Ashley Foote

Mrs. Otis
Final Inquiry Project
Due: November 9, 2014
With all of the food options and combinations in the world it may seem difficult to limit
what you eat to only a few selective food types for every meal every day. For some people this
sounds impossible; for others, it is their reality. A good majority of people who live this lifestyle
are also autistic or have a diagnosis from the autism spectrum disorders. Autism spectrum
disorders are defined as any various disorders, such as autism and Aspergers syndrome,
impaired by social skills, repetitive behaviorsand a restricted range of interest (autism
spectrum disorders). For many children with autism spectrum disorders, restricted range of
food interest is a major component of their life along with being stuck in their repetitive habits of
only eating particular foods.
Selective eating among children with ASD has become a hot topic for many
psychologists and researchers. One component that stands out to researchers is the relationship
between the child with ASD and food because researchers know that children with autism are
more than likely to have sensory aversions. Many doctors and researchers, including Sven Bolte
and Sowmya Nath, agree that often times a person with ASD has a difficult time handling food
and eating in general. Sensory difficulties in children lead them to be picky eaters who only eat
three or four or five types of foods as their everyday diet. When a child restricts their diet to so

few foods, many health concerns arise. According to the Nutrition and Autism page on the
Autism Speaks website, they found an overall low intake of calcium and protein among children
diagnosed with an autism spectrum disorder (Nutrition and autism). Protein and calcium
deficiencies can lead to problems in proper bone development due to lack of calcium along with
delayed mental development and growth due to lack of protein. When a child restricts such
important nutrients in their diet is when their diet becomes detrimental to their heath. At this
stage many children are recommended to attend food therapy sessions to help overcome this
situation.
Feeding therapy is more than just trying to get a child to eat more than a few different
types of foods. Feeding therapy is a process that involves many people, not just an occupational
therapist. A group of speech therapists, physicians, nutritionists, behavioral psychologist and
social workers help children and their families overcome their eating disorders (Treatment).
Dr. Darbari and Sowmya Nath gave examples of how multiple therapists work in different ways
to help a child accomplish their goal. With a broad group of specialist the therapy work can be
more effective than one person who covers all of the areas. The speech therapist, for example,
can help a child strengthen their jaw muscles and other muscles used to move the jaw and
tongue. By strengthening the facial muscles, the child can better chew their food which could
have been the original problem keeping them from eating in the first place (Feeding). Also by
improving a persons chewing habits the probability of their choking decreases. Physicians are
on staff to make sure the children are as healthy as they can be considering their situation.
Physicians are also helpful because they can help with general health tips at any time. The

nutritionist is on staff to help with an overview of the childs diet. A nutritionist can develop
proper diets for a child if they are on an all liquids diet or just starting out with solid foods. A lot
of times a child who only eats a few different foods struggles with proper intake of essential
nutrients (Feeding).
One of the factors that stand out most in children with ASD is their very picky eating
habits. In Naths article, she quotes Dr. Peter Girolami when he says that typically developing
children without ASD may also have preferences to foods but not to the severity that children
with ASD do. A patient with autism may want a particular brand of a particular food and will
refuse to eat what they are given and respond with a temper tantrum. When these tantrums occur
is when the behavioral psychologist on staff comes into play. The child can be analyzed by the
behavioral psychologist who then can make a plan for the child to help them better control their
emotions. A child with autism may also restrict his or her diet to only a handful of five or six
foods. A child might also refuse to have liquids in their mouth because they cannot handle the
texture of the liquid. Such restrictive diets are what cause the disorder to become a bigger
problem than just being a picky eater. Dr. Darbari and speech language pathologist Pamela
Tyler agree that when working with children, one of the obstacles that must be faced is if a child
is eating appropriate foods for their age and skill development. That means if a two year old
child is still on an all liquids diet, expecting them to consume solid food as soon as they are
introduced to it is an unrealistic expectation. First they must go through the stages of food that
any typically developing child would go through which is liquids, baby cereal, then chunkier
foods then to solid foods (Feeding). Having a child with autism move from one stage to the
next is a huge step in progress.

Another motor skill that an occupational therapist can help improve is the handling of
utensils. Proper use of utensils may seem like every day protocol for a typically developing child
but to a child with sensory or feeding concerns, the use of a fork or spoon or even how to
properly hold a cup could change the way they perceive food. In Dr. Darbaris interview and in
Food selectivity and Sensory Sensitivity in Children with Autism Spectrum Disorders, the
mention of adjusting a child to using utensils is a very important task. Maybe the first step is to
get a child to tolerate having an empty spoon touched to his mouth. If he can do this, and is then
rewarded, he learns it wasnt that bad. (Treatment) Dr. Darbari briefly mentions that one
simple feeding therapy technique of letting a child get used to a spoon touching his mouth could
help end temper tantrums or at least make them less traumatic.
Occupational therapists also encourage parents to over emphasize their reactions when
they observe positive eating behaviors in their children. By over emphasizing their reactions,
parents can help instill better eating habits in their child. There are also ways to help children
continue to eat more of the foods they already eat. Dr. Girolami mentions that parents can
present foods those children already like in different ways such as pureeing or chopping the food
into smaller pieces (Feeding). Dr. Olive and Dr. Girolami agreed that the best way to enforce
a feeding habit to a child is by giving reinforcement until the point when the child re-learns that
broccoli is a good thing. (Feeding, Treatment) Obviously both doctors did not use the food
item broccoli specifically but they both agreed that it was crucial to the childs developing food
habits that they do not give up on the positive encouragement. Having parents very involved in
the process of feeding therapy with their child is also important because the parents or primary
caregivers must learn exactly what is going on in therapy for when they plan to replicate it at

home. By creating a consistent learning environment for the child to develop good eating habits
at home along with in therapy is an effective reinforcement for the positive eating behaviors. The
social workers come into play when techniques are carried over from therapy to home. The
social workers do most of their work with the families. They support and encourage the family
members because many times the family can become discouraged or frustrated when their child
is not eating. If the parents are encouraged to move through the situation they can better
encourage their children through feeding therapy as well.
Feeding therapy is a growing practice that will continue to help many children diagnosed
with an autism spectrum disorder and their families overcome the many obstacles that come
along with the disorder. As it has been mentioned here, the use of feeding therapy is most
effective when multiple doctors and psychologist and researchers can work alongside each other
towards one goal.

Works Cited
Autsim spectrum disorders. Dictionary.com Unabridged. Random House, Inc. Web.
Nov. 09, 2014.
Feeding Problems in Children with Autism. Interactive Autism Network. Kennedy
Krieger Institute, 11 Feb. 2014. Web. 23 Oct. 2014
Nutrition and Autism. Autism Speaks. 07 Feb. 2007. Web. 07 Nov. 2014
Treatment of Feeding Disorders in ASD. Interactive Autism Network. Kennedy Krieger
Institute , 15 June 2010. Web. 23 Oct. 2014
Tyler, Pamela. What is Feeding Therapy? American Speech-Language Hearing
Association. PAGER, 19 July 2005. Wed. 23 Oct. 2014