Thursday, March 3, 2011

The Care and Feeding of my Autistic Children

Cameron, you cannot have any more mixed veggies until you eat at least one slice of pizza!
 Adam, I KNOW ham, broccoli and baked potato is your favorite dinner but can we just make due with a hot dog and fries tonight? It's all we have until I go to the grocery store.
Yes, pancakes and sausage is normally served on Saturday morning with Daddy but can we just try it for Wednesday night?
Yes, you can get carrots instead of fries. I'm sure the waitress won't mind the substitution. 
She will bring the mustard with your dinner, I promise. I know it's not on the table right now but I promise she will bring it or we will ask again-- NICELY.
I only see carbonated beverages on the menu, do you have any juices? No. Okay, water for the boys, please.

 Yep, these are all things I've said out loud and recently, if I were a better person I would totally be smug about all of this but NOPE! It does me absolutely no good at all to be smug about their picky eating habits, even if those habits tend to lean towards some freakishly healthy options. To counteract all of that healthiness the boys also have a deep and abiding love of all things ice cream and will do many many math problems to get their hands on junior mints. Since picky eating is a topic that comes up again and again when I talk with other Autism moms, I will attempt to share with you all the lessons I learned, what worked, what blew up in my face and in the end how it all fell in to place. Maybe you will find something that will help your own plight, or maybe I can make you laugh, either way it's a WIN!

When your child is teething, give them cold or frozen veggies to chew on. It will help them through teething and will give them the vitamins they need. (from a parenting magazine)
For us this totally worked! I carried around frozen veggies for years and years. I've even put frozen mixed veggies on McDonald wrappers right in between the cheeseburger and french fries! Now 9 years later I get a very cranky Cameron who feels that a meal isn't complete without something veggie on his plate. Adam cares less but will still eat mixed veggies, no salt and no butter, but he does still prefer them a little frozen. I can do that! 

Make your child try at least 2 bites of everything at every meal. They may find they like something new and really, 2 bites isn't too much to ask. (a pediatrician)
Uh... nope! This failed miserably! Lets not forget that our special Autie kids have tactile sensitivity and thats not just for fingers and toes everyone! Textures are a BIG DEAL! Cameron could not stand mashed potatoes no matter how decadent I fixed them or how loaded I made them, that soft kind of mealy texture was just too much for him to handle. This "just try 2 bites" started with a big fight at the table, us basically forcing him to try them and ended with vomit all over the dining room table in the middle of dinner. It wasn't my proudest mommy moment and I have never strong-armed Cameron into trying something ever again, bribery on the other hand....  Years later, Cameron now tolerates mashed potatoes. He prefers them lumpy and made with chicken stock instead of milk but he will eat them. 

Adam, on the other hand, was more subtle. As a baby (and even now) he LOVES to eat and there were very few things he wouldn't eat.  That was until we tried peaches. In some amazing feat of biology or chemistry or something the day he tried peaches, Adam also defied some kind of law of nature. Of course it was puree'd veggies and fruit for my then 6 month old, we started with a little rice cereal (yum!), ate 3 or 4 bites of peaches (baby grimaces are adorable) and then 1/2 a jar of green beans. THEN came the vomit. Somehow, some way, he was able to only puke up the peaches without even a hint of white from the cereal or green from the beans!!  This would prove to be only the first of many miracles from this child.

**SORRY for the delay, I'm back and trying to remember what else I wanted to write about!**

If you want your child to try something new, put it on his plate. If he doesn't eat it, put it on his plate the next time you make it. Eventually he'll try it once it becomes familiar. (I have no idea where I read/heard this but I think it was either from another ASD Mom or a doctor specializing in sensory issues)
Totally worked-- I think. By the time I heard this, Cam was much older and already had a pretty good list of foods he ate. We decided to try this idea with mashed potatoes since we knew it was a sensory thing more than a taste thing. We put a little on one of his divided plates (LOVE Corelle!) and he ignored it. I didn't grow up during The Depression so I'm pretty comfortable throwing food away especially if we are working towards a goal. I would guess that it took 4 or 5 times before he tried the potatoes and he did gag a little but he ate them. A few more potato dinners later he'll eat a whole serving and will gag only if we make him eat the potatoes. Here's where we fall down on this plan, now that we KNOW he'll eat them we often suggest that he eats all of them (often with gagging). I don't like that and I really shouldn't do it any more. I'm sure some days he is more sensitive and I shouldn't push.

Food is just food, you eat to fuel your body not to fill your heart. (my brain after reading long articles on stress/emotional eating)
I am a serious an emotional eater and as such should wire my mouth shut and get my keister to the gym more to work off all the effects of emotional eating. Not going to happen so instead I try my best to realize what I'm doing, decide if its worth it (because really, sometimes it is) and then deal with the outcome-- no excuses, no lies. Moving away from the old school, "food is love", "Grandma made this just for you, you're too skinny, eat up!", "lets celebrate, I'm taking you out to dinner" ideas is hard. So is trying to loose a ton of weight so really it comes down to which you would rather do.

For the boys, I try very hard to make food a non issue. If there is something I don't want them to have, I don't put it in the house. If I am eating, say, a cookie at 9am just because I'm an adult and I can, then if they want one they can have one too (but just one). All snacks come from the snack drawer in the fridge or the bin in the closet-- no exceptions and it is my job to make sure those snacks are things they like and things that are healthy. If Cam wants pancakes for dinner but we can't have it that night because I've already planned (or already cooked) something else, then he can write it on the calendar for whatever day he wants. Meals are not snacks and snacks are not meals. This means that when we sit down for a meal it will have some basic elements like protein, veggie/fruit, etc. it does not mean that there will be granola bars, cheese sticks or peanut butter crackers on a lunch or dinner plate. I have two personal rules about shopping, I have been rigid in them and I have never deviated from them (because for my boys it is either yes or no, sometimes to them would equal yes). (1)We don't sample anything given away at Costco-- this comes from Cam's food allergy days. I didn't want him to try something THEN realize that it contained an allergen, then once he was out of the cart I didn't want him to wander off to "try" something in a busy store. With 2 kids known for running off, even at 6 & 9, it's a chance I'm not willing to take. (2) We never buy anything at check out. When they were babies the answer was 100% no, 100% of the time, they stopped asking. Now that they are older, they occasionally ask again and the answer is still no. Typically if we are at a store with a candy isle, we're buying food anyway and there is a snack in the cart somewhere that they would like just as much. It's a simple re-direction, especially with the "that is not a snack, that is a treat" idea already firmly planted.

The outcome of this has been rather surprising. Now that they are older and choosing their own snacks and meals, they make pretty good choices. There are treats in the house, they get them occasionally. Nothing is "off limits" if it is in the house, just some things are "not at this time". They've responded pretty well. I'm looking forward to their teen years to see how it all carries over. I'm hopeful that they will understand the difference between snack and treat and will make choices accordingly.

A funny and enlightening story for me (because all things can be looked at different ways, this one is funny to me because it is enlightening)
Cameron recently started a program called Coping Cat along with a medication trial. We are targeting the stress, focus, anxiety and impulsivity that is getting worse as he is getting older. I avoided all pharmaceuticals until Cameron was 9, which I feel is a huge triumph since I've been getting pressure to medicate him since he was 2. At some point the anxiety he was feeling and his impulsivity was past the point of re-direction. When anxious, he would shut down and no once could reach him. It's a helpless feeling for both him and for me. I still didn't want to do meds because I didn't think he could communicate his feelings/hurts enough if something was going wrong. But we hit a wall, had to make a decision and we did. That doesn't mean that I like it though..... Anyway, back to the story. We tasked our beloved Behavioral Psychologist to come up with a plan for helping Cameron work through his anxiety, focus, and impulsively (Very different things, requiring different methods and different types of medications) and to recommend a doctor willing to walk us though the medication trial. So we started seeing a Pediatric Psychiatrist who specializes in Autism to start the med trials and we started a program called Coping Cat with the Behavioral Psychologist simultaneously. I'll save my medication rants for another day, my story comes from the Coping Cat program. This is a great program where the kids first identify emotions in pictures, tv, etc, then identify emotions within themselves, then identify how their body feels when faced with these emotions and finally how to help regulate the emotions. During one of the first sessions they talked about a time when Cam was feeling particularly emotional. He said, "dinner last night". The doctor thought this was odd because dinner isn't usually a particularly emotional time for kids, especially Cam since he doesn't have many eating problems and had just started eating a wide variety of foods. It took a while to figure out why chicken and rice was creating strong emotion in Cameron but in the end Cam decided that the emotion was jealousy. WHAT???  Cam went on the explain that he was jealous of all the other kids who didn't have to eat rice for dinner because it was so boring and he didn't want it. I immediately thought back to the night before where we were all eating, there were no issues and he ate his whole plate without complaint! I guess the whole time he was thinking, "ugh, I hate rice, I wish I didn't have to eat rice, it's so boring, other kids don't have to eat rice, I'm jealous of those kids who don't have to eat rice." You know, I haven't made chicken and rice since. Not because he didn't like it but as a silent and tacit reward for identifying his feelings and then expressing them. What a HUGE milestone!

I guess my bottom line on the care and feeding of my kids is:

  • are they eating some protein, some veggies, some fruit, some "other"?
  • are they taking a vitamin?
  • are they growing?
  • are they happy?
It's best to have a YES on all four but truthfully, if you have to have a NO for any of them at the dinner table it should be the last. I don't like that Cameron was jealous during our dinner of chicken and rice but if rice is what we had and rice is what he needed then I'll just have to deal with the jealousy. The occasional unhappy meal is inevitable but not insurmountable. 

1 comment:

  1. I know it's not done, but I just have to comment. Both my girls love frozen veggies and actually prefer frozen peas to thawed. Weird but I look at it as a sort of healthy ice cream treat! :) I love reading your blog and hope that I get to see you in person someday soon! We will be in MD this summer so maybe we can plan something!