Professional Tips: Dealing with problem eaters
Leave a CommentIs getting your child to eat a new food a stressful experience? Do you find yourself cooking 4 different meals for the family dinner? Have you given up on trying to get your child to eat fruits and vegetables? These are common experiences for parents of children with Autism Spectrum Disorder (ASD).. Picky Eating, or Problem Eating is much more common in children with ASD. We spoke to Judy, Feeding Therapist at Opya, to help us, as parents, understand why a child self-limits their diet and what we can do to help them and ourselves.
“Why is making my kids eat different foods such a chore?”
Eating is a multi-sensory experience. Each mouthful brings the possibility of a variety of flavors, textures and temperatures. They include:
- Flavors: Sweet, sour, salty, spicy, bitter planty, and bready
- Textures: Hard, crunchy, chewy, soft, puree, thick liquids, thin liquids and mixed consistencies
- Temperatures: Cold, room temperature, warm, and hot
A child/adult on the spectrum may have an aversion to one or many attributes listed above, depending on their sensory profile.
“What do kids with ASD experience?”
Food choices are based on individual children’s sensory experiences. Many children who are picky or problem eaters may have Sensory Processing Disorder (SPD). A child maybe hypersensitive, hyposensitivity, or a mixture of both.
A child with hypersensitivity, has heightened sensitivity to flavors, textures, temperatures, and smells, or hyposensitivity, may seek out strong flavors and hard textures to make up for experiences they are missing.
The smell and/or texture of a food may elicit the same noxious sensory response as being stuck in a room with skunk stench. “GET OUT OF HERE!” is the message the body will send.
It can be difficult for parents to understand their child’s preferences when they themselves do not share the same sensory experience. The symptoms in some children with ASD can be further exacerbated by their strong preference for routine.. This preference for sameness can show up at meal time as well. For example, wanting chicken nuggets only from McDonald’s on a specific plate.
“What is considered typical picky eating and when is a child a problem eater?
While it is common for toddlers and kids of all ages to be picky or fussy about foods …
… a typical picky eater tends to exhibit different behaviors and often outgrow these tendencies. This is often not the case in kids who are “problem eaters.”
A typical child may exhibit some or all of the symptoms below:
- Have aversions to some foods, but still eat a variety
- Eat foods from each texture group and food group
- Tolerate the presence of new food
- Be willing to touch or try new foods
A child with problem eating may exhibit some or most of the behaviors below:
- Eats 15 to 20 foods or fewer
- Refuse one or more food groups (example: preference of carbohydrates or refusing fruit)
- Refuse one or more texture type (example: preference of crunchy or puree, not both)
- Preference of color (example: eat only white foods)
- Preference of flavor (often sweet or salty)
- Preference of specific brands of a certain food. example, chicken nuggets only from McDonald’s
- Tantruming or meltdown at meal times
- Gagging when trying new foods
- Displaying anxiety over the presence of new foods on their plate, or even in the room
- Finding the smell of certain foods to be noxious
“My child is already has a busy schedule, I don’t see this as a priority!”
Parents may get dissuaded from thinking that feeding is an issue because the pediatrician’s growth chart shows the kid(s) growing normally. However the reality is that kids can grow quite well on diets that are not nutritionally balanced, eg. a carb-only diet. Additionally, communication difficulties, meltdowns and lack of time makes any eating issues seem trivial and hard to prioritize.
Having a family add one more commitment of weekly Feeding Therapy can feel daunting. Research has shown that for the vast majority of children problem eating presents itself when they are toddlers and they do not “outgrow it”. Early intervention for feeding is the key to having the best outcome, just as in the case of other therapy types (speech, behavior, & OT).
Additionally, research has proven that a nutritionally balanced diet is essential to thrive and has several benefits.
- Improve Constipation: Constipation is more common in children with autism than the general population. This problem usually is caused by a child’s limited food choices and it often leads to discomfort and some unnecessary behaviors during this time.This can typically can be remedied through a high-fiber diet, plenty of fluids and regular physical activity.
- Prevent obesity: It’s important to seek professional help because weight problems in autism seem to follow a specific course. The pounds start to pile on at a younger age, and persist into adulthood more often. Starting early is essential to break the cycle and help your child thrive.
Kids with ASD are 2x likely to be overweight, 5x likely to be obese, and 2x likely to develop Type 2 diabetes.
- Balance blood sugar: A balanced blood sugar level helps any child’s brain function. The reserve of it may impede a child’s brain function and affect an ASD’s child’s behavior. A balanced and nutritious diet can potentially help avoid and even improve some behaviors.
- Social functioning: According to spectrum.org, researchers are adapting programs to help children with autism expand their food choices and be less sedentary. The data showed that the benefits of the program go beyond physical health. In some young people with autism, they can also boost social functioning and self-esteem.
- Social Ramifications: As an individual grows in to a teenager the social ramifications around being a “problem eater” increases. When a child is a toddler many parents pack foods and drinks to go out to eat or visit friends and family. As the child grows and becomes more independent, needing to pack and bring specific foods to a playdate, sleepover, or a date draws attention.
“What can I do to get a head-start?”
Parents and professionals working with children are responsible for preparing and providing a well balanced meal at an appropriate schedule and setting. The child is solely responsible for whether they eat and how much they eat.
Before each meal
- Meal times should be a stress-free experience for a child. Stress not only makes them avoid mealtimes but it also decreases their appetite.
- Create the best schedule and setting for successful eating. Have meals and snacks at predictable times and locations. A written or picture schedule can be helpful.
- Eating and drinking should be done at the table for all snacks and meals. Avoid eating while watching tv other electronics.
- NO GRAZING. If children are allowed to eat preferred foods throughout the day, they will not be able to regulate sensations of hunger and will eat fewer healthier foods at meal time.
- Do not serve the same food everyday for the same meal. This sets a child up to “food jag and they will want the same food everyday, sometimes multiple times a day.
- Have children participate in meal planning and preparation is developmentally appropriate. Include them in shopping, choosing foods, preparing and cooking foods, setting the table, serving food etc.
During each meal
- Never force a child to eat
- Let children chose the plates and cups they use at meal times.
- Mix it up. It is okay to have pancakes for dinner.
- Offer a variety of foods at every snack or meal. Include preferred foods and non-preferred foods.
- It can take 15 to 20 exposures for a child to decide they like a food. If they are not exposed to non-preferred foods they will not add new foods to their diet.
- Don’t use dessert as a reward. This reinforces idea of having to eat “bad food” to get “good food.” Incorporate small amounts of dessert items into meals.
- Do not substitute nutritional drinks/shakes for snacks and meals
- Redefine “Success.” Even if no bites are taken: smelling, touching, poking with a fork, touching to lips chin, or licking is a measure of success and should be recognized.
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PRAISE, PRAISE, PRAISE any participation in food-related experiences.
“How can I take action?”
As a parent you can intervene by:
- Consulting your pediatrician and/or nutritionist with concerns regarding adequate growth, nutrition and hydration.
- Pursuing a Feeding Evaluation. It is important to find a feeding specialist who has experience with problem eaters. Speech or Occupational Therapists often specialize in feeding.Feeding therapy is generally covered by insurance.
- Programs addressing sensory processing and exposure to foods in a play based, non-threatening way are recommended. Programs using force feeding are not recommended.
- Seek out support from other parents of problem eaters.
- Continue to educate yourself about Sensory Processing Disorder and problem eaters.
Think long term, small steps today can make a huge difference! See a doctor or a professional before starting any new meal plan.
If you’re in the area, please contact Opya for any questions regarding our feeding services.
About
Judy is a licensed Speech Language Pathologist and the Director of Speech & Occupational Therapy at Opya. Judy brings 25+ years of experience in her field. Her level of expertise extends from pediatrics to neurologically impaired adults. She also served as a therapist and manager in the Department of Rehabilitation at Stanford Hospital for many years. Judy was the founding president of the Special Education PTA of Redwood Citv (SEPTAR). Her experience as the parent of an adult child with ASD provides her with a unique and beneficial perspective. She holds her Certificate of Clinical Competence (CCC) from the American Speech, Language and Hearing Association (ASHA) and is licensed by the state of California.
Professional Tips: Self-care for parents
Leave a CommentAccording to a University of Wisconsin study, parents of children with autism have stress levels comparable to combat veterans.
Between the hours of therapy appointments, unpredictable behaviors, demanding jobs, and uncertain future the stress compounds and takes a mental toll. Most parents focus on the child’s well being at the expense of their own. Sound familiar? Then this blog is for you!
IEP Tips From A Parent’s Success Story
Leave a CommentNote: The following blog is intended for parents who have kids with an active IEP and third-party services such as ABA, speech, OT, etc. outside of school hours.
According to the National Center for Educational Statistics, in 2016, 13% of kids between the ages of 3-21 years have an Individualized Educational Program, a.k.a. an IEP. This require a school district to provide a “free appropriate public education” (FAPE) to each qualified student with a disability who is in the school district’s jurisdiction, regardless of the nature or severity of the student’s disability.
An IEP process starts with an evaluation of the child’s current performance at school by a team of experts. The purpose of the evaluation is for the IEP team to understand the strengths and areas where the student would benefit from additional support. The IEP team & parents then come up with an agreed upon list of goals and objectives, along with services, accommodations, and assistance, to help them thrive in a classroom setting.
In order to help us understand this better, we spoke to an Opya parent, Lisa, who shares some tips from her experience. Lisa’s child was diagnosed with Autism Spectrum Disorder (ASD), over 2 years ago. Like every parent, she felt anxious about the process. However, she has come a long way with the support from the school and is grateful for her son’s progress.
Lisa found that prepping before IEP meetings led to more productive conversations and showed the school that she was invested in the process.
Here are some helpful tips that you can do to be prepared and assured that you have a great long-term relationship with the school and the IEP team.
Before the meeting
- If it’s your first meeting: Know your rights and familiarize yourself with the IEP planning and process. This can be done by reading blogs and books, attending seminars, and/or watching YouTube videos.
- Review materials sent by the school: The time during the meeting is well spent when both parties are discussing the details of the goals and services, rather than ingesting it during the meeting. IEP reports are usually handed out 24 hours in advance.
- Unify your therapy and IEP goals for faster progress: Unifying the treatment and IEP goals were found to improve the child’s rate of progress. Sharing the third-party treatment goals with your school and vice versa is the most effective way of unifying the overall treatment program. Check with your third-party treatment provider if this benefit is covered by your funding source.
- Take notes during the meeting: It is important to keep notes from an IEP meeting. Most parents find it challenging to take notes, participate in a conversation, and retain all the details of the meeting. Find someone you trust who can attend the meeting for the purpose of taking notes.
- Get to know your child’s IEP team: It is not a coincidence that parents who are happy with their child’s IEP have a good relationship with the team. Getting to know them and working collaboratively is often the best way to be aware of your child’s behavior and progress. Actions such as volunteering in the classroom and meeting periodically with the school therapists for parent training are excellent vehicles to help with this. If you have an inflexible work schedule or if your child is distracted your presence, ask what you can do to help outside of classroom hours.
- Initiate communication & track progress: If your child is already receiving services as part of his/her IEP, don’t hesitate to proactively reach out to the team to get an update on the progress on a regular basis.
- The IEP Binder: Something as simple as a physical binder that summarizes your child’s treatment services, goals, interests, reports, etc. is extremely effective. It is crucial in helping the IEP team create a plan that plays into the child’s strengths and weaknesses and grows as the child does. You can learn more about this on understood.org.
During the meeting: After you have prepared yourself, the material and have your Binder. You’re ready for the meeting.
- Setting the tone: Be calm, focused, and remember that you’re working as a team. Parents have found that this approach has always led to desirable results. When a difference of opinion arises, the recommendation is to use words such as “What can we do to help this situation … “, rather than getting upset.
- Ask questions: Many people have different opinions and that’s okay, ask a lot of questions, understand their point of view, get creative, and work collaboratively. The role of the school district to support the child based on the agreed upon curriculum-based goals and objectives. If you find yourself unable to get on the same page, contact your county’s special education representative. Their role is to play the neutral party and help both teams get on the same page.
- Finalizing goals & services: Please be sure that you agree with everything on the IEP report before signing it. Once it’s signed by you and the team, it becomes a legally binding contract. This purpose of this is to protect both the parents and the school. Please note that it is not a requirement to sign the IEP report and hand it in after the meeting. Even if you agree with all the details in the report, it is highly recommended to take an extra day to review the final details and turn it in the next day.
- Copy of your rights: Always accept a copy of your rights during every IEP meeting and file it in your binder, even if you already have multiple copies. In doing so, you show that you’re invested in the process.
After the meeting
- Keep monitoring the goals & progress: It’s important to see your child make progress on goals in school, home, and any social setting. Lisa was able to accomplish this and can be done by getting regular updates from teachers, school therapists, and the Opya treatment team.Start prepping for the next IEP meeting, rinse and repeat!
The amount of work and effort that goes into the IEP is without a doubt a shadow a mountain of work. However over time it does get easier and a little bit of time investment will not only help the child, but it also makes parents more confident, in control, and less stressed in the long run. Like Lisa, we believe that anyone can advocate for their children, even working parents, since they know their child the best.
About our Opya Contributor:
Lisa is a client (parent) at Opya. Besides being a mom, she is currently working on her Masters in Nursing (Leadership & Management) and works for Lucile Packard Children’s Hospital where she works as a nurse. She has been an advocate for patients going on 14 years and is now putting those skills to use in treatment and educational environments, including IEP meetings. She is also the President of the PTA at her child’s school.
Social Skills Groups @ Opya
Leave a CommentKids and adults diagnosed with ASD possess numerous strengths, however, they lack an intuitive social ability. This inhibits them from managing everyday activities as well as skills that would support them for the rest of their lives. Additionally, communication and interaction deficits can exacerbate the issue.
According to a blog on The Mighty, in a recent study, researchers used a fMRI machine to study the regions of the brain that are representative of a person’s social abilities. It was found that people with ASD who attended a five-week social skills camp (one hour, twice a week) showed significant improvement. During this process the individuals learned empathy, initiating play, and emotional recognition, which helped reduce anxiety and form friendships.
Not surprisingly many parents want this for their young ones so they can thrive in social situations. Opya listened recognized this gap and enhanced our service offerings by running our first Social Skills Group this summer; inspired by the renowned Michelle Garcia’s, Social Thinking™. It took a lot of passion and expertise to come together as a team and design and execute an evidence-based program to help our clients expand their social skills by providing them with a safe environment to practice, learn, and be understood. The goals of the program were to facilitate and improve:
- Communication cognitive and language skills
- Navigate through group/social settings
- Peer interaction and play initiation
- Listener response and group participation
Over the course of 8-weeks, the Opya leadership team and therapists, designed, supervised and facilitated the Social Skills Group at our San Mateo location. Opya’s Social Skills Groups consists of kids and young adults with and without an ASD diagnosis between the ages of 5-17. The curricula groups are designed, supervised, and led by BCBAs, supported by Masters level supervisors, occupational & speech therapists. Additionally, a one-to-one behavior therapist is provided for most clients as well. Our team actively worked on helping our clients improve their social skills by:
- Grouping the participants appropriately
- Implementing goal-based, and engaging, activities on subjects ranging from art, science, to music.
- Providing 1:1 support to help model & practice the subtle yet important aspects of communication and rules for interaction
- Reinforcing behaviors that predict important social outcomes like love and happiness
In doing so the participants had a chance to practice their newly acquired social skills, and hone them in a friendly, engaging, and team-based environment.
The results were outstanding! Not only did they see a direct implementation of the skills in the groups, but parents also reported that their children were able to apply what they learned in social and family gatherings. While the feedback Opya received from parents was extremely positive, the most exciting part of the program was when group members starting to form friendships and set up playdates outside the program. This was a complete 180 from the first day where the kids were reluctant to engage and interact with one another.
The results spoke for themselves. The success was overwhelming. The program truly bridged the gap between the treatment and the ability to generalize what they learned in other social and school settings.
The success of this program inspired us to make the Social Skills Group a regular part of our curriculum. It’s a four-month-long program, once a week, that is offered at our San Mateo & Santa Clara locations starting in September 2018. Please come join us! If you are interested, email us at contactus@opyacare.com.
Opya – Your Path To Amazing
Leave a CommentIt is my pleasure to welcome you to our website and thanks in advance for taking your time to view our video. Hopefully it helps you learn more about the incredible people who have decided to join us in changing autism treatment in America by successfully connecting treatment with technology. I’d also like to invite you to join us in our mission by becoming a client, joining us as employee or partnering with us.
— Jonathan Wright, Founder & CEO, Opya
2334 Walsh Ave. Suite D., Santa Clara, CA 95051