reward is not just on eating a certain amount of a non-preferred food, but on tolerating new food being around, or tasting a new food.

 

Exercise

 

Encourage activities, which involve movement and exercise. This can help with weight loss (if appropriate) and reducing stress, which may have contributed to over-eating or under-eating.  If the person is reluctant, think about whether there could be any underlying reasons, e.g. difficulty with balance, or socializing.

 

Professionals who could help

 

Your GP might refer you to one or more of the following professionals or places:

 

          -Dentist

          -Dietitian           

          -Eating disorder clinic

          -Clinical psychologist or psychiatrist

          -Paediatrician

          -Occupational therapist

          -Speech and language therapist

          -Counsellor