Autism-World

Q: Hi, son 12 with Aspergers. I know Autism involves alot of sensory issues. I actually have bribed my son just to try a tid bite size of like cooked carrots, cantaloupe, augratin potatoes, he will get it in his mouth and start gagging he could almost throw up. He has sat at the table and cried especially if I only cooked vegetables no chicken nuggets or corn dogs or french fries or anything he will eat. He alos is sensitive to heat. I will have run his bath water before and to me it is just warm. He will go to get in and start hollering “hot, hot.” He can’t stand the hair dryer on heat have to use cool setting. I worry about his health his eating. I have watched Dr. Phil who says cook what you are feeding yourself and the rest of your family don’t cook seperate food for a child when they are hungy they will eat whats on the table. But can you put this to a child with Autism rather Aspergers? He is going to grow up eating very unhealthy and i don’t know what to do..

Answer:

Autism definitely can involve specific sensory issues. This means that while sensory is definitely an area to be aware of and, possibly, respond to, there is no presumption that every child with autism (and Aspergers is on the autism spectrum) will have specific sensory issues. And, even more so, even those children who have sensory based issues reflect a wide range of differences in how, and to what, they react.

Lots of adults and kids have very different sensory based tolerances. Even without autism, for instance, there are many folks who simply don’t tolerate those ubiquitous tags inside tee shirts. In fact, this is so much the case that a number of manufacturers have taken to removing tags altogether and just imprinting directly on the material. The sensation of hot v. cold is another area in which there are wide variances across a great many of us. Spouses debate the house thermostat regularly and moms and kids disagree on the temperature of bath water routinely.

Of course, kids with autism can be a bit more reactive to and aware of certain sensory stimuli. But one point I am making is that when this issue does exist, it is not something all that unusual even if it may elicit a bit more intensive of a reaction from some kids with autism. So, consider that there can also be a fine line sometimes between sensory reactivity and the fact that how we react to the child can also inadvertently reinforce, and even intensify, such behavior.

For instance, think about a child who might not want to take a bath and can stall for even 15 minutes more while water is drained and refilled or the child who really hates long sleeve shirts (as many young kids can!) and is able to get back into short sleeves by loudly complaining or another child who immediately throws a fit and gags (as you describe) when given foods he or she doesn’t like and is able to have them taken away. And there are certainly lots and lots of younger children who go through gagging and such at the table??o include those with and without autism!

Now, any of these scenarios are directly applicable to your individual child since I could only offer such hypotheses if I were able to observe and administer a functional behavioral assessment (FBA) in real time. Instead, I give these only as generic examples and for consideration since every situation is different and each child and family unique.

It is also quite possible that my above mini scenarios can be the result of very real sensory-driven concerns. But even when there are true sensory based issues, how we react and respond can also cause them to be more or less of an issue over time. This is where an FBA becomes important in its ability to help us understand potential triggers and things which can maintain behavior. If you are interested, my website below has examples of the FBA process.

Ok??o what does all of this mean, exactly?

Well, again, without having some real time contact, I would never presume to be able to offer specific suggestions about your child and for your family. And, neither for that matter, should Dr. Phil! Dr. Phil has made a fortune by telling folks what they want to hear and by considering the most generic possible scenarios and over applying them to persons and families where they are often irrelevant.

Every child and family is different and cookie cutter, pop psychology driven approaches (Dr. Phil’s specialty), are often not directly applicable. A concern with Dr. Phil is his effort to make people feel that what is saying DOES apply to them??which is how he gets paid. I’d suggest watching Dr. Phil more for comic relief rather than specific feedback!

So?? few overall thoughts. With water temp, maybe your boy can help you fill the tub and let you know as the water is filling whether it works for him. Give him information and allow him to give you information as well. Communication is a powerful alternative to acting out and setting up opportunities whereby he can influence and offer such feedback about on-going things might be worthwhile (which, of course, might be happening already??ut this is an area which I always want to consider).

The food issues really do require much more explicit and individualized information. There are some things to think about overall, however. Guard against getting locked into specific food items since there are plenty of alternatives to each of the items you mentioned. I mean, lots of kids??ith and without autism??an become highly stressed with a meal of just vegetables! And lower preference items can also be combined with sauces and other things he might like towards flavor and such.

Sometimes, it can be helpful to place a little less emphasis on these lesser preferred items but continue to have them on the table and eaten by other members of the family. Meals are social events and giving folks ways to feel a part of the activity can be wortwhile. It is also important, then, to have a predictable and consistent meal routine in which the family participates which is positive and reinforcing in itself. And removing some of the extra attention given to some of these different food items might help to make him less resistant to trying things out over time.

Try, also, even having a small amount of lower preference food on his plate even if he chooses not to always eat it??nd let him know that he can make some choices. This way, it becomes a part of the meal??s with everybody else??nd also as with everybody else, he can also make some decisions about what he actually eats. And the more certain items are presented in low intensity ways, the more likely they are to become more neutral and, possibly, tried over time.

I might also suggest that you speak with your pediatrician and/or a pediatric medical nutritionist with regards to overall diet and health. I often ask families to do a food log over a period of a week or two of everything a child eats, when, how much, and related behaviors (if any) to better track intake and his response.

He also might not like certain items which make him uncomfortable. If he is less likely to say so verbally, he might be doing so behaviorally or more functionally. A food log can also help to this end by providing information about child behavior after eating specific items to include use of the bathroom, toileting accidents, increased irritability, and so on.

In doing Food Logs, we also sometimes find that kids are actually eating a bit better than it might otherwise seem! But the use of specific supplements to include milkshakes, for instance -or non dairy styled milkshakes if preferred since lots of dairy products might also not always be a good idea – can help to augment nutritional needs. This, since some of the issues you describe sometimes work their way through with a little consideration and time.

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This entry was posted on Tuesday, November 13th, 2007 at 12:10 pm and is filed under Ask and answer.