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Mealtime Routines for Eaters on the Spectrum

Mealtime can be difficult for children with autism spectrum disorder (ASD) due to sensory processing or behavior patterns. Challenges commonly seen by caregivers include picky eating, refusal to try new foods, attempting to escape the table, throwing food, and tantrums. This can lead to more severe consequences such as nutritional deficits due to the child’s limited intake from preferred foods. Because children with ASD thrive with rituals, establishing a set mealtime routine can help limit and overcome these battles to allow for a more enjoyable family meal.


A mealtime routine shouldn’t depend primarily on the child but allow for the entire family to be involved as well. Choosing a feasible time for dinner where all members can be present helps encourage participation from the child and helps them recognize that they aren’t being singled out but rather enjoying a family routine. Tips for mealtime include:


  1. Dine Together at a Table Present mealtime routines may include siblings at a table together without parents or on the couch in front of the TV. Having meals served at a table together helps establish a sense of routine where correct posture is involved. Dining around a table encourages family bonding time and allows for a more immersive meal.

  2. Limit Distractions Removing toys, iPads and TV at the dining table can help children focus on the task at hand- eating! Instead, parents can offer these objects as an incentive and reinforcement at the end for completing a meal with the family.

  3. Posture, posture, posture! The child should be set in a chair in which their feet can touch the ground or a stable surface. Back support on their chair is necessary to help prevent slouching and flopping that prevents participation while eating. Correct posture at the dining table is important physically to assist with the chewing and swallowing process as well.

  4. Introduce a New Food Some picky eaters may have preferred foods or a set diet that they eat at each meal. To help with introduction of new foods, parents can set aside a small portion of the meal the entire family is eating onto the plate of the picky eater. The child should be encouraged to try the new food at least once but aren’t forced or punished into eating it. If they do choose to eat the new food, verbal positive reinforcement should be provided to reaffirm the behavior. This prevents the child from developing aversive feelings to mealtime where they feel that they will have to undergo a negative experience. Instead, they can feel more open to try new things without restrictions of having to like everything.

  5. A Set Time and Routine Before and After Having a set time for the meal helps reaffirm the mealtime and allows for all family members to fall into the routine. Parents can also have a sensory routine or fun activity before/after the meal to signal that mealtime is about to begin/has ended.

References

1. Ausderau, K. K., St. John, B., Kwaterski, K. N., Nieuwenhuis, B., & Bradley, E. (2019). Parents’ Strategies to Support Mealtime Participation of Their Children With Autism Spectrum

Disorder. American Journal of Occupational Therapy, 73(1), 7301205070p1.

https://doi.org/10.5014/ajot.2019.024612

2. Enhancing Mealtimes for Children with Autism: Feeding Challenges and Strategies. (2017). Retrieved May 23, 2021 from https://extensionpublications.unl.edu/assets/html/g2285/build/g2285.htm

3. Sharp, W. G., Berry, R. C., McCracken, C., Nuhu, N. N., Marvel, E., Saulnier, C. A., Klin, A., Jones, W., & Jaquess, D. L. (2013). Feeding Problems and Nutrient Intake in Children

with Autism Spectrum Disorders: A Meta-analysis and Comprehensive Review of the

Literature. Journal of Autism and Developmental Disorders, 43(9), 2159–2173.

https://doi.org/10.1007/s10803-013-1771-5


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