When “Waiting Out” your Picky Eater with Autism doesn’t Work

In the world of picky eating and autism, it’s all too common to hear that a well-meaning person has suggested that you wait out your picky eater. 

Maybe someone - your child’s pediatrician, their teacher, your mom - suggested that if your child doesn’t eat the foods you offer at mealtimes, then you shouldn’t give them something else to eat. Instead, they suggest, you should wait until your child “gets hungry enough” to eat what you’ve presented. 

You know why? 

Because sometimes, this works. Sometimes, when nothing else is offered, kids eat something different or try something new.

But you know what? Sometimes, lots of times with kids with autism and picky eating, they don’t. 

Maybe you tried it, and it didn’t work for your child. Maybe you’re here because you’ve read the picky eating books, you’ve tried tons of strategies, and your little muffin still only eats something like 15 (mostly) starchy foods + candy. Maybe you tried to “wait it out” and your child chose to eat nothing…. for several meals in a row. 

So now what? What are you supposed to do?

Enter, choices and preferences.

The evidence base for kids with autism suggests that using choices and your child’s preferences can increase compliance, interest and sustained attention. (For more on this, see the More Readings section at the bottom of this post.)

Aren’t those all things we want more of at mealtimes? 

Compliance with coming to the table.
Interest in what’s offered on the plate.
Attention on eating.

Sounds pretty good. So, let’s talk about how to apply these 2 key elements, choices and preferences, at mealtimes.

1) Create your child with autism a food list of their preferred foods.

If you’re going to use your child’s preferences to encourage them to eat well, then we need to clearly identify what foods your child prefers. This can be tricky when your child’s preferences seem to change quickly, or if your child tends to eat 1-2 foods over and over until they burn out on that food and begin to refuse it. For this reason, I have a whole post and a nifty tool on how to create a master list of your child’s preferred foods.

2) Break your child with autism’s food list into 3 sub-lists using these categories:

1) protein foods

2) starch foods

3) fruits or vegetables

This step is also described in the post on creating a master food list. So, if you haven’t already, go back and start here. 

You’re going to offer a choice of foods from each of these 3 food categories at meal and snack times, so, you’ll need to get this step squared away before getting down to business.

3) Start offering planful choices.

By this point in the process, you should have a list of foods your child is highly likely to eat, divided by food category. At mealtimes, here’s what you can do:

1. Check your fridge and cabinets to see which foods you have on hand from your child with autism’s master food list.

2. Pick TWO items that you have available from each food category to offer to your child.

3. Then, ask your child which food they would like to eat from each category. You might say something like this:

“Mickey, do you want chicken or ham?” - This would be the protein choice.

“Do you want noodles or toast?” - The starch choice.

And lastly, “Strawberries or applesauce?” - The fruit or veggie option.

Something important to notice about this example:

You did not ask your child a series of questions that included one option. That would sound more like this:

You: Do you want chicken?

Child: No.

You: Do you want ham?

Child: No.

You: Do you want turkey?

Child: No.

You: Do you want pizza?

Child: No.

You: Do you want macaroni and cheese?

And so on.

While this does look a lot like giving choices, it leads to a few problems. One, your child has the option to say, “no,” (many times) as occurred in this example. 

Another problem is that the child ultimately received MORE choices because they kept saying no. What they can learn from this is that 1) saying no leads to more choices and 2) saying no enough times leads to more desirable options as you try harder and harder to find something that your child will say yes to.

Instead, you want to offer a clean choice of a few options from the start: chicken or ham, noodles or toast, rice or mac and cheese.

You may be thinking that if you offer just two choices, that your child may not select one of the choices that you offered. This is wholly possible, but don’t let that deter you.

Let me give you an example of how that can go:

You: Do you want chicken or ham?

Child: I don’t want those.

You: (In a calm, gentle voice): You can pick one, sweetie, or I’ll pick.

Child: Doesn’t respond or continues to refuse both options.

You: I pick chicken. (Then, you calmly proceed to either the next choice or meal prep.)

Benefits

The magic of this approach is that over time, your child will learn that they have an opportunity to choose between two preferred options and that if they don’t choose, that you will help them make a choice. This can encourage your child to do the following wonderful things:

1) pay attention when you offer choices

2) respond when you do so

3) make a selection from what you’ve offered

4) eat what they’ve chosen!

Another benefit of this approach is that it can result in your child being exposed to a wider variety of foods. When your child makes all of the decisions around what to eat, they might choose the same one food meal after meal. When you are planful with choices to offer, you prevent your child from getting stuck in that kind of rut. You can also ensure balance by selecting choices from each food group. AND, because you’re choosing items to offer from their master list of preferred foods, you are still always offering foods that they are likely to eat. 

More reading on using choices and preferences with children on the autism spectrum:

Using choice and preference to promote improved behavior

An evaluation of choice on instructional efficacy and individual preferences among children with autism

Engagement with toys in two-year-old children with autism: Teacher selection versus child choice

That’s a wrap! If your child is prone to refusing the foods you offer and often picks the same one or two foods when you allow them to choose meals, here’s some middle-ground for you to work with. You don’t have to wait them out or give them a million choices. Using these steps, you can use your child’s preferences and a few planful choices to create meals with balance and variety - that your child just might eat.

Have you tried to use choices at mealtimes before? How did you do it? I want to hear about it! Finish this sentence in the comments below: “The last time I gave my child choices at a meal or snack I……”

*This is not medical advice and is provided for education and entertainment purposes. As I describe here, a thorough assessment by a team of professionals is the best practice prior to making mealtimes changes.