1. Joan Peters Mental Health Practitioner CAMHS Alder Hey 29/1/19
Fussy Eating
Joan Peters
Mental Health Practitioner
CAMHS
Alder Hey
29/1/19

2. Session Outline Fussy eating and food refusal
Children with ASD- Restricted diet
Examples of CAMHS interventions
When and where to get help

3. Fussy Eating and Food refusal
Very common
Most common in pre-school children, but can also be found in school age children
Tend to eat favourite foods without any problems
Eat normally in certain situations but not in others.
Tend to be normal weight and in good health

4. Some common reasons Showing a sign of independence
Demand for attention
Children can learn refusing food is very upsetting for parents and therefore use food refusal to influence the house hold.
After an illness or infection

5. Helpful advice
Stick to a routine-three meals a day, healthy snacks in between.
Avoid snacks and drinks too close to mealtimes- leave at least 2 hours between snacks and meals
Ensure main meals involve sitting at a table
Eat the same meals at the same time as your children

6. Try to make meal times enjoyable and sociable
Try to make meal times enjoyable and sociable. Invite child’s friends around for meals
Involve child in meal selection, preparation and cooking
If your child will only eat a few foods, build on these. E.g if child likes potato, try different types such as mash, roast. Same if child likes certain texture , tastes or colours of food.

7. Offer a new food with a familiar food
Offer smaller portions. If these are finished more can be offered.

8. Try to keep your cool and keep calm even if a meal hasn’t been eaten
Try to keep your cool and keep calm even if a meal hasn’t been eaten. If you are anxious and tense your child will pick up on this and it could make the situation worse. So don’t make a fuss- just take the plate away without comment
Don’t offer alternative food or drinks; if a meal is refused this may be seen as a reward
Never use force, threaten with punishment or bribe a child to eat

9. REMEMBER
Patience Your child will eventually grow out of this phase Encouragement Praise and acknowledgement are always good motivators

10. Children with ASD- Restricted Diet
“I was super senstive to the texture of food, and I had to touch everything with my fingers to see how it felt before I could put it in my mouth. I really hated it when food had things with it like noodles with vegetables or bread with fillings. I would never, never put any of it into my mouth. I knew if I did I would get violently sick” in Atwood !1998)

11. Some reasons for food restriction in children with ASD
Physical health- pain, gastro intestinal problems, medication
Communication/understanding
Dislike of change-routine, appearance, packaging
Sensory difficulties- texture, taste. smell, physical environment
The social element

12. Helpful Ideas First step- create a food diary
Visual food charts/ timetables
Small steps- gradual exposure
Food books- diaries of achievement
Games- make food fun!
Encourage child to handle and prepare food

13. More helpful ideas Social stories Environmental adaptations
Distraction e.g music, story tape
Use special interest e.g Thomas the tank plate
Develop oral motor skills- straws, whistles, bubbles
Planning ahead and preparing for change or new situations

14. When and where to get help
If your child is losing weight, seems lethargic, weak and /or irritable, or is suffering from fever
Discuss with health professional- School Nurse, Health Visitor, GP
ASD – Isabella Trust, ADDvanced Solutions, ASD Pathway Training Team

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