Eating issues are a concern of the western world! Many parts, including the East, find food allergies and intolerances to be a non-issue. In fact, on a semi-recent trip to the Middle East, I spoke with an Israeli mother who was shocked to hear that children could be allergic to something as natural as a peanut. With the increased prevalence of allergies in our kids, I can't help but wonder, "what gives?" Are we super-sensitive in "this part" of the world, or is something going on environmentally which makes us more at risk!? As someone with plenty of allergies, this is a subject matter which holds special interest for me.
Moving beyond allergies, there seems also to be a prevalence in the number of children with textural intolerance. It is certainly more common to encounter this challenge with children on the Autism spectrum, but given that the spectrum itself is so wide, there is potential for many individuals to possess textural intolerance (whether or not they are recognized as on the spectrum). Just the other day, I sat in a "typical classroom" at snack time and watched a little guy, let's call him "Owen", struggle with the texture of the banana before him. He clearly liked the taste, but could not figure out a way to get into his mouth in a way that was not aversive to him. Even with a toothpick, he struggled to manipulate to banana into his hungry little mouth.
Part of a successful and holistic program, ought to include some aspect of programming which is exclusively tailored to developing healthy eating habits. For some, this may mean overcoming textural intolerance, while for others, it will be a battle to overcome the will (i.e. the will not to eat vegetables, cheese, fruit, or what have you). It is important to view eating as a behaviour; obviously, the consequence which follows the act of eating has a direct relationship with whether the behaviour (that is, eating) is likely or unlikely to occur again with the particular item (be it pasta, pizza, salad, or egg salad). Making eating a reinforcing experience is just one way you can increase your child's chances of developing healthy eating habits,
Think of it this way.... I don't want to eat vegetables, so every time I eat vegetable I will start to gag. When I gag, my teacher or parents react. If my teacher or parents react to the gagging by taking the food away and saying "Oh your poor kid, you hate your lunch" and offering me something much more palatable I am MUCH more likely to use this method of escape again. If on the other hand, the gag is ignored and the child continues to go on eating (at which point he or she is praised tremendously for his or her healthy appetite) the behaviour of eating is much more likely to happen again and the behaviour of gaging is much less likely to happen again. When you render a behaviour ineffective at achieving its purposes, it slowly fades away without the need for serious or prolonged intervention.
Many daycare and childcare centers serve a hot lunch family-style; family-style is when everyone sits around the tables together, and we all take turns scooping, pouring and distributing. Eating family-style helps children learn how to develop healthy and balanced eating habits. With one choice for lunch, children learn to expand food repertoire beyond the traditional foods made within their home-environment. This kind of exposure is especially important for children on the spectrum, for whom rigidity and the need for sameness may be an ongoing struggle to overcome.
In a post that addresses allergies, I cannot help but address the issue of gluten-intolerance in children with Autism. It should be made explicitly clear, there is no scientific evidence to support the removal of gluten and/or casein from the diet of individuals with Autism, as a course of treatment for the symptoms of Autism.
BUT....As children prone to allergies, all children on the spectrum should certainly be tested for food and environmental allergies;but really, this is a procedure all children (special needs or otherwise) should undergo periodically. There is an increased trend in gluten-intolerance in the population at large; if you suspect your Autistic child may be gluten-intolerant, do not rule it out just because there is no science to support that removing gluten "cures" Autism or its symptoms. On a separate note, be weary of anything that claims to "cure" a neurological impairment. Also be aware that underlying food intolerance may cause an array of behaviours (including self-stimulatory behaviours and/or tantrums).
Questions or comments?
*images courtesy of free digital photos.net
I loved your story about the banana! I also agree with you completely about gagging. I helped a 9 year old boy through gagging issues into a stable healthy diet with tons of vegetables. Lots of proprioception prior to eating is a big help.
ReplyDeleteThanks Teresa! I agree that sometimes a chewy tube is just what the doctor ordered to get the muscles moving.
ReplyDeleteWe are currently working on trying some elimination diet stuff while also expanding the diet of our special needs child and our other children. It's a challenge, but one I am GOING to meet!
ReplyDeleteThanks for your thoughts on this and reminder that much of eating is about behavior.