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WowLi
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18 Jan 2011, 9:57 am

I suspect my 2-year old grandson has Asperger Syndrome because he exhibits all categories of signs and I'm so grateful for the good guidance I've got here on other questions. I need clarification on the food issues.

All the literature I've read speaks of food/eating problems, but nowhere have I seen a definition of what those problems can be. So I don't know if my grandson's food issues are peculiar to him only or if his pattern is part of AS.

Most foods he will not eat, period. Then there are favorites, foods he seems really to enjoy - but even getting an adequate amount of them is a huge problem. His parents (who are inexperienced with little children and don't suspect he isn't neurotypical) are constantly worried about his nutritional and caloric needs. They are expecting a second child in a few months - they can't keep running around after him with a spoon, hoping to slip a mouthful into him when he's paying attention to something else! He does sit with us for meals, but the effort to get him to eat often results in an uncontrollable tantrum, little or no eating, and everyone, including him, upset and frustrated.

Any suggestions?


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CCat
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18 Jan 2011, 10:18 am

I had issues with my AS children eating well when they were small too, and it turned out that they had celiac disease. Eating made them feel bad, so they just didn't want to eat. Maybe food sensitivities are something that could be considered? Even after going gluten and dairy free,though, they're not good eaters. Their meals consist mainly of meat, ketchup, rice, cucumbers and dip, and grapes or applesauce, maybe the occasional banana.

My stepdaughter's son has AS symptoms too, and she's forever trying to get him to slow down and eat. He may have some food sensitivities too though, because he has terrible eczema and asthma.



jat
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18 Jan 2011, 10:20 am

It's generally a bad idea to create struggles over food, regardless of whether a child is NT or ASD. If there are foods the child will eat, making them available during meal times should be sufficient. Children will eat what they need, if there is food that they like available. Two year olds generally don't eat very much - and some eat less than others. As long as the child is not slipping down in the growth charts, and the doctor isn't expressing concerns about his size, there is no reason for worry.



liloleme
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18 Jan 2011, 10:24 am

I was really worried about my son not getting enough nutrition so I had a nutritionist sit down with me and go over what he does eat. As it turns out I was doing a great job of replacing the things he did not eat with healthy things that he would eat. After talking to her I felt better and did not stress as much. Even though he is my fourth child I still worried. If its mainly due to the fact that he does not stop moving long enough to eat ,try portable food. Ive found that you can put anything between two slices of bread, a tortilla or a pita pocket.



WowLi
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18 Jan 2011, 10:45 am

I was leaning toward what Jat and Liloleme are saying here. And I really think it's not a good idea for anyone to be upset when eating - child or parents (or grandparent!).

I agree with his parents that family dining is important for everyone. I don't like the idea of letting him out of his high chair before the rest of us have had 3 bites of food. On the other hand, sometimes he just can't be distracted from his demand of 'down!' and things kind of just escalate from there.

Although I've mentioned in passing that he 'isn't wired' like most children, I haven't suggested to his parents yet that he may have AS. I've got a book coming (Quirky Kids) and will read that before I take it further. I wonder though - a few days ago, my daughter got the movie Mary & Max from the library. Maybe the few things I've said have got her wondering too.


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azurecrayon
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18 Jan 2011, 11:31 am

with my asd kids, mostly what i see is texture issues. they both eat very little meat, in one case no fresh meats, only processed. mostly its fruit and carbs. they both have randomly stopped eating foods that they used to love.

keep in mind with toddlers, whether or not they have asd, grazing is really really common. they may not eat much at a meal, instead eating just enough to keep hunger at bay, and requiring several snacks between meals. some kids are just grazers who need to eat small meals every couple hours throughout the day. for little bodies with little stomachs who are active and burning a lot of energy, grazing is actually the only way for them to keep up with their needs and get a steady flow of energy.

my middle son went from being a grazer eating little meals all day a year ago to now eating us out of house and home. he still requires snacks between meals, but his meals are much bigger than they used to be. the other day he ate, and this was between coming home from school and bedtime 4 hours later and not including drinks, a double cheeseburger, some fries, 2 1/2 containers of yoghurt, and 1 1/2 peanut butter and jelly sandwiches. he's 7. my food budget is really missing those grazer days.


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MidlifeAspie
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18 Jan 2011, 11:52 am

I never had any eating issues so I would not assume this is a universal symptom.



amywesternor
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18 Jan 2011, 1:12 pm

our almost 16yo AS son survives on totino's party pizzas and occasionally fish...sometimes french fries.And milk and a few varieties of cold cereal



Stubbydog
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18 Jan 2011, 1:14 pm

My 3 year old (possibly AS, possibly not) has eating and stomach issues. He is reluctant to try things he doesn't recognize, and will go through phases where he hardly seems to eat at all. He's never been a big kid but also has stayed pretty consistently where he is on the doctor's charts...so I try very hard not to stress about it. I had a friend with a son who was constantly underweight...she used to do as you described and chase him around with a spoon lol. But in her case, she had a reason to be concerned as he fell off the charts underweight. He's NT, and is 7 now and eats just fine. :)

I try to make sure that I both introduce new things to his plate, and put things he knows and likes on there. So each dinner is a mix of stuff I know he probably won't try, and things I know he'll eat. If he is very hungry, he will sometimes try the new stuff. :) But in either case, I at least know he's not going hungry. I give a small snack in the afternoon...I cut out a later snack (we tend to eat later per my husband's schedule) and that has helped him be more hungry at dinnertime.

I did have him tested for celiac and it was negative, which was a relief to me. I know he's sensitive to dairy (mildly lactose intolerant, as am I and his older sister) so I limit the amount of dairy he gets at one time. You may want to suggest that they pay attention to his bowel movements and see if he seems to be having any issues there, it may be affecting how he eats. I know when my son's stomach isn't happy, he doesn't want to eat (neither would I!).

Like someone else mentioned, grazing is pretty common at this age AS or not. With my son at least, he will stay at the table without a fight. I wonder if they just need to get over the tantrum hump? I.e. let him get mad about it for a day or two but stand their ground? With my kids that is sometimes the case.



WowLi
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18 Jan 2011, 1:26 pm

We pretty much buy organic for most things and eat in as healthy a way as we can afford. Judging from some of the replies here, I'm thinking maybe we are doing better than we realize with my grandson.


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misstippy
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18 Jan 2011, 2:37 pm

A lot of kids with ASD do have eating issues, you're right. It's mostly because MOST, not all people with ASD have sensory processing issues. And one way that sensory processing issues can present is finicky eating. The textures might be too much to handle. My son was a good eater until about 2.5 years. He is extremely picky now. His main problem is with things like chili, soup, hamburger, mashed potatoes... he really just doesn't like lumpy things. He will gag on them. and sometimes, it depends on the time of day. He'll eat scrambled eggs in the morning, but might gag on them in the evenings.... because he's been on sensory overload all day and just can't handle it in the evening.

But, like other posters stated, kids at age 2 do tend to be grazers. My 22month old daughter is that way. She eats all day long in small amounts. My son was that way at that age too. Oh, and with my daughter... when she's done eating.. WATCH OUT! She's throwing food all over the place until you get her out of her chair or take it away!

That "Quirky Kids" book is great. I hope you like it.



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18 Jan 2011, 4:30 pm

Let's see... what issues do I have?

When I was little, I didn't choose foods I liked. I chose foods that weren't awful. Processed, store-bought foods, usually. I've never liked the same things as most people. All these subtle or strong or whatever flavors have never really been my cup of tea-- they're better now that I can tolerate more foods, though-- I always just have... backwards preferences. Hamburger is way better than steak, for intance.

Texture issues-- oh, man, these are awful. Used to utterly rule out everthing with onions in it (I'm still not too fond of onions). Pork chops, especially, are impossible. Steak. Basically, most meat-- fat, gristle, veins... just impossible. Ham is always just this side of impossible, but rarely actually becomes impossible. Unlike most other meats, though, it's the actual texture of most of the flesh-- usually that's not so much an issue. (Chicken is easiest. Breat, especially. As much just plain meat as possible. Light meat is better than dark meat. Drumsticks can be good, but they're never a sure thing.) Cooked vegetables used to always be completely impossible regardless of vegetable or cooking method (except legumes and corn; those are good), and cooked fruit was always even worse. Now I'm okay with lightly steamed broccoli, matchstick carrots in rice bowls, I've even eaten larger slices of cooked carrot without gagging (but I don't like it). Oh, and there's one good way of preparing zucchini that I like. :D

You might guess that I don't like soft things. That is not true. I do not mind the texture of pudding, jello, bread, pears, peanut butter, jelly (SO LONG AS IT DOESN'T HAVE FRUIT IN IT!! !! It CAN NOT HAVE FRUIT IN IT!! ! I mean, fruit juice, fruit puree, sure, but bits of cooked fruit? NO!! !!), applesauce, garlic cooked and spread over bread like butter (weird, huh?), honey, noodles... basically, yeah. Soft is fine. I don't know the word for the texture that bugs me-- squishy? Chewy?

I also like apples, most nuts (can't off the top of my head think of a kind I don't like), sometimes I like tangerines (I've never figured out how to eat oranges-- I like orange juice, but can't stand the pulp-- but I like tangerines on and off-- tend to eat a huge amount, get sick of them, not touch them for months, then eat a huge amount... but I tend to be very everything/nothing-- my version of moderation is to swing too far in one direction, then the opposite), I love pomegranates, I like pears, raw vegetables (broccoli, carrots, sometimes celery, cucumber, basically most veggies), plums (especially the big, sweet ones with the tart skins...), tomatoes, strawberries, basically most raw fruits and vegetables.

When I was little I was really fond of store-bought stuff. Stuff people called tasteless. I didn't used to be okay with melted cheese, but now it's fine, I like pizza. I used to love Kraft macaroni and cheese.

Also, a new twist on a food I know and like is hard. Like, hot dogs are good, but the first time someone suggested putting them in mac and cheese, I didn't really want to try. I just get used to stuff and it feels like... I don't want to risk it. It's something I need to be prepared for. It's hard. You absolutely cannot tweak a recipe and spring it on me. Especially not if you've said what you're making or I've asked for something.

Oh, and mixing foods-- I used to never be able to have anything on a burger-- all the veggies had to be on the side. Then I'd eat it all separately. Still do, depending on what kind of burger. But I have had good burgers that had veggies on them... different, though.

Bean burritos. Everyone likes these, it seems like. And when I say I like them, everyone feels like this means I like them with rice and cheese and all sorts of things. I don't. I can't eat them that way. Period. (I'll stomach as much as I can if someone else did me a favor and got me one. It's only polite to eat what people serve you. But it's awful. I wish I lived in a society where politeness wasn't about lying or suffering or pretending to like things you don't.) You have no idea how hard it is to order a bean burrito with just beans at a restaurant. You can repeat it five times in two languages and say please each time, but they will add rice. Or cheese. Or some kind of sauce. Or all of the above. Remember what I said about trying new foods? That's hard even if I like them. This is just ridiculous, it's really, really upsetting.

What this all means in practice is that I don't eat everything on my plate. I usually eat one thing, or two. Or everything BUT one thing. If served meat, I'll eat it, but I won't eat all of it. If served soup or stew, I'll usually eat some parts of it, and once it gets too hard to pick out parts I'm willing to eat from parts I'm not, I give up. My parents did figure out that I was avoiding specific ingredients rather than just not finishing. Sometimes I take an extra scoop, but I eat that one with even greater inefficiency. There are some meals that I'll eat all of. Mashed potatoes with fried baloney and ketchup. Zaru-soba (if you don't count the ginger and wasabi and stuff, or the leftover sauce). Some types of cream of tomato soup and crackers.

Actually, I'll eat all of a reasonably-sized serving of homogenous, processed meat. Meatballs, sausages, hamburger, Philly cheese steaks.

Bizarrely, I have no issues with sushi or tofu. (Doesn't mean I like either one. But I can stomach both; my reasons for not liking them are the same as the reasons NTs have who don't like them. They're... just not that great.)


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18 Jan 2011, 9:31 pm

The proof will be in his weight. I presume he is seeing a pediatrician and being weighed and measured on a regular basis? Is he continuing to grow and put on weight within the normal range for his age?
My sons seemed to live on air at that age. A few bites here and there, because they were just too busy to eat (eating is boring!). But even though they seemed to eat so little, the doctor was never worried because they continued to grow as expected. Most toddlers do eat best by grazing, rather than sitting down for family meals, and as long as a variety of healthy, nutritionally dense foods are being offered it shouldn't be a problem. Just be careful not to make mealtime into a battle ground over whether or not he eats, that is just stressful for everybody.

As far as whether this is a sign of Aspergers it is really way too soon to tell for sure. Almost all 2 year olds have quirky habits, and strong food preferences and aversions. Pretty well all the criteria for Aspergers could be applied to any toddler. Watching Dora the Explorer over and over again, klonking the kid next to you in the head with a train and screaming if you put them down to sleep with any but their favourite fuzzy blanket is normal stuff when you are two, it's when the child is still doing it at 7 or 8 that it becomes a bit of a red flag!
There are some things to look for. Link to the CHAT screening criteria:
http://www.autismcanada.org/pdfs/chatscreeningtool.pdf

But even so, I wouldn't get too worried and I wouldn't worry the parents either, as long as his doctors and parents think he's doing Ok. See how he's doing in a year.



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19 Jan 2011, 12:05 am

I really loved this book on feeding children; it's not specific to AS but she does have some advice for "problem feeders" on her website.
http://www.amazon.com/Child-Mine-Feedin ... 0923521518