Healthy Diet for Aspergers Children

Question

My son only wants specific foods. How do I ensure a healthy diet for him?

Answer

Youngsters with Aspergers commonly have difficulty when it comes to eating a variety of foods. Textures and smells play a part due to the sensory issues they experience. In addition, having too many choices goes against what is comfortable for these children. Finding a balance will take work and special accommodation.

Children with Aspergers have sensory issues that may prevent him from registering the feelings of hunger. Therefore, you can’t rely on your child’s hunger to motivate him to eat. Eliminating the foods he loves will create a true battle.

When you begin your attempts to alter your child’s diet, do so quietly. The less fuss, the less likely it will become a bigger deal than it already is. And keep trying. Success may come slowly, but the ultimate goal is improving your child’s diet. Every little victory will bring you one step closer to the

desired result.

The most common trick to entice your child with Aspergers to eat is to change the presentation. Altering the form of a food may work. If your child likes the flavor of strawberries, for instance, but cannot handle the texture, you could toss them in the blender with some yogurt and try giving him a strawberry smoothie.

Another trick you can try is the element of disguise. Many vegetables can be pureed and added to favorites without changing the taste of the texture of the food. One example is adding pureed vegetables to meatloaf or spaghetti sauce. The taste is overpowered by the favored food and the puree blends in undetected. This is sneaky, but a great way to meet the goal of a healthy, balanced diet.

Finally, create a meal/snack routine or schedule. This will appeal to your child’s need for order and structure. Eventually you’ll be able to introduce new foods without being sneaky. He’ll know that mealtime is approaching and he will be expected to try the foods you have prepared.

Aspergers & Aggression

"My son is very aggressive and lacks any type of impulse control. He cannot be left alone with his siblings. Does anyone have any recommendations? I know he does not want to do these things, because when we talk about it he says he loves his sister, etc, but he hurts her all the time. My poor daughter has to put up with his aggressions on a daily basis. I can't watch him every second he's awake. I also can't put either child in a protective bubble or send my son to his room and leave him there all day. I really don't know what to do with him and I'm not a big advocate of drug therapy. He's so young and I don't want to change his personality, only his behavior. Will this end soon? Will he gain control at 6, 7, or 8? I love my little boy, but I'm sad that he's so physical. He's starting to internalize his behavior and now said to me this morning that he's a bad boy even though no one tells him that, not us, or his teacher. I worry about his self-esteem as he grows older. We praise him when he's good, but he gets a ton of negative feedback. Don't do this, don't do that, etc. 'You need to go to your room for hitting your sister', I constantly feel like I have to micromanage him. But he knows he's in time out/ or his room a lot and I do that so he can calm down or to protect his siblings. Any advice would be helpful."

Aggressive behavior in the child with Aspergers occurs for a reason, just as it would with any other child. Inappropriate behavior, whether mild or severe, occurs in order to:

• avoid something
• because of pain
• get something
• to fulfill a sensory need

The first step in reducing or eliminating this behavior is to determine the need that it fulfills.

The second step is to teach them a replacement behavior (i.e., communicate what they want or don’t want). It may even involve using some of their obsessive or self-stimulating behaviors as a replacement. This is because it would be far less intrusive to others than aggressive behaviors, but still serve the same purpose.

This process takes time and initially, and depending on the behavior, you may not have time. If the behavior is severe, then you need to remove the child from whatever situation they are in at the time. Simply insisting that they stop the behavior and participate in whatever is occurring will not benefit the child or you, unless you remove them from the situation first.

Maintaining their routine will go a long way towards reducing the need for inappropriate or aggressive behavior in the first place.

A behavior analyst should be able to help you. He/she will work with you and your family to try to hash out the functions of the behaviors. Once that is determined you son will be taught replacement behaviors that he can use to meet the needs that his concerning behaviors are filling for him.

Try doing a web search for 'behavior analysis' or 'applied behavior analysis' in your state. That would be a good place to start.

Aspergers is one of the diagnostic subcategories of pervasive developmental disorders. It is characterized by a defect in reciprocal social interaction, lack of empathy for others and poor non-verbal communication. Antisocial acts, including aggression and sexual offense, are not considered to be uncommon in this disorder, but these symptoms are secondary to the diagnosis of Aspergers as a manifestation of difficulties with the "theory of mind" of others.

The usual treatment for Aspergers aggression includes:

• Art Therapy
• Behavioral contracts
• Cognitive behavior-modification
• Drama Therapy
• Language Therapy
• Music Therapy
• Occupational Therapy
• Osteopathy
• Physiotherapy
• Play Therapy
• Scripts and autopsies
• Social stories
• Speech Therapy
• Structuring the environment for social success
• Traditional behavioral consequences

Aspergers Syndrome and Repetitive Patterns of Behavior

Preoccupation Unusual in Intensity or Focus

Many kids with Aspergers Syndrome have a preoccupation that is unusual in intensity or focus. They may talk relentlessly about their particular area of fascination, completely unaware of their listener’s fading interest. According to Tony Attwood, "The most popular special interests of boys with Aspergers Syndrome are types of transport, specialist areas of science and electronics, particularly computers."

Females with Aspergers Syndrome can be interested in the same topics but clinical experience suggests their special interest can be animals and classic literature. Other common areas of interest are schedules and statistical information, as described in the following examples.

Danny went through phases of being intensely preoccupied with different odd interests. One of his first preoccupations was peoples’ birthdays. In fact, the first question he would ask upon being introduced to someone was the date of his or her birthday. He had an impressive memory for such information, storing the birth dates of dozens of people he had met. The preoccupation with birthdays seemed to give way after a couple of years to an interest in the hours stores open and close. He would walk down the street, paying close attention if a store’s hours were posted out front. Again, he had an incredible memory for such information, which, his parent joked, had a certain usefulness as far as she was concerned. Danny’s next fascination concerned movies. He was not particularly interested in the content of movies or in critiquing them, but rather was preoccupied with the ratings (e.g., G, PG, PG13, R) movies received. Similarly, he liked to create lists of the movies in which his favorite actors and actresses appeared. In addition, he had a unique method of categorizing movies, and was able to rattle off which movies fell under his rather unusual headings (e.g., movies that dealt with the subject of weddings, movies in which horses appeared).

Inflexibility Regarding Routines or Rituals

Of all the impairments common to those with Aspergers Syndrome, probably the one most likely to cause difficulties for others is inflexibility regarding routines and rituals. This particular difficulty has enormous potential to adversely affect the lives of family and friends as shown in the following example.

Evan firmly believed that he must watch certain television programs, especially particular game shows. One day a show that he always watched at a particular time was not on; in fact, it was taken off the air several days in a row. This disappointment was apparently more than Evan could bear and led to prolonged tantrums. His parent called the television station, inquiring about the status of the show but to her dismay, was informed the show had been cancelled.

In light of the child with Aspergers Syndrome difficulties with flexibility, it is helpful for those dealing with him or her to be creative and flexible in their interventions. Certainly, it is important for there to be as much consistency and predictability as possible. If changes are necessary, telling the person in advance, whenever possible, is helpful. Sometimes it is possible to reframe an issue in a different way. For example, Sean was insistent that he eat three meals every day. If the family woke up late and his parents wanted to serve brunch and then dinner, this plan was unacceptable to him. His parent learned that offering him a cracker in the middle of the day and calling it lunch was an acceptable arrangement as far as Sean was concerned.

Another useful technique to consider is to involve the child with Aspergers Syndrome in collaborative thinking or negotiation. For an in depth discussion of this approach, the reader is referred to The Explosive Child by Ross Greene, Ph.D. The following interchange is an example of this technique.

James's parents were considering moving him to a new residential home and he was invited to have dinner and meet the staff and students at the new residence. Before returning him to his current placement, his parents’ plan was to take him out for dessert while they had dinner. James found this idea unacceptable; in his world, if he were going to be in a restaurant with people eating dinner, he needed to be eating dinner as well (even though he had just had dinner). His response to his parents' disapproval of his plan was to tell them they needed to take him home and then they could go out to dinner by themselves. After explaining to him that this plan did not work for them (logistically, it would have them driving far out of the way), his parent asked him if he had any ideas as to how they might resolve the problem to everyone's satisfaction. James thought a moment and then asked, "Is it okay if I have a piece of bread and a drink?" His parent thought this was a fine idea. Apparently, James considered bread and a drink sufficient to meet his definition of a meal. If his parent had not involved him in the discussion, they would never have been able to come to this resolution.

Stereotyped and Repetitive Motor Mannerisms

An additional category under the heading of restricted and/or repetitive patterns of behavior, interests and activities is that of stereotyped and repetitive motor mannerisms. There are a number of mannerisms in which the child with Aspergers Syndrome may engage. These mannerisms include hand or finger flapping, rocking, or complex whole body movements such as spinning or jumping. These behaviors differ from tics in that they are voluntary movements in the motor sense; voluntary in this case does not imply that they are easily stopped. In fact, there is considerable support for the notion that these movements have a calming or regulatory effect on the nervous system. An unfortunate consequence is that these behaviors call attention to the oddness of the child, often resulting in teasing or ostracism.

Temple Grandin - Focus on Autism and Asperger's Syndrome