April marks Autism Awareness month, 30 days devoted to increasing attention to and awareness of a condition that profoundly impacts 1 in 50 U.S. children and their families every day. Autistic Spectrum Disorders (ASDs) exist on a continuum, varying from mild impairments to severe disability. Children with ASDs experience impairments in social functioning, interest in a restricted range of activities, and repetitive and ritualistic behaviors. Due to these impairments, children and teens with ASD experience unique nutrition and physical activity challenges. However, they also experience the same powerful benefits from a healthful diet and ample physical activity as their peers. For example, physical activity helps children with ASDs to improve social and executive functioning, decrease rates of obesity (which are very high in children with ASDs), increase social skills and improve behavior.
Here are 10 ideas to help make mealtimes and activity breaks into positive experiences for children and teens with ASDs:
- Create opportunities for your child to be successful. It is much easier to reward a child for exhibiting a positive behavior than to punish him for doing something that is inappropriate. Set your child up for success by making it easier to do the “right thing.” Create a healthy home in which healthful foods are the only option. Make physical activity the norm by always walking to school.
- Reward generously. Smiles, hugs, high fives and stickers go a long way in helping a child learn to engage in positive behaviors. “Catch” your child trying a new food or appropriately playing a new game and praise him.
- Keep a consistent daily schedule with times set aside for meals, snacks and physical-activity breaks. All kids thrive on routines, and that is especially the case for children with ASD. To facilitate your child eating at scheduled meal and snack times, avoid offering drinks (other than water) and foods outside of those times. Also, keep the scheduled posted as a visual reminder.
- Eat family meals. Prepare one meal for the whole family to help your child learn what a balanced meal looks like. While many children with ASD prefer a specific and limited number of food items, it is important that they be offered a variety of foods. When other family members model healthy eating behaviors, a child is apt to learn to eat in a similar manner. The family meal also helps the child to become an integrated member of the family. Keep mealtimes calm and free of distractions.
- Include at least one food the child likes at meal times and one “new” food. Many children with ASD are very picky eaters and would be content eating the same foods at every meal. Help a child learn to like a wider variety of foods by offering at least one food that the child likes as well as one “new” food at each meal. Remember that it takes 15 to 20 times for the average child to like a previously rejected food. It can take even longer for children with ASD. Increase the chances of acceptance by offering the “new” food repeatedly on consecutive days paired with a food the child already likes.
- Ask for help. Some children with ASD exhibit peculiar feeding habits, including chewing and re-chewing foods, severe picky eating and “mouth packing” (placing large amounts of food into their mouths at one time). Sensory issues, gastroesophageal reflux, developmental delays and anxiety can also interfere with healthy nutrition patterns. In these cases, consultation with a registered dietitian, occupational therapist or other professional specifically trained in working with children with ASDs is not only helpful, it’s essential.
- Respond to self-stimulating behaviors with physical-activity opportunities. Self-stimulating behaviors like body rocking, spinning, head nodding, hand flapping, object tapping and light gazing can be frustrating to parents and interfere with a child’s ability to establish relationships with peers. Research supports using aerobic activity such as light jogging and swimming to help decrease these behaviors, possibly because these types of repetitive activities help to distract from the self-stimulating repetitive behaviors.
- Break it down. Children with ASDs are more likely to be successful in sports and other physical activities when the activities are broken down to their component parts. Teach a child with ASD a new sport by starting with the fundamentals in organized steps. When a child has mastered each step, reward generously (but ideally not with food).
- Use yoga to transition. Yoga poses not only can help to increase a child’s flexibility and interest in physical activity, but they also serve as useful and routine opportunities for soothing between transitions, which can often be very difficult for a child with ASD.
- Support and share: Engage with other families who share similar experiences and interest in optimizing health, nutrition and physical activity. Also, seek out support and resources from organizations committed to optimizing quality of life for children with ASD. A few resources include: Autism Speaks, The Autism Society, American Academy of Pediatrics Interactive Autism Network National Institute of Mental Health.
Do you have more ideas for how to help children with ASD optimize nutrition and physical activity, experiences to share, comments or concerns? Please share!
By Natalie Digate Muth
Natalie Digate Muth, MD, MPH, RD, FAAPNatalie Digate Muth, MD, MPH, RD, FAAP is the Senior Advisor for Healthcare Solutions for the American Council on Exercise, a board-certified pediatrician and Fellow of the American Academy of Pediatrics, a Diplomat of the American Board of Obesity Medicine, registered dietitian and board-certified specialist in sports dietetics, and ACE Certified Health Coach. She is the author of "Eat Your Vegetables and Other Mistakes Parents Make: Redefining How to Raise Healthy Eaters" and the textbook "Sports Nutrition for Health Professionals." She has been ACE certified since 1998.
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