Supporting your child to learn to eat new foods

• Research shows that approximately 80% of young autistic children are selective eaters, and 95% are resistant to trying new foods. This can cause parents a considerable amount of worry and stress.
• Expanding the range of foods your child will eat will bring many health benefits.
• Feeding progress tends to be slow and it would be overwhelming to implement the strategies below all at once. Consider starting with one or two small changes to help your child gradually work towards improved mealtimes.

Expanding food preferences through exposure

Developing a liking for a new food requires repeated exposure over time to that particular food in a calm, non-threatening environment. The strategies outlined below are all designed to increase your child’s exposure to new foods. Exposure does not necessarily mean tasting.

Before a child will put an unfamiliar food in their mouth, they must first feel comfortable with the sight, smell, texture etc of the food.

1. The Power of Play

Children learn best through play. Research shows that letting children play with food without any pressure to eat it, helps them explore new tastes and textures in an anxiety-free environment. Choosing a time outside of mealtimes works best. Consider using your child’s favourite themed toys to gain their interest, for example dinosaurs. Messy food play can use wet or dry foods. Provide different utensils such as tongs, measuring jugs, containers, funnels and explore the different properties of food by pouring, shaking, splatting, blowing and so on.

Imaginative Play

Set up a pretend kitchen, shop or restaurant and use a mixture of real and pretend foods. Imaginative play where your child is in control, allows your child to explore foods in contexts where they are not expected to eat.

2. Social Modelling

You and your family have the most important influence on your child’s development. This includes their eating behaviours.

Have nutritious foods within sight, and model healthy food choices. This usually works better than persuasion, coaxing or any form of active encouragement.

Eat together as a family as much as possible. Shared mealtimes can be a valuable opportunity for a child to interact with foods that others eat, even if they are not ready to taste these foods yet themselves. Some children eat better alone without being watched; you will know what suits your child bests.

Have a “self-service” meal where everyone helps themselves to whatever they prefer from serving dishes placed in the middle of the table. This is less pressurising than putting food on their plate. It also helps the child to see different foods and see others choosing them. Alternatively give your child the task of serving your food – this will encourage your child to handle and interact with foods they would otherwise not choose for themselves.

Talk about the food in a matter-of-fact way rather than in a way that could be seen as pressurising. For example, describe how the food feels or tastes to you – “these carrots are crunchy”, “these chips are salty” instead of “mmm these carrots are delicious” which could be seen as subtle pressure. By doing so, you may also be helping your child develop new vocabulary.

Be aware of your own interactions with different foods, including your facial expressions. Try to be positive about the food even if you do not feel particularly positive about it.

3. Routine and structure

Establish consistent, predictable meal and snack routines. Having small scheduled snacks between meals will help avoid grazing between meals. Grazing can dampen your child’s appetite and lower their motivation to eat at mealtimes. Offer 3 meals and 2-3 snacks at consistent times every day. This also helps your child know what to expect.

Visual timetables of meals and snacks can be helpful for some children.

Give your child a signal to prepare your child e.g. “dinner in 5 minutes”, “wash hands for dinner”

Involve your child in setting the table

Make sure your child is sitting at the right height for the table so that they don’t need to kneel up. Good trunk support helps your child concentrate on the task at hand, i.e. eating and drinking. Booster seats can be helpful.

Ideally remove or turn off any distractions such as TV and tablets. Some children need distractions to reduce anxiety at mealtimes. A “Meal toy-bag” (interesting toys that are only brought out at only at mealtimes) may be a nice alternative to screens to distract from mealtime anxiety.

Limit meals to 30 minutes, and snacks to 15 minutes. The use of a timer can be helpful.

When the time is up, remove any uneaten food and allow your child to move on to another activity. Prolonging mealtimes will add to your child’s anxiety and rarely leads to more food being eaten.

Mark the end of the meal by cleaning hands.

4. Involve your child

 Providing a choice between two different foods or meals can be helpful. It allows a child to feel a sense of control, even when neither choice is their favourite. Ensure that all choices are realistic, e.g. “Would you like a banana or an apple?”. Choice boards can be helpful for some children.

Involve your child in food shopping, food preparation and cooking in an age -appropriate way. The more a child is involved in choosing, preparing and cooking ingredients, the more they have invested in it and the more attached they become to the meal that is prepared. Keep doing this even if your child does not want to taste the food.

Give your child a choice of plates and bowls. Do they prefer food altogether or on separate plates? What are their favourite interests? E.g. bowl with spaceships, animals etc.

Some older children with autism may be motivated to make more nutritious choices simply through education about nutrition. This should always be done in a “matter of fact” way or it soon becomes nagging and persuasion.

5. Introducing new foods

When choosing which new foods to introduce your child to, consider food chaining. This involves identifying new foods that are similar in colour, texture, smell and taste to foods already accepted by your child. It involves choosing a food that is different in only one variable to a food already accepted. Talk about how similar it is to the child’s accepted food. For foods that look very similar, be sure to tell your child it is a different food before they taste it so they do not get an unpleasant surprise. For example strawberry yoghurt > raspberry yoghurt (same brand, same colour, texture, different taste). Another example is mashed potato > mashed parsnip.

Avoid mixing new foods into accepted foods without your child’s permission. This can lead to the accepted food being “contaminated” in the eyes of your child and they may lose this food from their accepted food repertoire.

Serve foods out of their packaging if possible to avoid an accepted food being lost if the food packaging changes.

Consider introducing a “learning plate” next to your child’s lunch or dinner plate. Small amounts of a new food can be placed on the learning plate. This reduces pressure on your child to taste it, and also avoids any “contamination” of accepted foods.

Allow your child to spit out a food into a napkin or “spit bowl” if they don’t like it or can’t manage it – your child needs to feel safe around food.

Present food in small, easily chewable pieces or in long thin strips which are easy to hold. Allow your child to use their hands instead of utensils if they prefer.

Try different flavours e.g. spicy flavours can be more alerting and are often accepted easier by children whose diet is currently very bland.

It’s ok for your child to eat food combinations we wouldn’t eat as adults e.g. carrots and mustard, or even carrots and custard!

NEVER force your child to interact with or taste a food they do not wish to – all progress must be at your child’s pace and with their permission.

Remember it can take 15-30 (or more) repeated presentations of a new food with positive reinforcement before a child will begin to eat that food regularly.

Small goals > small changes > BIG wins!

If these strategies do not work and/or your child is very distresses, please discuss this with your child’s Dietitian and/or Doctor