Your Guide to Autism Feeding Therapy
The everything-you-need-to-know guide on Autism Feeding Therapy is here! You’ll learn what autism feeding therapy is, who it’s for, and an example of one child’s autism feeding therapy in action. (His name is Timmy.)
Timmy’s Story
Timmy is a 5-year-old boy with autism who struggles with picky eating.
In fact, not only does he dislike trying new things, but his picky eating is so extreme, that he only eats 6 foods on a regular basis. The foods he eats include Cheerios, 1 brand of toaster waffles, homemade pancakes, noodles with red sauce, blueberries, and chicken nuggets.
Because he doesn’t like to get food, and especially anything wet on his fingers, he only eats the pasta if his mother feeds it to him.
Does any of this sound familiar?
Unfortunately, children on the spectrum struggle with eating at very high rates. As many as 90% have feeding difficulties. If your honey is having difficulty at mealtimes, you may be wondering if feeding therapy is right for your child.
Who Is Autism Feeding Therapy For?
Autism feeding therapy can addresses a range of feeding challenges. Here are some of the concerns that I’ve heard families share when they come to feeding therapy:
· My child only eats 5 foods
· My child doesn’t eat any foods and drinks all of their calories
· My child has not learned to use utensils
· My child only eats foods if they are the right brand
· My child only eats foods if they are a certain texture
· My child only eats foods that are pureed
· My child will not come to the table to eat
· My child gags or vomits when I offer new things
· My child is tube fed and does not show interest in eating orally
· My child has challenging behavior at mealtimes
Who Should My Child See for Autism Feeding Therapy?
Because eating is a complex skill that requires many systems in the body working together, there are professionals from a few different disciplines that specialize in helping kids with feeding challenges.
These professionals span 4 areas:
1) Medicine
2) Nutrition
3) Feeding Skill Development
4) Behavioral Psychology
When you take your child for their first feeding appointment, you may have providers from one or more of these areas meet with you and your child. Please see this post all about having a feeding team and what questions should be addressed in your first few visits.
If your feeding therapy appointment only includes a provider from one of the 4 areas above, then I recommend 1) talking to your provider about the importance of looking at your whole child, and 2) making a plan to seek out additional appointments with other provider types to ensure that your autism feeding therapy takes your whole child into account – and is safe.
What Will Happen at My Child’s First Visit?
At your child’s first appointment, you should expect the provider or team of providers to assess your child’s eating and feeding history.
This could include:
· Questions to you about your honey’s eating history
· An observation of your child eating
· A therapist collecting data on the observations of your child’s eating
· A review of your child’s diet or current mealtime schedule
· A therapist asking your child to trial an eating-related activity
· Written questionnaires for you to fill-out
· A physical examination including a weight and height of your child
· A therapist asking you and/or your child what your goals are for your child’s eating
Your provider(s) should be able to offer some information to you about your child’s eating and how their feeding challenges can be addressed with treatment after 1 or 2 visits.
What Should Happen In Treatment?
After your child’s feeding assessment, you and the provider(s) should agree upon goals for addressing your honey’s feeding needs in treatment. Some kids might begin by working on a skill like learning to drink from a cup, while others might begin by learning to get their body used to new foods or food textures.
Depending on your child’s goals and their assessment, some of the providers who were apart of the initial assessment may no longer be needed on a regular basis. For example, if your child doesn’t have any feeding skill concerns, you probably won’t continue to see an expert in that area.
While your child is attending their feeding therapy visits, your provider(s) should be doing the following:
· Measuring your child’s progress regularly
· Teaching you about the treatments they are using
· Or, teaching you to implement the treatments
An Example: Timmy’s Autism Feeding Therapy
Timmy’s first autism feeding therapy appointment included a full feeding team, so, he and his momma saw a nurse practitioner, a dietician, a speech and language pathologist, and a behavior analyst on their first day.
Medicine: Seeing the nurse practitioner
The nurse practitioner took Timmy’s weight and height. She mostly asked questions to his mom about his health. He thought it was funny that a lot of the questions were about his poop! They learned that even though he has stools 3 or 4 times a week, that it could help his eating if he was going every day, so, they made a plan to help his body have to go more often.
Timmy will go back to the nurse practitioner in 2 weeks to check on how stooling is going.
2. Nutrition: Seeing the dietician
The dietician wanted to know a lot about the foods that Timmy eats, so, before the appointment, she sent a food log to his mom. She came prepared with the log filled out. From the log, the dietician could see all of the foods Timmy ate for the past couple of days.
The dietician also asked questions to his mom. He wanted to know how many times per day Timmy usually eats and if he tells his mom that he’s hungry.
Because Timmy doesn’t eat very many foods from each food group, the dietician also wanted to know what foods the family usually eats in each group. The dietician said that foods other family members eat are good ones to target for Timmy since they are usually in the house already.
The dietician said that because Timmy is eating a small amount frequently throughout the day, he might not be feeling very hungry at mealtimes. He said this can make it hard to introduce new foods.
The dietician would like to keep seeing Timmy in order to help his mom make a plan for carving out a few meal and snack times. This could help Timmy come to the table feeling hungry and more flexible.
3. Feeding Skill Development: Seeing the speech and language pathologist (SLP)
Next, Timmy went to see the SLP. Because Timmy doesn’t like to feed himself pasta, the SLP wanted to watch Timmy eating toaster waffles by himself with a utensil. Since he was able to do this, she said that his refusal to feed himself noodles is probably not a skill concern.
The SLP had some questions for Timmy’s mom. She asked if Timmy has any difficulty with swallowing foods, coughing, or gagging. Because his mom said no, and because he could feed himself the waffles, she said that Timmy doesn't have any feeding skill concerns that needed ongoing therapy from an SLP.
4. Behavioral Psychology: Seeing the behavior analyst
When Timmy went to see the behavior analyst, it was still time to eat. He only had a few bites of waffle with the SLP, so, his mother took out the rest of the foods she had brought along for the visit. She had some things Timmy liked and some things he didn’t – especially, applesauce.
The behavior analyst asked Timmy’s mom to offer all of the foods to him the way that she would at home for a meal. She had a clipboard with a data sheet and wrote a lot of information down about what Timmy ate.
When Timmy’s mom asked him to eat the applesauce, she past it to him on a spoon. He said, “Applesauce is yucky!” and pushed his mom’s hand away. He did this a few times before she set the applesauce down and told Timmy he could be all done eating.
The behavior analyst thanked Timmy and his mom for letting her watch him eat. She asked his mom about her goals for Timmy’s eating. Timmy’s mom said that she wants him to try new things and be more open to wet, puree textures like applesauce.
The behavior analyst made a plan to see Timmy weekly for therapy. In the visits, the behavior analyst would teach Timmy’s mom how to help him tolerate and try new foods, including different textures. She would also help his mom with getting Timmy on the mealtime schedule that the dietician recommends.
In Conclusion
As you can tell from Timmy’s story, every child’s journey in autism feeding therapy is unique. The assessment and treatment for your child’s feeding difficulty will vary based on your child’s goals, skills, medical history, and current diet.
Did I answer all of your questions about autism feeding therapy? Leave me a comment below to tell me if there’s something I missed!
Like this post? Get some of my best tips to improve picky eating in this free resource.
