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Good health and proper nutrition are the cornerstone for learning and improving life-long independence for all individuals. Nutrition related problems can result in poor attention, decreased motivation, and potential long term health risks. Individuals with autism spectrum disorders often experience alarming food aversions and feeding problems. According to Mayes and Calhoun (1999), 75% of children diagnosed with autism spectrum disorders experience atypical feeding patterns and have limited food preferences. Approximately half of the autism population studied were hypersensitive to textures and lumps in the food. Further research was conducted by Lorna Wing (2001), who reported that nearly two-thirds of the 230 children with autism spectrum disorders in her clinic experienced eating challenges, which included limited food diets and severe food fads. As represented by the research, the numbers of individuals with autism spectrum disorders who struggle with eating a balanced and appropriate diet is overwhelming. Currently, there are limited resources available to address this pervasive problem. This presentation will review a comprehensive feeding program and provide practical strategies for increasing food selections in the home and school for resistant eaters.

Most children and adults enjoy eating and derive great pleasure from experiencing new foods. Unfortunately, this is not the case for many individuals with autism spectrum disorders. This population tends to have food aversions and resistance to eating. Resistant eaters are on the extreme end of the eating continuum. Resistant eaters are a mixed group and include a myriad of characteristics. We all have food preferences and some of us may be considered picky eaters. Resistant eaters go far beyond the eating continuum than a picky eater. These children and adults may be eating less than five different foods and some resistant eaters are refusing to eat entire food groups. Some resistant eaters have medical issues or physical impairments. While others have a sensory dysfunction or poor oral motor skills and have not developed appropriate tongue control, chewing, and swallowing skills. Resistant eaters often have a diagnosis of developmental delay such as autism. There is not one single criteria to identify a resistant eater.

Eating is often perceived as a very simple process. Just put the food in your mouth, chew, and swallow. But that is simply a myth. Eating is incredibly complex and can be challenging for many individuals. It requires the cooperation and coordination of all the bodily systems. A number of factors can interfere with a child's oral motor development and feeding patterns. Providing support and assistance to resistant eaters is important for a variety of reasons. First, resistant eaters can permanently impair their long-term growth. Children identified as resistant eaters will often have a low percentile for weight and height. Second, a lack of an adequate balanced diet can interfere with their inability to learn properly and progress academically. Without proper nutrition and adequate vitamin intake, resistant eaters are limiting their potential in the classroom. Third, starvation and hospitalization can occur for some resistant eaters. Although most people believe that children will eat when they get hungry, a small percentage of resistant eaters will not eat and eventually be hospitalized for malnutrition and starvation. Lastly, not eating properly can negatively impact socialization and self-esteem. Eating and socialization are closely connected. Many cultures, including our Western culture, include eating as part of their holiday celebrations with family and peers. Resistant eaters are often isolated from their families during mealtimes and may not fit into the mealtime environment. Eating is an important socialization skill and builds a sense of belonging. Parents and professionals can not overlook this serious issue or rely on outdated treatment methods. Food aversions and eating challenges are serious issues which require a comprehensive multisensory treatment approach. Whether you are the parent of a resistant eater or a professional, it is extremely important to seek appropriate treatment.

The purpose of this presentation is to assist families and professionals in supporting the needs of the resistant eater. Addressing the needs of the resistant eater is a collaborative effort between the parents and other professionals working with the child. Although parents are the primary caretakers, classroom teachers and other professionals can play an important role in the execution of the treatment plan. A collaborative team approach will insure that the plan is implemented across settings and throughout the child's day. A successful outcome will be influenced by the quality and intensity of the feeding program. This presentation will address easy to implement techniques that can be utilized in the home, school and other professional settings. Addressing the behavioral, physical, and sensory needs of a child with food aversions requires a multidisciplinary team including the parents for a successful outcome.

It is my hope that with the strategies and beliefs shared in the presentation, participants will be empowered to implement these strategies and create a nurturing mealtime environment. For most adults, the goal of any feeding program is to “get the child to eat more food.” Although increasing food selection is an important secondary goal, the main focus of the presentation is to provide children and families with a positive mealtime environment and support them in their exploration of new foods. This presentation will be filled with many common sense tips and practical strategies for supporting resistant eaters and creating family connectedness during mealtimes.