Ask A Therapist: Picky Eater

I have a question regarding a 4 year old boy diagnosed with autism in a school setting. At first, he was only eating baby food (various flavors). Now, he eats baby food with Beech Nut baby cereal, still a puree, but a thick oatmeal texture. Sometimes I add a mashed banana to that mixture. He also eats mashed potatoes with some mashed egg whites (although sometimes he needs that dipped in banana baby food in order to eat it). My problem is not getting enough for him to eat, but getting him to accept more textures, and CHEW FOOD!

He accepts a chewy tube, but he will not chew on it if he sees, smells, or feels anything come out of it. He spits out pieces of banana in his babyfood/cereal/banana mixture. He will not allow Gerber puffs near his mouth. It took 5-6 months to transition from the baby food-only stage to where we are now, and I am at a loss, as nothing is working. I would appreciate any and all suggestions for trying new textures that will eventually (hopefully) lead to chewing.

Thank you so much!

It sounds like you have made some nice gains with this child. Are you doing lateral tongue massage and bilateral tongue hugs? Have you progressed to chewing hierarchy level #2 with the chewy tubes? If so, do you see tongue retraction and lateral tongue movement? If so, will he tolerate cold temperatures? If yes, use a syringe to fill a thick straw (Starbucks or Dunkin Donuts thickness) with a favorite puree, and put it in the freezer. Present the ice straw using chewing hierarchy level #1 (perpendicular to the lateral molar ridge at the first molar) and work on facilitating repetitive chews. This could be a good transition to bite, chew and swallow. If moving directly to solid foods is not working, you may have to task analyze his goals.

Good luck!

Lori Overland

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