Can anything be done about this fussy eating?

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My 5-year-old daughter who has HFA has always been a fussy eater but it seems to be getting worse and worse.

She just wants to drink a vitamin-fortified milk drink all day. Sometimes I can get her to eat chicken nuggets, salami, a small amount of grated cheese or juice. On rare occasions she's eaten toast. Other than that, she's not interested in anything else. She's never liked fruit (except grapes, but they're out of season at the moment and I can't find them anywhere!) vegetables in any shape or form (unless you count tomato sauce or french fries?) meat, yoghurt, cereals or any kind of home cooked meal (except for pasta bolognese, but only sometimes)

If we eat out at any restaurants, it's the same story. Not interested in anything on the menu except for french fries.

I've got her on a waiting list for occupational therapy to address her sensory issues, and I've asked her pediatrician to arrange a referral to a dietician.

In the meantime, though, I'm pulling my hair out. She's a little overweight and I'm concerned about lifelong weight problems and malnutrition. Apart from the vitamin-fortified milk drink that she loves, I sometimes sneak children's vitamin drops into some juice and give it to her as well. But is it ok for someone to get all their vitamins and minerals from artificial sources like that?

Does anyone have any tips or strategies that might work for getting her to accept more foods into her diet, or any experience in this area? Or just commiseration if you're going through the same thing? lol. I know this is very, very common with ASD.

Thanks...

I have fussy food board/chart, I cant find it on ebay at the moment but this is somehting similar.
[img][800:768]http://i263.photobucket.com/albums/ii139/grhutchinson/Food1.jpg[/img]
http://cgi.ebay.co.uk/112-FOOD-PHOTO-PE ... ational_RL


with this they pick some choices for food they like and a new choice for them to try at each meal. This helps as they can be prepared for what they are going to get, and have some control over it.

I would also get a reward chart in their special interest (Im presuming Dora in your case)


http://cgi.ebay.co.uk/PERSONALISED-MAGN ... ational_RL

and give her a reward for every new food she tries.

sorry that the food image is so big

willaful started a thread on a similar topic not too long ago
http://www.wrongplanet.net/postt132221.html

I thought she and her DH had some good ideas for motivating their son to expand his food repetoire!

yes there should be several threads in this forum if you do a quick search for picky or eating.

Have you ever tried a smoothie? That's really the only way I like to eat fruit. If you use a hand mixer or good blender, it can be pretty lump free. I would also suggest looking into food chaining. That has helped a little with my son.

There was news coverage recently of a study of kids on the spectrum which found that A - they are fussy eaters and B - that they have no health issues as a result.

As with much of what happens with ASDs,, the problem is in the expectations of their parents. Mommy & daddy want Junior to try everything and experience the pleasures of different foods. (That is NOT to blame parents for causing the problems, but their solutions are often those which work for NTs and fail when tried on Aspies).

Aspies have sensory issues. Clothing causes problems with seams, textures, materials, etc. and we make allowances for them, but expect their child to like every food put in front of them, regardless of their taste, smell, texture, appearance or effect on their digestion.

I'm in my 60s and when I was a kid, my parents demanded that I try everything, so mom would plop a pile on my plate and she and my father insisted I eat it. Some of those things made me sick to my stomach, not eating them, but the idea of putting them in my mouth. It could be what it looked like or how it polluted the air in the kitchen when it was being prepared, but there were some foods that I just could not taste, let alone swallow. They would gobble it right down, but I could not bring myself to do more than sample the flavor by licking it or smelling it (maybe). The mere thought of putting some foods in my mouth would make me gag and wretch, but I could not leave the dinner table until I finished what was on my plate, so I missed the evening's TV programs and dessert and sat at the dinner table until bedtime.

The process was not an intellectual exercise. Life at the dinner table devolved into a visceral battle when they had something I couldn't eat, complete with yelling, threats, being deprived of future activities and participation in events and tons of tears. They thought they were making me a better person by exposing me to varying tastes and I'd cry myself to sleep.

Parenting an Aspie is hard enough. Why even go there? There are loads of things that parents of Aspies can change, so we have to learn to pick our fights carefully and only choose to engage in those which we can win. Why accommodate Junior with sweats or seamless socks, only to demand they eat things which look, smell or taste like dog poops to them? It makes no sense, particularly when it leaves such a lasting scar on their psyche and your relationship with them. And it IS a big thing to them, something they will be able to recount to their grand kids 50+ years from now as some of the earliest and worst memories of their lives.

If they are healthy and growing normally, don't obsess on their pickyness. Forcing them can destroy their trust in you and open a schism that can last a lifetime. They will add to their likes as they get older and their tastes change. You can help it along with variations of present likes and ALLOWING them to try new foods, but when they say they don't like something, believe them. They don't.

I hope this perspective of 'difficult eaters' and life from their side of the table helps.

Good luck

Rick

EduAdvocate
I do appreciate your point of view, I was a picky eater myself, though not the degree you describe, so I think I can empathize a little. I also often sat at the table until bedtime because I could not put something in my mouth without gagging.

However, I am not sure where you are getting your information that kids on the spectrum have no health issues as a result of being fussy eaters. I am not advocating the type of treatment you described happened to you but there is AMPLE evidence that a significant percentage of kids on the spectrum are under-weight and/or are not in good physical health. Whether this is due to picky eating or metabolic problems causing low absorption rates is debatable. I think we are talking here about encouraging kids to try things. I know I have gone to great lengths to avoid dinner time turning into a battle. I work all day and the LAST thing I want at dinner time is to do battle. At the same time, I don't think it is healthy for my son to eat spaghetti EVERY night which is what he would do if he had his way all the time. Kids don't have to eat everything we think they should try but I have serious concerns about my son's health so I will continue to try to expand his food choices when and where I can.

Hi Bombaloo,

Thanx for your warm welcome.

Sorry, but I don't make it up as I go. I'm new here, but I've been at this for decades and, even if I can't send you a link to the source, if I post it, I read it somewhere reputable. In this case, it was even in the mainstream news last month.

The following is quoted on xxxx under the headline:
"Vegetables, Schmegetables, Autistic Kids are Picky Eaters; Study Says Relax"

Parents working themselves into a tizzy about how their child's picky eating will affect his growth and development can unknit their brows.

Researchers looked into the matter and found, the website xxxxxx reports, that the kids are all right.

"Although the autism spectrum disorder (ASD) children were eating less variety of foods compared to the rest, they were not growing less well or more likely to have anemia (low levels of iron in the blood)," Pauline Emmett, Ph.D, a senior research fellow at the Nutrition Centre for Child & Adolescent Health at the University of Bristol, England, tells xxxxxx. "Their diets were similar in energy and most nutrients, so it suggests that parents of ASD children can relax a little about whether the diet their children are eating is likely to be adequate."

Researchers' findings appear in the August issue of xxxxx.

(the site won't allow me to post the URLs of the links, but you can Google "autism, picky eaters" to get to the article)

I hope this clears things up.

Rick

PS - if you lived in Italy, spaghetti every night would not be unusual. YOU don't like the same thing every night, but Aspies like things to be the same and YOU should be willing to see his point of view. (He's the one with the disability). Spend a half hour on the weekend to make a pot of pasta and sauce, freeze it in individual portions and microwave one each night while dinner is being prepared. Use fortified spaghetti and try spinach pasta for more vitamins, etc.

PPS - since we're seeking verification of FACTS, what AMPLE evidence are you referring to?

Sorry if you find me less than welcoming. When you have a child who has consistently been in the lower end of the percentile for body weight and seems to have trouble keeping weight on, it causes one to worry and people telling me I shouldn't worry because some recent study says I shouldn't kind of rub me the wrong way. There has been reputable research that says that boys with ASDs tend towards low BMI. Following is an abstract from one. Hebebrand and Sobanski have conducted other studies as well with similar results.

Eur Child Adolesc Psychiatry. 1999 Dec;8(4):312-4. Sobanski E, Marcus A, Hennighausen K, Hebebrand J, Schmidt MH.
"The study explores the common clinical impression and previously reported finding by Hebebrand et al. (7) of reduced body weight in male children and adolescents with Asperger's disorder (AD). Body weight and height of 36 consecutively admitted male patients with AD were retrospectively assessed for the calculation of body mass indices (BMI, kg/m2). The BMIs were transformed to percentile ranks and plotted into BMI-centiles representative for the German population. In addition, comorbid psychopathology was assessed to explore a possible relationship between associated psychopathology and body weight. The mean BMI-centile of all patients was 34.7 +/- 31.8 and, thus, differed significantly from the mean centile of an age- and gender-matched psychiatric control group, which was 52.7 +/- 28.3. Thirteen patients had a BMI below the 10th centile and five even below the third. Three of the latter presented with disturbed eating behaviour. Altogether four patients showed disturbed eating behaviour. They had a significantly lower mean BMI-centile than the rest of the group. The BMI-centiles of patients with other additional psychopathology did not differ significantly from the mean percentile of the whole cohort. The results clearly show an increased risk for underweight and disturbed eating behaviour in patients with Asperger's disorder which should be evaluated in further studies."

To expand on this a little -

My NT child went through a phase where he would only eat spaghetti and pot stickers. Because these choices were actually pretty nutrient rich, I prepared a mont's worth of sauce, froze it in week sized containers and let it go.

I made sure that each of the selections did have appropriate nutritional content. We changed the pasta to organic whole wheat, snuck some veggies in the sauce....

I will say he now eats a pretty good variety of foods. My kids (NT&AS) eventually move off of the current favorite. It is much easier on all of us if I let them manage it.

That said, my kids are not underweight or sickly and never have been. Therefore, I have never had to worry that their diet is hurting them.

i did read this article, "Vegetables, Schmegetables, Autistic Kids are Picky Eaters; Study Says Relax", and there are a few things to point out about it and the study it reports on.

the study sample size is small, only 79 asd children versus over 12000 control subjects.

the article itself quotes:
[Susan Hyman MD, an associate professor of pediatrics and the division chief of neurodevelopmental and behavioral pediatrics at Golisano Children's Hospital of the University of Rochester Medical Center, N.Y., agrees. "When you manipulate what children would normally eat, you change the rules," she says. "This study would not be reassuring if your child eats a little mac and cheese, a little frozen waffle and 30 or so other foods, which is a more typical restricted autism diet," she says]
and
[Pauline Emmett, PhD, a senior research fellow at the Nutrition Centre for Child & Adolescent Health at the University of Bristol, England, in an email (said) "If the behaviors are very extreme in a minority of ASD children there could be a chance of nutritional inadequacy, but our study is saying that this is not the case for the majority. Parents who are worried about this should see their family doctor or ask to see a trained registered dietitian."]


so the message to take away from this study is that asd children can have feeding issues starting at birth, and that for the children in the study it had no significant effect on their bmi, height, or weight.

that does NOT mean every child who is a picky eater is going to be just fine. in my personal experience with my own kids, am extremely picky eater can result in an overweight child at risk of diabetes, heart disease, etc. my oldest, if left to his own devices, would eat nothing but carbs like mac and cheese and mashed potatoes. like EduAdvocate, he has an extreme gag reflex and cannot put things in his mouth he thinks he doesnt like or he will gag. we cannot simply let him choose his own foods to eat as he will not make good choices.

something i see with my youngest asd child is that he arbitrarily decides he does or doesnt like something. it has nothing to do with the smell, look, texture, or taste. ironically a lot of his food choices are about language and name. he will flat out tell you whether he does or does not eat something, and nothing changes his mind about it. we do constantly offer new foods to try, but do not push him to eat them. he is difficult to feed as he is constantly narrowing down his food options by deciding he no longer eats something.

oh, i was going to make a new post, but will just stuff this here instead as its very appropriate. my youngest has for the first time in 4 1/2 years of life eaten fresh meats over the past month. multiple times now hes eaten chicken breast and pork chops. he also ate tortellini which he previously never did. how did we manage this you ask?

WE LIED. and breaded it. all meats in our house are now breaded (we use fortified cereals to bread meats as a healthier alternative) and called "giant chicken nuggets." tortellini is the new mac and cheese. like i said, he is more about language and names.

and something incredibly weird happened yesterday. he sat at the dinner table, put a chicken drumstick on his plate, announced he was eating a chicken drumstick, and then ate 2-3 bites of it. of course, then he put it down and said "i dont eat that" and asked for a cheeseburger. =P i asked him later if he liked it and it was good, he said, "yes, but i dont eat that".

go figure.

My diet is still very limited. I still have to eat my "favorite" food everyday. If it is of any condolence to you eventually my food choices became a lot healthier, even if they are the same thing everyday. I would encourage your child to become interested in healthy eating, and not to push foods on them.

Actually, I didn't tell you anything. My post was in reply to the original question. If it applies to you, great, but please don't get on my case if you disagree with the study. I'm just the messenger.



Wonderful. A study conducted 11 years ago. Are you aware that France considers ASDs something that is treatable through pyschotherapy? That England brought us Dr Whitfield with his bogus mercury/autism link? You must be very careful with European based studies. They see autism/AS through a different lens.



ADMITTED? What were they being admitted for? They address comorbidities, but that does not explain whether there were other issues involved that would change their BMI.



Yes, their group of 36 was skinny and picky. What about the millions of others who are picky, but suffer no ill effects?



And it was, in the study referenced to in my reply. And they found that kids who are picky don't suffer harm from their limited diets.

Aspergers does encourage one to stay with what is known and manageable, but that works against us when it comes to how to deal with our kids. Much of what we know, from how we were trained, is wrong for this community and no longer acceptable.

With the interest in AS that has grown since being acknowledged as an official disorder(1994 - 5 years before your study), there are scores of studies and research projects being added to the information available to us. We have to assess each for its reasonability and application to our child, but that does not mean ignore info that contradicts what has been passed off as gospel. If we all did that, Aspies would still be institutionalized and some would be scheduled for lobotomies.



Low BMI? By what measure? Today's charts of ideal weight, which has been revised to account for the burgeoning population of obese kids? That's a joke. Look at photographs of kids before the 1950s, when the explosion of fast foods and sugar laden drinks and snacks hit the market. They were considered fit when they had no flab and the lardass was the exception. Now that we have computers and TVs and mommies are afraid to let Junior play outside, where they might get stolen, baby fat is acceptable and kids can be as wide as they are tall. If that's the 'normal' they are rating kids by, the thin kids are the healthier exception.

Try to balance your worry with reason. There is sound medical information that indicates that picky Aspies are not endangered by their diets. Maybe doing further research into recent studies will lead you to see the revelation as an epiphany that would help you to be more at ease with your son's diet.

One can only hope.

Our kids are truly amazing. Just when you figure you've got them figured out, they never fail to surprise.

It is still possible that your son has sensory issues with food. Even though he said he liked the flavor of the drumstick, the feel of it as he chews may not be pleasing and turn him off. (Drumsticks are dark meat, which is greasy vs the white meat that nuggets, etc. are made of).

I don't know if it has been accepted here, but researchers have found that the brains of many ASDs develop at 2/3 the rate of NTs. The 4 1/2 yo AS can have the functional abilities, in the areas of their developmental delays, of a NT child of 3.

He can be verbal, but not have developed the expressive skills to differentiate between 'taste' and 'feel.' He answered your question about whether he liked it, but may not be able to conceptualize 'feel.' Yet he knows he does not like that part of it. Like the two yo, who wails about how 'foot hurts' when he is trying to let you know the seam in the toe is what is bothering him. Because he can't express it, doesn't mean it is not real.

Lying works. I loved Lima Beans, but would not touch Peas until my mom called them, Lima Bean's Cousins. Worked for me.