It Is Never Too Late to Start Feeding Therapy

Hi and welcome to “What Works Wednesdays” where we share a success story from one of our clinical cases. All names have been changed to preserve the privacy of the child and family. Our intent is to show readers how successful ABA can be.

We are often asked,”At what age should we begin behavioral feeding therapy?” Our reply is a consistent one: sooner is better than later. However, please do not take that to mean that if your child is older, that behavioral feeding therapy will not work for him/her. We have helped several children over the age of 10 learn to eat new foods and overcome their picky eating. So, today, we thought we would highlight the positive outcomes of one such case.

We want you to meet a teenager named “Alex”. Alex was much like any other teen. He wanted to get his driver’s license. He was tall and lanky and he liked typical teen food such as pizza and he also over-salted all of his food. On top of being a teenager, he was also diagnosed with autism spectrum disorder (ASD) and he suffered from a long history of gastrointestinal (GI) disease.

His mother contacted us because she wanted him to learn how to follow the gluten-free, casein-free (GFCF) diet that was prescribed as part of the treatment for his GI condition. We were happy to teach Alex how to eat. It worked to our advantage that Alex was also studying nutrition at school. He was learning about the food groups and how it is important to eat a healthy, balanced diet.

As part of the planning process, we developed a social story for Alex so that he could better understand the importance of learning to eat a healthy, balanced GFCF diet. In the social story, we showed Alex how each type of food helped his body and we tied it back to his lessons in nutrition at school. For example, protein helps build big muscles. We used this image:

We ended the social story by explaining to Alex that learning to eat healthy will also help his brain so that he could study for his driver’s test. And finally, we added the winning argument that girls would more likely be interested in guys that eat right and have healthy brains and bodies.

We would be lying if we said that behavioral feeding therapy is easy. For 90% or more of our clients, the first day or two of therapy is hard. The children are mad because they want to eat the foods they are comfortable with. They are scared of new foods and when they are asked to try new foods, it causes reactions. Most children use their words to explain their feelings while others use their behaviors.

After Alex got over his difficult days, he took off. We attribute much of his success to his mother. She used games on the iPad as an incentive to eating. She told him, “If you eat your _____, I will buy you _______ for your iPad.” Most games on the iPad can be purchased for under $1.00 so this was a cheap incentive. Additionally, this helped associate food with something positive. Before long, Alex was developing new favorite foods such as rice and mixed vegetables.

Teaching teens to make healthy food choices independently is important because we cannot be with them at every meal. If we teach them the skills to choose a food from each food group, we increase the likelihood that they will make good choices. Teaching teens that healthy food also tastes good, is another  important step. It only took 4 days for Alex to learn to try and like new, healthy foods. I wonder how he is doing on that driver’s license test?

Another mom talks about her child’s success here (and we’re not just highlighting this case because she thinks we are awesome–they both did a great job in overcoming this difficult issue).