Blog by Self-Reg Learning Facilitator Program leaner, Miranda
As an Occupational Therapist, supporting autistic “picky eaters” has been a focal point of my career. A diet often consisting of bland, beige, soft food (think white bread, chicken nuggets, fries, cookies, etc) was almost always very distressing to parents and a top priority to change. When I first started working with autistic children, my workplace used strategies from Applied Behaviour Analysis (ABA). ABA assumes there are four functions for any behaviour: to get attention, to escape, to get something, or for an automatic/sensory reason. When working under this frame of reference, it was obvious to me that picky eating fell under the category of escape. The child didn’t want to eat the broccoli, they wanted to avoid it or escape the situation. So they refused to eat it, they threw it across the table, or they left the table. Using this frame of reference, I looked at kids who had a severely limited food repertoire as being rigid, stubborn, or unwilling to change. The solution, within an ABA frame of reference, was therefore to use rewards to change/shape their behaviour. And while this strategy did have some success, it certainly wasn’t guaranteed. But more importantly, what we now know is that ABA causes immense harm to some autistic individuals and can be particularly traumatic when it comes to food.
When I left the world of ABA and came to learn about Self-Reg, it greatly changed the way I approached my practice. When I started to think about reframing picky eating, I knew I had to start by looking under the surface. What if picky eating originated from something biological? What if some people are more sensitive to certain sensory inputs like taste, smell, or texture? What if the muscles in the mouth weren’t very strong or the tongue wasn’t moving food to the teeth efficiently? What if sameness in foods brings feelings of safety and security to the child? What if previous experiences with new foods or how they were introduced were traumatic? All of these factors (and many more!) can impact the foods a child chooses to eat and we do a real disservice by just labelling them as “picky”.
My favourite example to illustrate potential reasons behind picky eating is talking about blueberries vs. McDonalds chicken nuggets. No matter what McDonalds you go to, those nuggets are the same. They’re the same shape, smell, taste, and feel. They come in the same packaging. And for a child who relies on sameness to build feelings of trust and safety, you can see why they’d seek this particular food out. Now imagine a pint of blueberries. One blueberry is big, one is small. One is sweet, one is sour. One is purple, one is blue. One is squishy, one is firm. One has a stem, others do not. Basically, it’s a sensory nightmare for someone who craves sameness and cannot yet handle such wild variations within a single food! When we reframe picky eating in this manner, it’s clear why many autistic children seem to have a preference for packaged food or food cooked the exact same way, every time.
I’ve seen this theme played out again and again in my work. A child who will only eat a bagel from Tim Hortons when it’s presented inside the packaging. Or a child who insists on their grilled cheese being made with the same bread, same cheese, and same margarine every single day, cut into the same four triangles, never two. None of these kids are being difficult or trying to make their parent’s lives harder. They are seeking sameness because, to put it simply, they know safety when they see it.
When I take a Self-Reg view of picky eating now, I’m able to uncover the patterns of a child’s eating by analyzing the properties of the foods they do eat. I can take a more holistic view of the child and their previous experiences with foods in terms of their oral motor skills, the mealtime environment, and the pressures put on the child to try new foods. I’m also able to help parents identify and reduce the stressors on their child in regards to foods and mealtimes, which truly is the first step for making progress.
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Miranda’s reflection highlights how important a Self-Reg lens can be to shining a light on the behavioural issues we find ourself approaching day after day in our homes, classrooms and places of work. If you haven’t done so already, we highly recommend learning the Self-Reg science to give you the tools to address any situation in front of you. Explore our:
