⏺️🎙️Feeding Strategies and How to Present New Foods

Following on from Ozgul’s webinar last year ‘Feeding Challenges and Mealtime Strategies’ join Ashleigh to learn more about feeding strategies and how you can present new foods. Ashleigh will take us through: 

• Tips for family mealtimes
• How to present new foods in a safe and fun way
• Understanding ‘safe’ foods
• What are ‘safe plates’ and ‘learning plates’ and how you can do them 
• More on the data collecting your coach could support you with. Take some time to check out Ozgul’s webinar prior to have a full understanding of where to start with your loved ones' feeding goals.

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Transcript

So we're going to talk about feeding strategies and how to present new foods. I'm Ashley. I'm a coach here at Autism 360.

See? Let's jump into it. I'll tell you a bit more about myself and the webinar. As I mentioned to some people that jumped on early, this webinar is following on from Ozgul's webinar last year. It was titled Feeding Challenges and Mealtime Strategies. If you've had a chance to watch that, amazing. If not have a look in the webinar section in your app.

Look for that title and it's going to be very complimentary to hers. So following on from her chat, a little bit about me. So I'm an NDIS behavior support practitioner, which means that I write behavioral plans for clients. I have a bachelor in psychology and I minored in children and family services. 

And I come from a behavioral background doing early intervention therapy. In terms of the food side of things and what we're talking about today, I have completed a workshop in SOS feeding program,  which talks about supporting people who are problemed and picky eaters.  So that's a little bit about me.

Look, a note, because this is a feeding topic, that this is general information, so it isn't tailored for your loved one that you're joining to hear more about today. It's general because as you'll see while I go through the webinar, everyone's experience with food is different. Everyone's challenges with food is different.

So I can give you broad ideas. I can cover a range of suggestions, but at the end of the day, this isn't going to be a one size fits all. It wouldn't be fair on your loved ones. So it is just general information. But. We can cover at the end how you could get tailored support. If what I share with you today sounds very interesting and you think that tailored support is needed, I can also get that.

So let's jump into it. The topics that I will cover today is what are safe foods? So just a little explanation on some terms that I'll use. What are safe plates?  How can we present new foods? So that's going to be a bit of a strategy. Learning plates. That'll be a second variation of a strategy that I'll share with you.

And then some broad tips for family meal times that we can look at including into our nightly meals, breakfasts, lunches. And at the end just a little bit more on food diary and preferencing. Data collections. Osgoode mentioned it in her webinar. I'll go a little bit more into detail about them and explain how data collecting around this sort of topic can be helpful.

That's the plan for today. I'll jump straight in and let's talk about safe foods. Pretty self explanatory, but obviously safe foods are food items that we are happy to eat 100 percent of the time. That means that they don't yield any oral motor challenges. So this means that when you watch your loved one eat them, they don't appear to be finding it challenging from an oral motor perspective.

They're not struggling to chew when spitting it out, putting it back in their mouth, spitting it out. They're not gagging or choking. So it's safe in terms of their oral motor skill level.  The food doesn't yield any sensory challenges. So you don't see them kind of recoil when they touch the food.

That touch is too overwhelming. If they smell it they don't gag. And there's no negative past experiences. So there's been nothing like say choking on it in the past and now they look a little bit apprehensive to begin with. Overall it is a safe food to touch and eat. So positive experience.  So that is what I mean when I mentioned safe foods throughout this safe place.

Same concept, just extended that bit more. So it is when food and the presentation of food is not overwhelming. So the food on this plate is all safe foods. We've got our dinosaur chicken nuggets that feel safe because they're in the dinosaur shape. We've got our chips that are whole, not broken.  They're not touching.

And there's no new food like a broccoli casually on the plate. Everything about the plate is safe.  Which means that we're not trying to challenge our loved ones.  It's all about comfort and we're ensuring that they're going to consume food. So this plate would be intake focused.  We need to make sure that they're consuming calories and we're not reducing it by challenging the plate.

So that's a safe plate. I'm sure a lot of you are thinking right now, I know exactly what my loved one's safe plate is. This is exactly what we're going to talk about. So let's dive into a strategy. I want to start with the two big strategies first and then some little tips for you just so we can paint a picture overall of how we can try the big stuff but also then make small changes to try and help food and mealtimes feel that little bit more safe and positive. 

So in terms of presenting new foods, I'm going to talk today about how we can do exposure. Keeping in mind, everyone is different. So if our loved one doesn't have a really strong sensory challenge, we could try this. If your loved one is a bit sensory sensitive and they can gag at food, you'll understand why I'm leaving them out of this one as I go through it, because it is exposure therapy in a way, and exposure therapy shouldn't be done on sensory overwhelm and sensory challenges.

During a mealtime, what we could start to do is have one new food item that's always going to be placed in the middle of the dinner table on a platter. So that it's really specific, it's got its own plate, it's not on ours, in the middle of the table, basically like a new version of a salad sorry, a fruit bowl.

It's just going to have its place in the middle of the table moving forward. We can think about what new food we're going to use strategically.  And I mean that from a perspective of being fair. So let's just say  potato chips is a safe food for your child or your loved one.  Maybe we'll go sweet potato as our first exposure.

We're not going to necessarily do a drastic jump and start having some broccoli or Brussels sprouts in the middle of the table. Let's be strategic in terms of gentle. We want to prepare the food in a few different ways. because if we're going to do exposure we might as well expose it in how it can look in different ways.

So like the watermelon picture here for sweet potato we might have the whole sweet potato on the platter and also some cubed bite sized pieces of the sweet potato next to it and then on the other part of the bowl plate we might have them cut long like chips so that eventually they can become sweet potato chips. 

Now we don't necessarily have to go cooking them every night because I want to talk about strategies that are also easy for you to maintain. But it'll just be that casual exposure in the middle of the table. We would, number four, place it on the table prior to everyone sitting down so that we don't feel like we're springing something on the mid meal.

It would just be sitting there casually. And we would tell the loved one why it's there. So this is a new food plate. We don't have to eat it if we don't feel ready but we're going to learn about it. So we might talk about the food  and again, reassure. We're not focusing on eating. You don't have to.

It's just sitting there on the table for us to talk about and learn about. For the sake of consistency and to hopefully build up to them maybe trying it, we would want to do it for at least a week. So seven days. Now in terms of making this maintainable for you and your busy lifestyle, I usually try and paint the picture of, say you pick dinner, pick those foods that you can just keep pulling out from a container for every night.

So your sweet potato, what I would say to families is, for those first few nights,  don't cook the cubes and the chips, but just be having it on the platter. And once we've talked about it for a few nights, maybe let's ask them on night five or six. Would you like to try one of these tomorrow night? And just gauge how they've gone with that exposure.

And if they were to say yes, or if they showed interest one night, you could say let's plan for tomorrow night. Which one would you like? Should I have the cube one ready for you to try? Or should we make the long ones into chips in the oven? And then you could prepare it. Because of course we don't want to be chucking out food wastage every single day and then re preparing it on top of dinner every single night.

So set yourself up for success in that way. And the pre planning obviously lets your loved one regulate anyway.  And then continue this process. So rotating new foods. So again, pre planning for yourself. What you could do is make yourself a list of six food items that you're going to do over the next six weeks.

You can schedule those foods in to be bought in your shop. You can pre plan how you can prevent that wastage, how you can put it in containers each night, bring it back out, and set yourself up that way so it's nice and easy. Ideas outside of mealtime, because we don't just want to focus on learning and trying to push ourselves to try in mealtime.

We want to do stuff outside of mealtime too.  We can do things like food reply. We can encourage our loved ones to help with food preparation. And this, it doesn't mean getting them using the knife and chopping stuff up. If that doesn't feel attainable and we've got young ones involved, that can literally just be them being a little helper and getting the ingredients out of the cupboard, out of the fridge.

You could say to them, look, I'm going to make your favorite meal. Can you go into the freezer to get this? Can you go into the cupboard and get the sauce? If it's a food items that you know is a little bit challenging for them it's not a safe food, you don't necessarily have to get them to do that in the first few times.

So if there's mince in the fridge, leave that one off of the list to grab and you just grab it. But after a few times of them feeling like that's not too overwhelming of a job to help you with, you could ask and see if they're ready to get that mince out of the fridge and just put it on the counter. For slightly older kiddos, teens, early adults we could get them participating in the grocery shop.

And by doing that, we can use catalogs that they could flick through and start prompting them to think about if they want to pull out anything that's new that they would like to try one day.  And they can create this, maybe one day I'll eat this, or try this and writing the shopping list out. Get them thinking about ingredients that go into their safe food meals.

Get them mapping it out, breaking it down, and actually doing the shopping together. It's walking through and doing it.  And the last suggestion could be making a recipe together. So again, a safe food. Say for my daughter, it's peanut butter cookies she loves.  Getting her involved in pulling out all of the ingredients and seeing the peanut butter become melted. 

mixing the wet and dry ingredients together. It's a safe food when it's in its entire form as a baked cookie, but let's get them engaging in the steps before, because that is a different type of exposure. So as you can see already, another reason why we would want to customize these strategies for your loved one. 

Do we want to practice that sensory side of things and do those sensory plays? Could making a recipe together be too challenging from a sensory perspective? Obviously this list is not just a list for everyone and work your way through, so we've got to factor in those things. But that's the start of how we can have a food platter. 

Slight variation, or you could combine it with that exposure, is a learning plate. A learning plate is an empty plate that is going to be placed near your loved one, so next to their dinner plate, say, and it's going to be where they can put food that's new that they're not ready to try yet. So it lets us offer them new foods,  but it doesn't have to go on their plate if they're not ready.

It can just go on the learning plate and we learn about it.  You could do that just solely as its own strategy or you could use it in those final days, day six, day seven of the presenting new food strategy. You could have that plate on the table, you could give them some tongs and you could say, would you like to pick up some of that new food with the tongs? 

And would you like to put it on your plate to try?  Or would you like to put it on the learning plate and we just keep learning about it? So you could use both or use it singularly. Of course, we talk about if they're starting to become dysregulated, that's okay. We're just learning about this food and then we leave it for now. 

Something important to know about feeding and how our gut works is that if we are in, say, fight or flight mode and when a part of our brain shuts down and we go into fight or flight mode,  Our gut doesn't absorb nutrients as it should. That's a thing that shuts down too, because we go into that basic mode.

So if we consider how I'm talking about, that's okay, we be gentle, we leave it. It's because we truly don't want to challenge our loved ones. Not only is it not fair, but it's also not productive when it comes to eating nutrients and that sort of thing. Look, a lot of us might reflect and go, There's been a time where I've probably pushed too far, and it actually hasn't been productive then.

For instance, we find out our child is low on iron, and we bring out iron rich foods, which aren't safe foods. And we have that stress, we know that they need to get some iron in their diet, so we really heavily encourage them to try and eat this particular food. There's a very fair reason behind it for us. 

But just know that if we push that too far and they go into fight or flight mode, not only is that creating a negative experience with food, even if they consumed it, there is a chance that their gut isn't going to absorb those nutrients as well as it may normally. Obviously everyone's gut is different, how we absorb nutrients is different. 

But if we know that we are putting the stomach offline,  they have that broccoli and we feel better,  but they may not have even got the nutrients out of it. So let's keep mealtime really relaxing. Be really gentle and slow with your steps. Because if they do eventually try it, the point was to get the nutrients in them, right?

We don't want that kind of not happening.

So I might have jumped ahead with that one, but let's talk about some broad ideas now. This is creating mealtime as more of a family approach. I'm going to look at it from two perspectives, skill based and then environmental.  Skill based Osgoode covered this in her webinar. But basically there is.

Oral motor challenges that can be at play if our loved one has a really restrictive diet. And there can be sensory challenges at play. Oral motor challenges would be things like, Oh, my kiddo only has pureed foods or meltable foods. They don't go near the really chewable steaks and jerky and that sort of thing that they have to work really hard to chew on.

For all we know, and it would be OT's help that you'd be looking for, is do they have oral motor challenges? They find chewing really hard or they haven't mastered that kind of rotary chew where we move our jaw off center.  And so there could be those challenges at play.  Like I said, that's definitely an OT thing to see in person and to check and eliminate, but at the bare minimum, we could sit as a family so that your loved one can see those skills modeled by you. 

And so this could be that we be a little bit over the top in how we model, how we chew things. How we put it in our mouth at the front and I'm moving it to the side and look, ah, chewing,  and we talk and be messy, but we're showing that oral motor use. Or if we're thinking that maybe sensory is at play we do need to make those changes to make them more comfortable because we don't want them coming to the dinner table in that fight or flight mode.

So if they're sensory overwhelmed, Can they have more space from family members and family members plates  and new foods?  And so say the presenting suggestion that I just spoke about, maybe for your loved one the middle of the table is too close and that wouldn't be fair on them. So we could have it up on the kitchen bench in a distance a bit further away.

Could they sit that further away from everybody else who is eating because they have different food on their plate than your child's safe foods? Environmentally already touched on it, but is family mealtime relaxing? Because that is super important. So let's try to remove the stress, which I know is easier said than done, because we need to make sure our loved ones are consuming enough  and are consuming some stuff to keep them energized and going.

But let's try to make it relaxing. We could do things like fun conversation games. Even as simple as we've each got a piece of paper and colouring pencils. We have a few mouthfuls of our food. We draw a little bit. It could be a shared activity or just an activity on our own. So we can see each other drawing.

But trying to take that real heavy emphasis off of we sit, we eat, we have to get through it. It's just what we need to do. Try to make it that little bit more relaxing. Can they be seated first? I know that it is  our way of thinking, okay, mealtime has been stressful. Let's keep them at the table for the shortest time possible. 

But  if you think about coming last to the table, that could be just as overwhelming. So let's just say there is the sensory overwhelm involved or I'm just remembering how stressful it's been for me. If everyone was sitting at the table with their different foods and I was brought last and plonked down last, it would be like public speaking and walking in, in front of the whole crowd.

Whereas if you were seated first and you got started on your safe food, people trickle in, sit down at the table with their different foods. That could be more of a positive experience. Making sure that the correct postural supports are in place. Osgoode might've touched on this one, but it's super important.

So I'm going to mention it.  My little yellow lines off to the left hand side there. That's so that I don't have to do some funny hand movements, but basically we need to have three 90 degree angles. And that being that we have our back and bottom is at a 90 degree angle. We have our legs to knees,  and I left a line off.

We have our legs to foot, to feet, so feet are nice and flat. Those three 90 degree angles, Basically, eating is a really taxing task on our body. It uses a lot of systems, and we want to make sure that when we consume the food that we're consuming, it's being processed correctly, because that's the goal. 

And our body needs us to be in the correct posture to do that. So for our younger kiddos who are still in high chairs, look for those high chairs where you can adjust the footrests.  So that you can drop it if your kids have long legs and so that they're at that nice 90 degree angle. For older kids, teens, adults, if we're sitting down and we've got our legs up on another chair, that's not ideal posture.

We want to make sure that we are in optimal position to absorb the nutrients.  Also, things like choking can be increased if we're  slouched. Those sorts of bad things that we want to avoid can be increased. So not sitting up nice and straight. Focus is off of them and is more on the food. And obviously when I say that though,  that's different for every loved one, every client.

I don't mean taking the focus off of them, you must eat, but then overdoing it of, Oh, look at this new food. Oh, yum. Wow. It's mushy. Oh, look. And we talk too much about it  because for our loved ones who experience sensory overwhelm, that could be too much. And for our loved ones who have oral motor challenges, they may be overwhelmed by that because they feel like that's not in their skill level or achievable.

But they feel like you're showing them that's like a green choice and that, that's not sustainable just yet. Within reason, focus off of them, a little bit of focus on the food, you find that bright sweet spot. Try to eat at regular times. This is for predictability, also for them to regulate prior, so that they're coming into mealtime knowing that, yep, it's coming up to dinner time, okay, and we're not surprised, or it's come earlier than expected. 

Within reason, obviously, family life is very busy. Not saying that you need to be sitting down at 5. 30 every day,  but some sort of predictability is going to be helpful for regulation. food presentation. So obviously we had a little bit of that in presenting the new food three ways, but we can involve them further in asking them how they want their plate to look.

So it could be, okay, tonight we're having this, and this how would you like the potato to look? Do you want it mashed? Do you want it in chunks? Would you like them not touching? Involve them in that presentation because.  Our end goal is that they have a better relationship with food. Our end goal is that they branch out and try more and feel safe to try more. 

And so we don't need to be taking control of their plate and that be challenging them. That's outside of what we're aiming for. And ensure that there is at least two preferred safe foods available on Good English on their plate. So we basically want to make sure that when we start prompting these strategies, we don't go too far and all of a sudden we see this decrease in eating because that's, I'm sure, really unpreferred.

If you're feeling your loved ones have a restrictive diet or a low intake amount already, we don't want to risk going further. So we should absolutely have access to safe foods at every meal.  Adults, we have that in our control. I don't have to sit down at dinner and just have one preferred food on my plate and four others.

I just wouldn't be cooking that for myself.  So for children's, teens, they're allowed that type of autonomy too. So always making sure that they can see and can access preferred foods when we're trying strategies as well. And it's been at the bottom of all the PowerPoints, but I just want to reiterate with any strategy, with any suggestions, learners, so people that are practicing new foods should not be left alone while eating or exploring them.

Obviously we want to protect them from things like choking. If they start to get really enthusiastic with our presenting food strategy and they grab that food we want to make sure that we're watching them to make sure that they don't choke on the texture if it's something chewier than they're used to.

So we do really need to, regardless of age be present for the whole time of mealtime, whole time of eating or exploring foods for their safety so that they have that positive experience if they do try it.

Just some general troubleshooting but obviously everyone's troubleshooting is going to be different, but some common things. We need to be watching out for non verbal cues of distress. So the real obvious ones would be running away from the table. Is this avoidance? This is a train of thought, how I've written them.

Is it avoidance? Identify why. Was it too overwhelming? Do we need to make routine visuals? Make it more predictable, more regulating? Are we going too fast? So  start to look at troubleshooting from a perspective of  Okay, I want them to have a positive relationship with food, and this was obviously a bit too challenging.

How am I going to strip it back? We don't want to push through. We don't want to go that path of making them comply. That would be a negative relationship with food. That would be turning off their gut from absorbing the food. Not productive. Are they crying? Overwhelmed, usually. So are they overwhelmed?

Identify why. Are our expectations too high? Was that presenting platter too close to them? Do we need to move it away off of the dinner table? Do we need to talk a little bit more about how you don't have to eat? No eating. Are we moving too fast?  Should we create some distance between them and that food?

Them and other people's food? So start to see again how we can strip it back. And if they're appearing reluctant, so you're just learning a little bit of reluctance. It's not dysregulation, but still a little bit. We need to pull back from that too. So do we need some gentle encouragement? We can talk about that food, the new food outside of mealtimes.

So tomorrow we'll make sure that even before dinner we'll do some googling of where that, how that fruit is grown or vegetable is grown. What we can do to take the pressure off of this is presented at the table and you're going to maybe try it. And add in some more food play activities so that they can explore the food again outside of mealtime, away from the expectation of I need to eat. 

So that's just a few things. But look, basically data collecting. Data collecting is going to be where do I get started? I've said a lot today about how it's going to be different from everyone. So I haven't necessarily given you a clear starting  place,  but data collecting with your coach can be a great way of finding that starting place.

So we have two tools that we use.  So you might have seen these already, or you might see them if you ask for a food goal. The first one gets you to list out all of your child's food preferences as it stands. Asks about yours too, because your exposure your child, your loved one is seeing what you are eating.

So that's helpful for us to know.  And then talks about sensory properties as well, that your child or your loved one likes. and that you like. Again, shows us preferences. And then food diaries are super helpful because it shows us the safe foods, how much we're consuming of safe foods things like, okay, dinner time is where this loved one consumes their most food. 

Maybe we'll do the presenting new foods at breakfast because we don't want to make dinner time challenging. That's where they're getting their calories in.  So data collecting is what allows this to be really customised. Which I'll just cover. Covers the Autism 360 program. Because we work with parents or carers, and that would let us data collect and then we can do, say, a food goal.

And in that food goal, we can chip away at these things. Identifying if there's any challenges, and then picking those strategies, which order they should be done. And of course, there's a lot of other strategies that I just can't cover in an hour. Obviously we'll do stuff like SMART goals. So for our parents and carers that are here today, and they're already with Autism 360 and have goals with us, You'll know about these and how we periodically review our goals to make sure that we're getting some success.

Making sure that we don't need to recalibrate the program. Obviously, though, it's not for everyone because it is something that we do consistently. So it's a dedicated time. We meet you weekly, fortnightly, whatever it may be. And we're making sure that we're following through a program that we create for you.

So we'll customize the goals. But then we'll have it scheduled in. So we need that kind of follow through. So it's not an online course. You'd be working with a practitioner, a qualified practitioner to do it. So it's important to respect their time and make sure you can commit to the longer goal.

Food goals, especially take time. We have to have a positive relationship with food to move forward. Just a few benefits of the program as well. You'll become a great advocate for your loved one. So this can be things like you do a food program with us, you identify that your loved one needs that bit more space at mealtimes, and then they're able to try new foods if they have that space.

So we might go telling school about that and asking that they have that same sort of space at school. So you'll be able to advocate for them. You'll be able to identify opportunities and design strategies for yourself. You'll pick up on what we're putting down and you'll start to adapt things and you'll start to come to the sessions and say you've tried stuff too.

And so that's what we want, that empowerment.  And you'll be supported on a regular basis by our team of practitioners. So you'll meet with your practitioner and you'll discuss how you're going. Of course, access to the app, which if you already have it and you haven't seen Ozgul's video, jump on there, that's where that is. 

And you're likely to see some real tangible process progress. What I'll do is we're going to jump to question time soon. But here's the code to scan if you haven't got the app, if you're interested in talking to someone, booking a call, talk about what goals you're thinking about, whether I've got you thinking about a food goal today, just put your phone up to that.