Autism Resource #3: A Strategy for Picky Eaters

Picky eating is coming with kids with autism. My child isn’t the pickiest eater, but he eats a limited number of fruits and vegetables and a history of dropping foods from his diet (ie pasta). I came across an article on the UCSB website, so I decided to put it to the test. We started with granny smith apples. This is because he says he likes them, but when you give it to him, he won’t eat them. He had to take a nibble and got to choose between two sweet treats. After 3 days, he had to eat half of a thin apple slice. Three tries later a whole slice. Now he eats apples (albeit still with a sweet treat following). You can start lower down on the hierarchy if needed (touches food and motions it to mouth). The publication and link to the article follows (scroll down to 2012).

Koegel, R., Bharoocha, A., Ribnick, C., Ribnick, R., Bucio, M., Fredeen, R., & Koegel, L. (2012). Using Individualized Reinforcers and Hierarchical Exposure to Increase Food Flexibility in Children with Autism Spectrum Disorders.Journal of Autism and Developmental Disorders. Vol. 42, No. 8, 1574-1581

Activity #30: Put on sock puppet show

Description: Use your new sock puppet to make a puppet show. We crouched behind the side of the bed to make the show. The show you put on does not have to be overly creative. Telling a story of an event that happened during the day works well. This may get your child so excited that they want to put on their own puppet show.
Age: Any
Purpose:
Story telling
Recalling past events
Prep time: minimal
What you’ll need: a sock puppet. If you don’t have a sock puppet you can use stuffed animals
Fun Factor: This was a big hit with the children. They laughed and really enjoyed the story telling. My son on the spectrum got so excited about it, he wanted to tell a story too.

Tip: You can use the sock puppet to make other parts of you day fun as well. Here are some ideas:
Read a story with the sock puppet as the narrator
Use the sock puppet to count down when you are turning off the lights at bedtime
Use the sock puppet to sing silly song during teeth brushing

Activity #29: Make a sock puppet (and a craft box)

Description: We used Dad’s old sock to make a sock puppet. I did all of the sewing, but they chose they eyes and nose. We used buttons for eyes and a piece of foam for a nose. While I sewed on their choices they explored our craft box (see tip). See tomorrow’s activity to see how we used the sock puppet to work on story telling.
Age: 3+
Purpose:
Creativity
Labelling
Expanding adjectives
Learning about different materials
Prep time: moderate to extensive, depending on how extravagant you want your puppet to be.
What you’ll need: an old sock, items for eyes, nose and ears (optional), needle and thread
Fun Factor: Once the kids made their choices they weren’t really interested in watching me sew. However, they enjoyed exploring the different materials in our craft box. It lead to a really nice learning opportunity. My son asked, “Why do grown-ups use sharp things”. I set up a nice little experiment with a styrofoam ball. I asked him to poke a toothpick and a popsicle stick through it. Now he understands, that sharp tools make some jobs easier.

Tip: make a craft box
We have a craft box with a number of odds and ends, so you can be ready if the kids want to do a craft. I have it organized in little containers and ziploc bags (not like the picture). The kids enjoy looking through the box and exploring the materials (and making a big mess). Some items in my craft box (felt, pom-poms, pipe cleaners, styrofoam balls, google eyes, buttons, toothpicks, popsicle sticks and a few other odds and ends). Most dollar stores and big box stores have nice craft materials.

Activity #28: Have a food flexibility meal

Description: Our occupation therapist encouraged us to serve meals on a platter in the middle of the table. Then, everyone takes food and puts it on their plate. This is supposed to encourage trying new things in a non-threatening way. We have never been very good about doing this. So, we had a picnic where we tried this out. We had plates of different types and presentations of cheeses, one with different types of crackers and one with different fruits and vegetables. Each platter had something that was liked by the children as well as some new foods (but nothing too scary). We all sat down and ate off the platters.
Age: any
Purpose:
Food flexibility
Expanding food preferences
Eating a meal together
Prep time: moderate to prepare the platters
What you’ll need: platters with various foods, you can customize to your family’s likes
Fun Factor: Everyone enjoyed this. My son made a cracker sandwich of two or three different types of cheeses and chips. Although he may not of tried anything new, mixing food together for someone with food inflexibility is a major win. The kids said a number of times that the meal was fun.

Parenting Tip#3: Offer choice throughout the day

Offering choice is a good strategy to create language opportunities, and to give children a sense of control. Choices should be specific and it is not the same as asking what they want. For example, instead of asking “what do you want for snack?” you can ask, “Do you want, raspberries or cucumbers?”. Offering choice can also work when your child doesn’t want to do something. For example, “Do you want to go on the big toilet or the potty?”. There is always an opportunity to provide a choice if you think outside the box.

Other Examples:
Give a choice between two shirts when getting dressed
Toothbrushing: choice of toothpaste, toothbrush, choose who will help brush, choose where to brush
“Would you like 6 pieces of grapefruit or 8?”
“Would you like to play cars and marker for 10 minutes or 15 minutes?” (My son’s repetitive interest.

Child choice is a large component of PRT. For further reading: Read Overcoming Autism by Lynn Koegel and Claire LeZebnik

Activity #27: How are the same game

Description: I used to play this game called Tribond. They would give you three words or phrases and you had to figure out how they were related. It was a really hard game. I created the child version of this game. I had 3 sections: things that go, food & treats and math & science. They had to pick a category and then say how the three items were related.
Age: 4+
Purpose:
Categorizing
Answering questions
Prep time: extensive to think of clues and put them on a game board
What you’ll need: pieces of paper with three related words on them
Fun Factor: They weren’t really into the game show theme. We did finish all of the clues and there was no escape behaviours, but I wouldn’t say it was their favourite activity.

Activity #26: Colour obstacle scavenger hunt

Description: For this activity, I combined an obstacle course and a scavenger hunt. They had to run through a series of obstacles, and grab a piece of paper with a colour on it. Then, they had to find an object in the house of the same colour. They would put it in a coloured circle on a large piece of paper. I also added some rules to prevent them from grabbing only markers: “you cannot pick the same object for two colours”. Some new obstacle ideas: have them roll a train along a wooden train track. Grab a piece of Lego from the top of one couch and put it on a Lego base on another couch. The latter was to get them doing some climbing.
Age: 3-4+
Purpose:
Gross motor
Colour matching
Search and find
Following directions
Prep time: moderate to extensive, you have to set up the obstacle course, make coloured pieces of paper and coloured circles for them to put the objects in
What you’ll need: Pieces of paper, markers to make the colours, and items for the obstacle course
Fun Factor: This was a motivating course. They went through and found objects for every colour and did not need encouragement. However, they did try to use markers for every colour. So I had to remind them to pick a variety of objects. The train portion of the obstacle was well liked, but was a little distracting for my little Thomas fan. Moving Lego from couch to couch was also a favourite part of the course.