Ideally, children should have their feet on the floor or support and sit up without slouching (within the constructs of their physical abilities).

As children become comfortable sitting together, gradually introduce the concept of eating at the table. Try to stick to set times for eating as much as possible. Aim for three meals and one snack per day, with no more than 2-4 hours between meals depending on your child's age (note: determine the ideal number of meals/snacks per day with your dietitian). If a child experiences hunger between meals, this provides a learning experience to tune into their bodies. By establishing set times for eating, children can learn to accept food at the appropriate times, and they will come to anticipate their daily routines.

Be a role model! Meals are a powerful time to model ideal behaviors. So, parents, eat a varied diet and demonstrate how you would like your child to behave.

ADDRESSING FOOD SELECTIVITY

Children's food selectivity comes from a place of fear. It is essential to recognize that new foods are very anxiety-provoking and a source of discomfort for many children with ASD.

Gradual exposure may help improve acceptance of new foods and ultimately improve nutritional intake. If a child is fearful of oranges, start by having the child look at an orange from across the room. Over time, move the orange closer and have them touch and play with it. As their comfort increases, show them an orange in different ways; cut into chunks, slices, and orange juice.

juice. Try food-chaining! Food-chaining is an approach where you introduce new foods to your child while building on previously

accepted and successful foods. Dietitian Jenny Friedman, RD, has developed helpful visuals if you need ideas transitioning to new foods. (check her out at jennyfried- mannutrition.com).17

Expand on already accepted foods. If your child accepts McDonald's french fries, try substituting oven-baked fries, then work towards transitioning to zucchini fries. You can also try swapping foods with similar textures (e.g., swap yogurt for pudding).

Focus on the food not the behavior. — Jenny Freidman

POPTART TO STRAWBERRIES: LEARNING TO ENJOY FRUIT

Food chaining is a way to get your selective eater to try new foods. It takes into account the sensory properties of foods that your child likes and builds on his/her preferences. Essentially, it's a tool that helps you identify which new foods your child is most likely to eat. The chain is created by making gradual changes to the accepted food.

MEALTIME MATTERS : A RECAP

Enlist Support: Find a dietician: eatingright.org/find-a-nutrition-expert Meal Environment: Ease into meals with an anxiey lowering activity • Sit at the same table, consider assigning seats • Establish set meal times • Model ideal behavior. Food Selectivity: Understand fear of new foods is similar to fear of spiders or heights • Try exposure therapy • Consider food chaining to move children away from less nutritionally desirable foods.

ABOUT THE AUTHORS:

Heather Seid, MS, RDN, CPS, CNSC, CLC, is a registered dietitian specializing in pediatric and maternal health, and she is a 2021-2022 Fellow in the New Jersey Leadership Excellence in Neurodevelopmental Disabilities program. She oversees the Bionutrition research core at Columbia University and is a Doctor of Clinical Nutrition student at Rutgers School of Health Professions. Dr. Jane Ziegler, DCN, RDN, LDN is Interim Chair, Associate Professor and Director of the Doctor of Clinical Nutrition Program in the Department of Clinical and Preventive Nutrition Sciences at Rutgers School of Health Professions. She is a faculty mentor in the New Jersey Leadership Excellence in Neurodevelopmental Disabilities program.

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