Feeding & Eating Problems in Autistic Children

Hey, guys, this is ming here from agentsofspeech.com I'm a speech therapist, and today we're going to talk about feeding issues or eating problems in autistic children. All right, so first of all, eating and feeding is actually a sensory motor process, right? You need to feel it in order to move, in order to bite and chew and then swallow it down. These incorporates, like, all the sensory and motor skills of a child's, like jaw, lip, tongue, and then also all the small muscles within this whole system over here. So I'm not going to go through all of that, but what I'm going to tell you is the sensory issues that happen in autistic children. And why I'm going to talk about this is because this is actually a big problem for autistic people in general. Okay. Sensory problem is different, or what we call sensory profile would be different from person to person. And this difference actually makes like, it becomes even bigger when you're comparing neurotypical person like myself and an autistic person. Okay? So we will taste food very differently, even if it's the same thing. Even for you and I. I might prefer something more salt, salty. You might prefer something more bland or more. A little more sweet for me. I cannot take sweetness that much. Okay. It's actually quite sensitive to sweetness. Okay, so imagine a child on the spectrum whose sensory profile is all over the place. You haven't gone to know which places are a little more sensitive, which places are hypo, meaning not enough sensory. They're seeking for sensory. So you don't know that within the mouth yet. Right. So what we need to do is that we need to check out a child's sensory profile, at least inside of the oral cavity. And how we do that is we use something called a tooth that maybe I'll put a picture up here, and we do a quick, like, brush around the mouth to see which parts are seeking for sensory meaning. They like it. They don't have enough. They want more, or they're hypersensitive and they find it too much for them. Right. So the best way you can do it is to do this is to see a qualified speech therapist to help your child determine, like, which parts, what sensory is going on and so forth, and what the kind of intervention is needed for that. I cannot tell you right here because you really need to see how a child reacts to all the brushing and stuff and so on. Right. This is really important because we don't know how a child feels towards a certain sensory. So by Trying it out with something that is not a food, like just a too thick brush, makes it a whole lot easier to manage. All right? That's number one. Sensory issues. Number two is oral motor problems. So oral motor problems are a huge part of eating or feeding or swallowing or whatever, chewing. And it's called sensory motor for a reason. If a child cannot sense. The first problem we were talking about was sensory issues. If they cannot sense it properly, meaning they. It might be too much or too not enough sensory input, then what's going to happen is that you cannot really chew nicely or you cannot control the food inside of your mouth nicely. So imagine you going to like a dentist, right? And then you get, you know, the painkillers and it makes you like numb all over. I mean, you must remember when you are getting like your tooth removed when you were a kid, the painkillers really numb everything here around the mouth, you start drooling, right? You start to not able to speak clearly because you can't sense it. Therefore your muscles don't know where to go, especially your tongue. And when you eat, it's very easy to mismanage the food and have it like go outside of your mouth. And that's the same for children who have a sensory problem. And therefore they cannot like have the correct motor planning or not really motor plan that they cannot execute the motor motor patterns necessary for eating. Okay? When this is a problem, when oral motor is a problem, right? Once you have done, finished and managed the sensory needs, the next step is to teach them the correct motor skills in order to eat. So if something that they eat is very difficult to manage, you know, when you eat with friends outside, you know, some people don't like to eat food fish because of the bones, they don't know how to manage it. And that is exactly what happens with children. They get scared of managing, I don't know, like food such as a jelly, because they don't know how to like munch it up and swallow it. Maybe it was too big, so it caused them to choke at one time. And what happens is that they become scared of it. And I'll talk about it later on as the third reason, but for now, for all the things you have to remove, all the hard, difficult things that they cannot manage for them. So. So for instance, if it's a really big piece of chicken, cut it up in smaller pieces and then gradually increase the size of it, okay? Or if it's like teaching them to manage bones, which is not our topic here, but just as an analogy what you can do is to go from big bone to a small bone and slowly teach them to manage how to do it by through, like, controlled practice. Okay, so this is what we do for helping them during the feeding process, right. During the mealtime. And what we can do other than that is oral motor exercises. You know my stance about oral motor in this channel, agents of speech, right. We talk about that it might not be the best thing to teach speech with. Sometimes it is, sometimes it isn't. But taking the whole motor process of chewing and eating and breaking it down into smaller parts and doing that as a oral motor exercise is valuable. Okay. For instance, if your child doesn't know how to chew with their molars, like the big teeth at the back, then what you can do is use talk tools like. Like a chewy tube and teach them to go up and down and chew, right? And go from a bigger chewy tube to a smaller one and from a softer one to a harder one. So that they learn that chewing requires the muscles here and the process of going up and down. So there's a lot of things that us speech therapists, we look at when we're dealing with this kind of problem. So one of them is, like, is the jaw, lip and tongue. Are they all, uh, they're able to move by themselves? Meaning dissociation. Right. You can check it up on Google if you want to. I'm not going to talk about it here. But the major thing is that when a child or a person, when they chew, what happens is when the jaw goes left and right or back in front, like going from front to back, then that means the jaw isn't stable. And therefore, we need to do some oral motor exercise to help them stabilize the jaw, increase the strength and the mobility and range and so on. And afterwards, try to generalize that into eating. Okay? All right. The last one is about rigid behavior. And rigid behavior is something that is learned. So if you've heard of it, it's. There's a term called tactile defensiveness, right? Which means someone had a bad experience, and therefore it becomes a defense mechanism to stop doing that kind of stuff. So you might have a friend. I have some friends who don't like to swim. And the reason why is because they've had a bad experience with it or once or twice, right? Like, my friend who doesn't eat pork anymore is because he had a bad experience. He ate pork and it was, like, really dirty, and he got a stomach ache, doesn't want to eat anymore. Same with children. Especially autistic children who are rigid. Rigid as in I. This they don't know how to understand. This is a one off instance. They think that everything from now on, whenever they eat that thing, it's going to create that bad feeling. Okay? So I've got, I've had children who hated. Hated with a capital H, right? They really disliked eating jelly, right? Because whenever they ate jelly, it reminded of them choking. Right? Another child doesn't like to eat rice because of the sensory profile and the motor stuff. It got all, got stuck here underneath his lips. And then because it was very sensitive and he didn't have the motor skills to use his tongue to like take it out or you know, drink some water and wash it out, it became very uncomfortable for him. So he doesn't want to do it anymore. Okay? So you have to remember these happen to children, okay? And people in general, bad experiences equals I don't want to do that anymore. You know, so whatever you do, try not to force your child or the person to try out the things you, you want, okay? It's very difficult because sometimes we put our needs in front of the child or our wants in front of the child. We say, I know better for you and you should eat because it's, you know, this is nutritious or whatever you got to eat or else you won't grow, whatever. But at the same time, are you thinking about, oh, are they too sensitive to eat this? Is this a texture they can manage? Number two, are the motor skills good enough for this? Like, can they manage putting that food to the left or to the right, put it to the molars, chew it and then swallow? Is that something they can do? If they cannot, then, you know, maybe make the food a little bit easier to ingest. Maybe even using puree. Okay. I've got quite a few students who are still on puree to this day. Okay. But we're working towards, we're taking out the problems that he or she has and using like non speech or remote exercises like chewy tubes or doing tongue exercises to help them manage food better later on. Okay? And the last thing is the rigid behavior, the defense mechanisms. Are you thinking about, oh, have I triggered something that they don't like? That's something you have to remember. So at the end of the day, this video is to tell you know, why your child doesn't eat properly. Is it behavior thing? Is it abilities thing? Is it a sensory thing? Get a speech therapist, check it out. Okay? You know, this is the end of the video. And if you haven't go to agents of Speech.com checklist to get a list of tools and toys we recommend that you get if you're starting home therapy and that's the end. If you have any questions, do put it in the comment section below and I hopefully I'll answer them right there for you. See you next week. Bye Bye.