successful strategies in getting child to use cutlery

[sphil]

DS2 is 8 and severely autistic. He eats quite well, though has a limited number of meals he will eat. However, he eats everything with his fingers. Tbh, I don't mind this too much at home - I'm pleased that he generally eats what I put in front of him - but I'm aware that it's more of a problem when we go out, especially as he's getting bigger. Not only does it accentuate his 'difference', it also makes a huge mess (he also crumbles everything before putting it in his mouth and wipes his hands on his clothes). And I think by being so relaxed about it at home, we may be setting up problems for later - a teenager who eats shepherds pie with his fingers is a very different prospect.

I've tried getting him to use a spoon at home - he is very resistant and tends to leave the table if we force the issue.

Any ideas or success stories would be greatly appreciated.

Marking my place for the response.

Can he physically eat with cutlery as my son can only use a spoon or fork in the right hand and uses the left hand as a "shovel"!

my ds is 10 also severe autistic, he too uses his fingers and makes a great mess. he has to break up even tiny pieces of anything and also sometimes eats a bit then takes back out his mouth, i know where your coming from. it's ok at home but you do get funny looks outside. i think even more so because it is an invisible disability so because he visibly looks ok others dont understand he has any problems. at his sn school the teacher is working very hard on hand over hand with him, so he is now sometimes able to put a loaded spoon to his mouth. also the ot got him a special spoon (dont know whats called) but it is a bit heavier n chunkier so he can manage to hold easier than a normal spoon. would be useful if you could ask your ot (or school) for help in getting special cutlery. I still havent managed to get him to eat using cutlery at home however he seems to be doing much better in school. Good luck

Hi - I am also watching your thread with great interest though my ASD son is only 3. He will only use a spoon for yoghurt and 'daubs' his other food into his mouth, picks pieces out and wipes his hands on his top.
I just googled 'cutlery autism' and some really interesting products came up that look like they might have potential - weighted cutlery, a utensil hand clip etc. Am going to ask the SN nurse we see what the issue is with cutlery to try and work out what might work. Is it a sensory thing where the objection is the metal against the lips or the sensation of holding the cutlery? If anyone has any insight I'd be really interested

I'm also watching, both my dd's (5&7) eat with fingers, dd2 eats well but refusses to use cuttlery and dd1 is a fussy eater so i kind of let her do what she wants (don't make a fuss) to get her to eat. OT has recommended using a tripp trapp high chair so dd2 is higher up at the table (making it easier to use cuttlery) but i still don't think she will use it .

I did manage to get DS to eat some peas using a spoon but had to bribe him with smarties. 'Peas with spoon first, then sweeties' (DS is only just beginning to talk so I always use 'first, then')
It did work (was expertimenting) but not sure it is something I can do long term.

There must be some ABA-ers out there who have taught cutlery use

You are describing my ds (10), right down to wiping hands on clothes. He did use a spoon when he was a baby but now won't use any cutlery, despite all my best efforts.

His school has had some success getting him to use a fork with hand over hand but he only has school dinner once a week (friday chips) as he won't eat much else on the menu. I did try full time but I can't afford to spend so much money on food he doesn't eat.

When he's at home he hides his fork under the edge of his plate and if I insist by doing hand over hand as they do at school he gets cross and leaves.

So, sorry I can't be much help but you have my sympathy and at least you know you aren't alone! (I can't help imagining the outraged looks if we all met for a meal at a posh restaurant with our ds's .)

Thanks for your responses - at least we're all in the same boat! I've tried weighted cutlery but I think it's the sensation of the metal or plastic against his mouth he doesn't like. he also seems to have a need to feel his food before he puts it in his mouth - whether it's to feel temperature or taste I don't know.
I would also be grateful to hear from ABAers - the trouble is that his strongest reinforcers are videos, computer etc - and I don't want him to get down from the table!

I could never ever EVER imagine my ASD DS eating with cutlery- he was so accomplished at eating with his hands, plus i thought it would be too hard for him coordination-wise and oh yes, he's never been particularly motivated by food (well not meals at any rate). But (and I can still hardly believe it) our ABA consultant cracked the problem within a few days, to the point where, if he was spooning cheerios into his mouth and dropped some on the table, he would pick them up and put them back in the bowl so he could use the spoon.

It really was just a case of being persistent and breaking the eating with fingers habit, sadly there was no magic wand! And there was relatively little protest from him, as a) he realised we weren't going to back down and b) despite not being a massive eater, it dawned on him that he could eat much more efficiently with a spoon. I had worried it was a bit cruel as he was so happy eating without cutlery but he is a lot happier now and it does look a hell of a lot better when we are out anywhere.

I can't remember every stage of the process but it
started with us doing hand over hand, and praising even that v highly. Then we would fade back our help, so starting him off and then letting go, or letting him start and then helping him bring it to his mouth. AND this was the biggie...not letting him pick the food up with his fingers, just blocking that completely. It's like potty training, you can't really give mixed messages.

We did also set up the laptop on the dining table for a bit and put a fave programme of his on iplayer, pausing it until he made some attempt to use the spoon and then playing when he did so.

Like I said, my non verbal son with his floppy fingers and awful co-ordination, plus incredibly stubborn nature...I could never see it happening. But once the penny dropped for him it was a breeze, and he would never dream of reaching for food with his hands (except the appropriate ones iyswim). Perseverance is the key, and belief that it can be done.

HTH

Completely agree with above - ABA is about constant re inforcement of the desired behaviour (re inforcement is getting to eat !) and extinguishing/blocking the undesired behaviour. Hand over hand done on a persistent basis should do it !

Fedup - did your DS have a sensory problem with the metal in the mouth? I just wondered if the ABA method works on this issue too.

Auntevil...I can't say for sure, as he's never really had sensory issues, but he would initially seem very scared of even the sight of the spoon, let alone it coming anywhere near him, in a way that he wasn't scared of many other things.

ABA would most definitely deal with this aspect too, through (I would assume) gradual desentisation. Initially the child would get rewarded for letting the spoon come near him, then for touching it with his fingers, etc etc

that's great advice - thanks so much. I think the problem has been that much of his diet could, at a stretch, be classed as finger food (chips!) so we 've been giving the sort of mixed message that you warn against - fingers OK for some things but not for others. Also, a lot of his foods are hard/crunchy, so need a fork - he doesn't have good hand strength, so stabbing things is very hard for him. But I guess we could practise this too, away from the dinner table - stabbing play doh with a fork perhaps?

Hi autumnsmum here i have the same problem with ds5, he eats with his fingers and also wipes his hands everywhere so reading thread with intrest

Your OT will be able to help. She showed ds2 how to use a knife and fork, etc. Hers had little stickers on them to show where each finger (ie peter pointer) should go and with reinforcement at home what a massive improvement x

Just thought I would update. We've been working on this with DS2 all half term and tonight he ate his chicken and oven chips more or less on his own with a fork! There's still a bit of helping the food in with his fingers, but he seems to have mastered the stabbing part. Its much easier when he's eating food he really likes though - the shepherds pie yesterday wasn't quite such a success. I think he needs to feel food he's a bit suspicious of, to be able to eat it, if that makes sense.

That's great news, sphil! Both of my boys like to touch their food - it does seem to be quite common.

DS2 will only usually even attempt to use a spoon with yoghurt (this took weeks of hand over hand) and even then, he gets tired so easily and becomes really flustered if he spills a bit. I persuaded him to feed himself a few spoonfuls of his breakfast, this week, though - he'd fed me my breakfast, his hand over my hand :o, the day before (took me ages to get my breath back, I had to chew and swallow so quickly!) and on that particular morning, he put his hand over my hand when I was feeding him. I decided to grab the moment and made our hands swap places, then let go after he'd scooped, then let go entirely and he managed about 1/4 of the bowl before getting tired, turning the spoon upside down and giving up. He was really proud of himself, though! I just hope we can gradually build up to doing it more.