Tips to apply for feeding problems in children with ASD.

 Feeding problems are commonly found in children with ASD(Autism spectrum disorders). Being a pediatric occupational therapist, I have seen several children having feeding problems especially children with ASD. This is a major concern for many parents. So, in this article, I will be sharing some common feeding problems, their reasons, and what you can do about them step by step.

What is ASD?

Autism Spectrum Disorder, or ASD, is a complex neurodevelopmental condition that typically appears during the first three years of life. 

Children under ASD have varying levels of difficulties in the following areas:-

1. Difficulty in social interaction
2. Difficulty in verbal & nonverbal communication &
3. Repetitive/restricted patterns of thoughts & behavior.

Some common symptoms are:-

➧Poor eye contact, 

➧Delayed speech,

➧Lack of response to name,

➧Inability to interact or socialize with others,

➧Showing some repetitive behaviors like hand flapping, stimming, or spinning, disliking any routine changes, and many more.

Find out about the Early signs & symptoms of ASD in 👇

https://abhipsaot.blogspot.com/2021/07/early-signs-and-symptoms-of-asd-what-how.html

Since these children have some sensory processing difficulties and also narrow, restricted interests, many children with ASD demonstrate delayed, primitive & /or abnormal oral-motor development, which impacts their feeding development. Feeding problems can be seen in different forms.

The most common symptoms of feeding difficulties are:-

➽Cries or fusses when feeding

➽Refuses to eat or drink

➽Eats only certain textures, such as soft food or crunchy food

➽Takes a long time to eat

➽Has problems chewing food 

➽Can chew only hard food but needs water frequently to swallow meals(usually semisolid or mixed textures food)

➽Coughs or gags during meals

➽Spits up or throws up a lot

➽Picky eater & has a very limited variety of taste that he/she prefers to eat

➽Refuses to try any new food. Needs the same food every day

These are some of the common symptoms but, they can vary from child to child.

Causes of feeding disorders in children with ASD:-

➤ Sensory processing difficulties.

Face and mouth areas can be over-sensitive or under-sensitive to certain smells, tastes, or textures of food.

➤Motor planning difficulties 

Leading to difficulties in coordinating jaw and tongue movements during feeding.

➤Having difficulty sitting at a place to eat 

Due to less attention span, the child cannot focus on eating the meal from start to finish sitting at a place.

➤Poor postural control

➤Fear of feeding

Due to any of the above difficulties leading to low self-esteem.

➤Difficulty expressing their needs

Cannot express when they are feeling hungry or what they prefer to eat

If a child has feeding problems, it can lead to many other problems as well due to the inadequacy of nutrients to the brain & the body.

Feeding problems can cause:-

👉Irritability

👉Sleeping problems

👉Frequent constipation

👉Frequent gut disorders

👉Low self-esteem

👉Other infections easily affect the child due to low immunity and many other problems.

👉 Overall growth and development is affected

What can you do about it?

A detailed assessment is essential to plan the intervention of your child.

If your child is having any feeding problems, you must refer to an occupational therapist who will assess your child and develop the stepwise treatment plan specific to your child's needs.

The Occupational Therapist may work on:

⏩ Making the muscles of his mouth stronger

⏩ Helping him/her move her tongue more

⏩ Helping him/her chew foods

⏩ Getting her to try new foods and drinks

⏩ Helping with sensory issues. Your child may not like the way food feels in his mouth or on his hands. The Occupational therapist can help him get used to how food feels.

⏩ Changing the way you hold your baby or the way your child sits when eating

For achieving the above, your therapist can use some tools like- A chewy tube, A vibrating toothbrush, a Nuk brush, etc.

In this article, I will be sharing some ideas about the kind of foods to choose and some activities that you can use to facilitate awareness and matured oral-motor movements essential for feeding to provide a general guideline that you can follow.

Foods to Choose

Foods that help to promote matured oral-motor movements needed for feeding:-

͍✔ Crunchy solid foods:- Crunchy solid food gives a lot of stimulation and facilitates chewing skills.

Thus, including some crunchy foods in your child's diet can be very beneficial.

Examples are- Carrot sticks, Apples, Corn chips, Besan chaklis(murukku), Homemade potato chips, etc.

Encourage your child to bite & chew crunchy foods using his/her molars & premolars teeth more rather than using the front teeth.

✔ Challenging foods:- As the chewing skills of your child improve, you can introduce some more difficult foods to chew (after consulting with your therapist).

Examples are- Apple chips, banana chips, licorice sticks, drumstick fries, cucumbers, Zucchini fries, chicken nuggets, etc.

Chewing gum may be used to encourage side-to-side movement in the mouth across the midline.

✔ Foods that encourage sucking:- These foods, such as citrus foods, promote tongue and lip control and facilitates tongue movements in all directions.

Examples are- Orange slices, Lemonade, Lime or orange juice bars, etc.

✔ Foods with a strong taste:- These types of foods help to increase oral awareness and can be used for those children who have less awareness to touch in their mouth areas. 

(Kids who don't close their mouth after taking food, or the food keeps coming out of their mouth, or take a long time to finish the food, etc have low awareness).

Examples of food are-  Something spicy added to the food (meals like lunch or dinner) like pickles, lemons, Ketchup, etc.

Foods to Avoid

Some foods should not be given to children who have difficulty chewing, sucking, or transferring food.

❌ Nuts & popcorn

❌ Small pieces of cereals

❌ Foods that stick to the roof of the mouth like butter, jelly, cadbury dairy milk, etc.

❌ Foods with two or more textures at the initial stage when the child has difficulty chewing.

Example- Soupy noodles, a good alternative to that can be thick tomato soup.

Activities that promote matured oral motor skills development

Use your creativity to make the activities fun and thrilling for your child.

❤ Blowing activities

They facilitate lip closure, cheek control & jaw control, all being essential for feeding.

Activities can be:-

➤ Blow air hockey:-  A straw can be used as a hockey stick and a cotton ball as the puck.

You can play this game on a tabletop. 2 teams on 2 sides of the table. Ask your kids to blow the cotton balls using the straw until it reaches the other end.

➤ Blowing bubbles:- This activity is very much enjoyed by small kids and is a fun way to teach blowing.

➤ Blow painting:-  This activity not only is beneficial to facilitate oral motor control, but also helps to develop creativity, improve attention span, and makes the brain more calm & organized.

➤ Blowing different types of whistles 

❤ Sucking activities

➤ Sucking a lollipop:-

Sucking small lollipops can improve lip closure, tongue and cheek movements.

➤Sucking lollipop closing lips and pulling it out making a "pop" sound

➤Sucking a frozen fruit bar

➤Sucking & licking a lollipop or frozen fruit bar:-

Rubbing the lollipop around your lips and lick off. Sucking and licking off the lollipop inside the mouth.

The same activity can also be done using a frozen fruit bar.

➤Sucking liquids using different types of straws.

Sucking throw straw helps to develop lip, tongue & cheek control. It facilitates lip closure.

You can start by drinking water & frooti or thin juices with a straw. Then, you can give thick liquids like banana shakes and also longer or zig-zag straws to make it more challenging.

❤ Activities to promote tongue movements

➤Imitation of different movements

Imitation of sounds:-

For those kids who can imitate, making different sounds like "click clock sounds", "Lalala sounds" and different other sounds that you can make with your tongue.

You can play a game with your kid of- "who can make these sounds faster", or  Take turns - I make a sound and you make another sound with tongue.

Or, to the beat of the music. Kids will love this game.

Imitation of movements:-

You can also ask your child to imitate you while you make different movements with your tongue.

Touching the roof of your mouth with the tip of your tongue,

Touching the sides of your mouth, moving your tongue side to side,

moving your tongue in circles inside the mouth, etc.

➤Tongue movements using honey/lemon 

Use an ice-cream stick or cotton swab to put some honey/lemon on different areas of your kid's mouth.

Put it on the upper lips, lower lips, and on the sides. Ask him/her to lick off using his/her tongue.

All the above activities are meant to improve oral awareness & separate lip & tongue movement from jaw movement which is usually lacking in children with ASD having feeding disorders, an essential skill required for proper chewing & swallowing.

Some tips to apply before oral-motor exercises or his feeding time

➤Using a washcloth

Use a small washcloth, you can dip it in lukewarm water or just normal water. Children usually enjoy sucking water off the washcloth. The soft cloth fills their mouth giving them tactile inputs. it helps kids who are oversensitive to touch.

They can chew on the washcloth, or wipe their mouths.

Using this before feeding time or before oral-motor exercises can be very beneficial.

➤Facial massage

Giving a facial massage or tapping can help to relax your child making him ready for the oral-motor activities or feeding time.

(Ask your therapist before applying any massage/tapping)

If you apply some of these on a consistent basis, you will definitely notice the changes in your child's feeding abilities which will make your life easy.

Do apply these techniques and let me know in the comment box how it worked out for you!

Enjoy Reading!

Happy parenting to all my readers.

About the writer :-

The writer’s name is Abhipsa Parida. She is an occupational therapist specialised in pediatrics and has been handling kids with special needs since 5 years. She is quite experienced and skillful in observation, assessment and planning intervention for kids with special needs. She uses evidence based practice and is very creative and updated in her approach while handling kids with special needs. She has her own clinic in Bhubaneswar and has handled many kids of different age groups with varying needs.

If you have any queries, you can mail them at abhipsaot21@gmail.