Ask the Experts: Encouraging Healthy Foods

“My child is five years old and we’re worried about his diet. He doesn’t like any meat (with the exception of chicken nuggets) and eats very few vegetables. He enjoys crackers, chips, cookies, french fries and most crunchy foods. We worry about this affecting his overall health and would like to expand his diet to include healthier foods.  How can we expand his diet while still honoring his hyper sensitivity to smells and taste/texture of foods?”

Rachelle Enemuoh, CCC-SLP

Mealtimes involve social interaction, sensory experiences, engagement expectations, fine motor coordination, physical strength, and the actual act of oral consumption. This is a lot for a child with autism to process during a mealtime! Crackers, cookies, french fries, and the like are all beige in color and consistent in their taste and appearance. There’s a reason for these similarities! The predictability and consistency make these foods easier to process than homemade dishes, fruits, or vegetables. They’ve become his “safe” foods.

In order to work towards expanding his diet, promote small changes to his preferred foods. This will slowly encourage variety in his diet. To do this, begin by making small changes to his preferred foods by changing the shape, color, texture, or taste of the food. For example, rather than giving him the same brand or shape of chicken nugget for dinner two nights in a row, change the shape of nugget at each meal. Cookie cutters are a fun way to change the shape of foods! By slowly continuing to make changes, you will increase his comfort with other types of related, yet different foods, which will translate to his tolerance for trying other new foods too!

For family meals, I often recommend use of a “learning plate.” This is a separate plate at the table for foods that he will learn about during the meal. Have your child decide if he would like each of the foods on his plate or on his “learning plate.” This allows him to have a sense of control on where the food is placed while you as the parent increase his exposure to each food. While this does not mask the smell of your foods, it will give him a sense of control. During the meal, explore each of the “learning plate” foods with your child. The focus is to explore using his senses. How does it look? What does it feel like? This encourages conversation and allows for his brain to process these individual components of the food in a safe and positive way.

Jacqueline Braemer, Parent

I have been in a similar situation.  First of all, you are doing great if he will eat chicken nuggets and some vegetables!  It took my son until age 6 to eat carrots (which is his only vegetable).

We went through a sensory feeding group with our speech therapist.  The ultimate goal was to explore different foods without forcing the child to eat it.  They talked about the color, shape, texture, and smell.  My son had to pick it up and at least smell the item.  This works on bringing different foods to their face and tolerating it.

The next step was to bring the item and touch it to the lips.  Then touch it with their tongue.  Then hold it in their teeth.  And eventually taking a bite.  He was allowed to spit the food out if he couldn’t tolerate chewing the item yet.  All of this takes time and needs to be done at the pace of the child.  It’s a lot of repetition and eventually you will know if the child just truly doesn’t like the taste.

I also created a game for my kids.  I took a paper plate and divided it into 6-8 pie pieces and cut up numbers to equal the pie pieces on the plate.  We made a plate for each person that was here (including our therapists).  I then put a small amount of food on each pie place and everyone had the same thing.  So for example, spot 1 had cheese and spot 2 had carrots.  There was always something fun and familiar in some of the spots but a few had new things.  We would take turns drawing the numbers.  If the #4 was drawn, then everyone had to eat what was in spot #4.

If you’re giving supplements, I have one last suggestion. There are powdered supplements that say they are odorless and tasteless but this didn’t always work for us because my child was able to sniff it out. I found that Doritos can hide a lot.  The oils let the powders stick and the seasoning is so strong that it overcomes the slight taste.  If they are going to have the “junk” food, at least we can make it more nutritious!

Take a deep breath.  Take it slow.  Celebrate the little accomplishments.  Good Luck!

Brittany St. John, OTR/L &  Karla Ausderau, PhD, OTR/L

Great question! Overall, I would encourage you to do the best you can to keep eating fun and light when you implement any mealtime strategies. Children are more likely to explore new foods if they can be playful or opportunities are provided to explore in very small steps. This can be incredibly hard when you are concerned about the quality of your child’s diet and your child is hypersensitive to many food properties.

Here are some beginning strategies:

Adding new foods can take time and lots of repeat exposures-maybe even 40, 80, 100 or more! Continue to offer new foods even if your child has never eaten them. You can provide exposure by even just having the non-preferred food on the table near your child.

Start with introducing small changes to foods that your child already eats to increase flexibility. For example, try a different brand of chicken nuggets or potatoes that are fried in a different shape (steak french fries compared to crinkle french fries).

Offer foods that have similar sensory properties that your child prefers. For example, if your child prefers crunchy foods, but you are hoping to add fruits and vegetables, consider trying crunchy vegetable sticks, dried 100% fruit leathers, or one of many other freeze-dried fruits/vegetables that are now available.

Explore new foods playfully – touch and smell the food without the pressure of eating it, talking about the food properties. For example, what does it look like, smell like, sound like when someone else eats it, or does anyone else in your family eat it?

Let your child give feedback on the food – is it a food that they might eat sometimes? Do they like it more or less than the last time they tried it? What if the food was prepared in a different way? What do they like or not like about it?

Also, allow your child to provide feedback using non-verbal methods such as a thumbs up, down, or in the middle.

Include your child in mealtime preparation as often as possible for increased food exposure. This may include setting the table or preparing a part of the meal such as helping dish up food for another family member, getting something out of the refrigerator, stirring, pouring, etc.

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