Overcoming Special Needs Feeding Challenges

Explore five mealtime woes and possible solutions to help your child’s mealtimes be more enjoyable.

Dinnertime comes at the end of a long day, but as many parents know, cooking a meal that your child will approve of can be anything but relaxing. Regardless of ability, children can be picky, finicky, and fickle.

For those with autism spectrum disorders, multiple disabilities, or both, textures and flavors can further complicate preparing a meal. How can parents better understand their children’s preferences when it comes to meals and snacks?

There are multiple variables to look at. Sensory, oral-motor, medical, behavioral, and environmental factors are important to consider.

Sensory

Sensory issues can be a major factor to consider when choosing foods for your child with special needs. There are children who AVOID certain types of sensory input and those who SEEK other kinds of sensory input. Typically, olfactory, auditory, and visual stimuli overlap with one another.

Avoiders tend to have a dislike of food textures, smells, or visual inputs that are perceived as being too ‘’strong.’ Imagine the child who only reacts well to food that is bland, or even white; the desire to not have different foods on the plate touch each other; or preferences for foods that provide minimal smell or texture.

On the other side, there are seekers, those who crave and tend to seek out the crunch, the snap, the spice, and the chewy textures. These children may even attempt to eat non-food items because of a familiar or perceived texture.

Both of these types of eaters provide challenges for families looking for everyone to eat the same meal. Some children may become more comfortable and feel safer with familiar foods of certain colors, minimal smell, or that provide a smooth texture.

Some children may only want to eat soft, white foods, such as rice, pasta, mashed potatoes, etc. When presented with other foods, such as carrots or Brussels sprouts, they may refuse to eat them as it is not “the right color” or “not the right texture.”

Think about taste, smell, and textures when you are planning your meals. For some, vegetables like spinach and peas may be better received than broccoli or tomatoes. Others may prefer spicy food such as wings with hot sauce.

Try letting your child pick their own condiments. He or she may be more open to trying a new food if it contains a familiar taste.

Sensory preferences are very specific to each child. Things like smells and textures could be a trigger to one child, but might be preferred by another.

It is important for parents to speak with their OT/PT therapists to figure out what their child needs and how to target the appropriate therapies that could help them overcome their sensory issues.

Oral-motor

Oral-motor-based feeding challenges may be due to issues with tone and muscular strength. It is important to determine what your child can safely eat (with and without assistance) if they have feeding and swallowing difficulties.

If oral musculature is weak, you will want your therapist to focus on exercises that can be done outside of mealtimes to help develop key muscles for easier eating, chewing, and swallowing. Prior to mealtime, it is often important for a child to receive appropriate sensory input, guided by a therapist for functional oral motor performance.

Medical

Medical issues with a child on the spectrum are what will ultimately dictate other variables that affect the eating experience. If your child has physical disabilities in addition to being on the spectrum, or gastrointestinal issues, reflux, GERD, or other swallowing challenges, the medical implications of your meal choices become the primary consideration. Whether that be food with too much acidity, dairy, or spice, you’ll want to curate a diet that avoids triggering a negative response.

Behavioral

From a behavioral perspective, if you’re looking to introduce your child to a new food and they seem reluctant, eat the specific food in front of them and really sell how delicious it is. Seeing how much you’re enjoying it might pique their interest.

Wait longer between meals so that your child comes to the table hungry, not satiated from a snack. Have specific rules and guidelines before meals start. For instance, if your child finishes their meal or takes a certain number of bites, they can have their choice of dessert.

If you are trying to change behavior, do it incrementally. If your child has an adverse reaction to crunchy foods, such as vegetables, cook the vegetables longer. Every few days or weeks, cook it a little less, so as to slowly reintroduce crunch and texture.

If the child has issues with the proximity of one food to another, start with plating the food very far apart and moving it closer over time. Mealtimes should be as stress-free, comfortable, and relaxing as possible.

Environmental

From an environmental perspective, the color, decor, lighting, seat position, and textures can have an impact on the overall dining experience. We know that colors like red, orange, and yellow stimulate the appetite. (McDonald’s knows what it’s doing with its yellow arches and red background!) Too much visual clutter (fabric patterns, art on the walls, knickknacks around the room) can contribute to over-stimulation in a child on the spectrum and lead to poor eating at mealtime.

Consider the comfort, materials, and height of your dining scenario. Is your child better off in a heavier, cushioned ‘’booth-like’’ seating arrangement; a soft, cushy booster to elevate their height; or conversely, short, floor-level seating so that they do not fall (or jump out of) a tall chair?

The combination of these sensory, oral-motor, medical, behavioral, and environmental variables contributes to best practices families can implement. These challenges require advanced thought and planning to maintain the equilibrium of the family meal, as well as the health, nutrition, and wellness of children with special needs.

*This article was written with input from Mary Roeder, OTR, Greg Reisman, MEd, BCBA, and Christine Hartz, MS, SLP-CCC.