Advice needed re ADHD/ASD child and meal times, plus tips for dealing with stroppy behaviour.

[buttons99]

Hi. I would be grateful for any advice to help me deal with my DSD aged 13 who has ADHD and ASD. There are two problems that are really getting me down and I so wish for her sake and the rest of the family that we could make life more pleasurable.

1. Meal times ? DSD can take up to an hour to eat a meal and this is with encouragement, and the older she gets the worse it gets, where as I would have expected with age it would get easier. She just seems to chew and chew and unless we say ?... swallow what?s in your mouth please? she would not doubt just chew and chew for goodness knows how long. An example being over the weekend we had a roast dinner. She had one slice of meat, a few carrots and peas and a roast potato. Myself, DH and dd aged 12 had adult carvery but dsd had childs despite being 13 as we knew larger would overface her. After we had all finished and waited and waited I noticed she put one carrot in her mouth and chewed and chewed it. I told her to swallow it. At which point she opened her mouth to show me all the peas which were well chewed and stuffed in her cheeks. So we started having to tell her to swallow a few, wash them down with a drink if necc and then swallow a few more etc. Eventually after another 15 ? 20 mins we got her to have finished a VERY small meal. This was an example of when we were out but it wasn?t the environment of eating out etc distracting her as every meal at home can be the same. Plus one day she will happily eat weetabix with warm milk on for breakfast then next wants cold milk only. Then today gave her cold milk and was told it was disgusting and she only eats warm milk on cereal. I am at a loss as to whether this is all ASD related or ADHD behaviour and she is just trying my patience and being awkward for the sake of it. 2 hours a day in the week and 3 at weekends just to deal with meals seems excessive. School also have to use 5 hours of her support for lunchtimes just to get her to eat her packed lunch!
2. In addition the stroppy and mouthy mood in a morning (not every day but certainly a fair few a week) is upsetting me to the degree it takes the shine off the whole day and I struggle to not let the whole day be ruined by her behaviour first thing. I understand she isn?t a morning person, but I don?t believe she has the right to bite my head off and flounce around making everyone else feel they need to ?dash for cover? to get away from her bad mood, just because she has been asked to get up. Before taking her on when I met DH ( 6 years ago) I enjoyed mornings, breakfast etc with my children and a pleasant start to the day. Now I wake up thinking ?Oh goodness, here we go again.? I put on a cheery face, speak to her pleasantly when waking her etc and lo and behold get ignored for first few mins, despite the fact she is clearly awake and then get a torrent of strop. I have tried being pleasant, being strict, being fun and just get a sinking feeling as nothing seems to work. Then if its a bad mood day she eventually arrives at the breakfast table in a ?grump? and everyones mood is burst like a pin in a balloon.

Previously we all seemed to cope better as we had a break at weekends as she stayed with her Mum then, but as this doesn?t now happen we don?t even have that let up. I know lots of people don?t get any respite from their disabled child but for us we did and the family are finding it hard to adjust. We know we have to adjust but any tips to help would be great.

Can anyone give me any pointers in helping her, me and the rest of the family. Thank you

Well, if it helps, there's every possibility that the stroppy and mouthy behaviour is simply normal teenager. Our older 2 went through it around that time. How you react to it depends on the teenager. With some, you need to flat out lay down the law, with others ignoring the behaviour works better. All depends on your DD really.

As far as the meals, I sympathise, as our DS2 (5yo) needs constant encouragement and refocusing to get him to eat a proper meal. And he also has distinct likes and dislikes that seem to change with the wind. It can be hard to keep up, but I tend to keep options open and not allow myself to get too wound up over it. He doesn't appear to be doing it to make me crazy, just simply voicing what he wants IYSWIM.

I know, easier said than done, to not let it get to you, but unfortunately that's all I've got at the moment. LOL I'm sure more will be along with more fine tuned advice. Best of luck.

Hi, thanks for the reply. DSD is the fourth of five children DH and I have in our ?blended? family. We have three older already in or through teenage years and DSD is def different to anything we have dealt with before. I guess one of the reasons it seems more noticeable now is due to the fact youngest child is 12 months younger than DSD yet the gap in maturity etc etc is getting bigger and bigger all the time despite her being younger.
I guess if you imagine the frustration you have with 5 year old and move it on 8 years and to still be where you are now, makes you realise how frustrating it really is. We know she can eat and yet its so hard as to how you encourage her to and at a more normal pace. It must be awful to eat more than half your food stone cold or certainly no more than tepid.
Although we know she is 13 she is much younger (say 8 or 9) in many ways and this seems to be a plateau we are stuck at, which worries us greatly, not just for ourselves and our difficulties in dealing with her but for her future too. She has no friends as other children dislike her and because she is so blunt and rude to them although we have encouraged her to make friends it just doesn?t seem to work. Most people who meet her are stunned when they know how old she is and yet how she behaves. Thanks again for advice, I will try to not let her get to me. Any other advice from mumsnetters greatly received.

buttons99 - sorry, I didn't mean to minimise your problems. I just think that sometimes when we're dealing with daily frustrations and problems related to SNs, everything tends to get blown out of proportion. I know I am guilty of that on a regular basis. Something that would not even have registered as anything more than a slight annoyance with us for DS1 (27yrs) or DD (25yrs) when they were younger will really aggravate us with DS2 - mainly because we're already exhausted and stressed and often having coping issues. It's just because the stress level on the whole is sitting so much higher up as a baseline, if that makes sense. We've been fairly lucky - DD has been pretty level headed all the way through her teen years, with a few hiccups. DS1 has been a challenge in some ways, but fine in others, and seems to finally be coming into his own now. So it's a toss-up what DS2 and DS3 will do.. scared of thinking about it sometimes. LOL

We do worry about how things will play out as DS2 gets older, especially the teen years, but DH & I were just talking this morning about the importance of not letting things get out of proportion just because we are tired or stressed.

You are so right. It is the stress levels and tiredness that prob makes things seem worse....and I suppose at times the thought that it could have been so different if I had made different choices and not taken on as part of a step family a sn child.There are days I think much as I dearly love DH that she will push me too far and ruin what DH and I have. Guilt some days that my own 3 should not have had to be part of this and also that I maybe naively went into it not realising just what hard work it would really be. I try so hard to be "Mum" to her and yet it is very hard to be Mum to her as she is just so tiring and frustrating.

i was wondering if you knew of anything that could of upset dsd from her baby/younger yrs with regards to eating, ie if she started choking on food, someone could of said this happened because you didn't chew your food enough, iyswim. have you tried saying and reminding her to chew 8 times and swallow, remind her a few times each mealtime and it should get easier. as for the morning strops i think it's general teenage behaviour. (same in my house) i ignore it as the more you make a big deal of it the worse it gets,

Thanks davidsotherhalf. When you ignore it in the morning, how do you manage to get your children to school on time?? If I ignored DSD she would take so long to get ready and so long to eat breakfast that either everyone would be late or I would have to drop them off and bring her back to finish getting sorted in order that the others were not late for school, and at weekends if we ignored it she wouldn't get ready at all and would have no breakfast which as she is under the hospital for her weight she has to eat.
I have asked her Dad and no issues from her younger years, just her brain seems to switch off from the eating process and gets stuck in chew mode.

I think certain things you can organise ahead of time - making sure schoolbags put together the night before, set out clothing so it's ready to go. As much prep work as possible.

Are there certain foods or types of foods that she is better about eating? DS2 eats a fairly decent breakfast (again, with constant encouragement and refocusing), but he also has an apple every day on the way to school.

have you got a visual timetable for her, tbh with my dd (this might sound cruel but it worked) i arranged for a day out 1-1 with dd and told dd we had to be there for 9-30, (really 10-30) she was rushing round trying to get ready, as she was looking forward to the day. she was ready to go and i was still in my pjs. she was trying to hurry me up and even tried helping get dressed etc, i explained to dd this happened to us everyday when she wouldn't get ready for school etc. suddenly the penny dropped and she would try to be on time.

It swaps and changes. The cereal that she loves one week is hated the next and short of buying one of each every week (which obviously is unrealistic) I can't keep up with her likes and dislikes. Tried toast and a drink of actimel etc but then she would only eat the middle of the bread without alot of coaxing or she would not eat enough to keep her going or maintain her weight which is a biggy as hospital are watching her weight. She can't eat an apple in its whole as she has a brace now (problems were from before, not since the brace) and she does have cut up apple for school lunch. The brace had made it harder as everything is a huff when we suggest something to eat as she knows that involves teeth cleaning which in itself she finds very annoying and good grounds for stropping about. Hygiene she doesn't see the point of and although she will have a shower and wash her hair its always after alot of why's and strops. Makes me just think...why not just have it as you know you will have to so why bother with all the negatives on the way. It just seems so relentless and tiring dealing with her. Her Dad is laid back most of the time and lets me get on with it, but then when she has gone too far and upset everyone he wades in and reads her the riot act.

My NT daughter was like this at breakfast/lunch/dinner aged 4-7yrs. We had the badtempered strop, the refusing to eat anything, the attention seeking at meals. Obviously your daughter is older but from my experience of ASD it can mean you are "stuck" in an earlier developmentall state on emotional things like eating, sleeping, relating.

What we slowly realised is that she was waking up with low blood sugar, hence strop, and this meant she was even more likely to say she wasn't hungry. She couldn't identify what was making her bad tempered, just knew that she felt like hogging the limelight,in the worse possible way.
So, we tackled that problem by giving her Ribena or hot chocolate, in the cosiest possible way (like bringing it to her in bed like room service, or straw or that sort of malarkey) Once she felt a bit more cossetted and approved of, and blood sugar levels had risen, the morning problem naturally resolved, and we were able to give up the special treatment. She no longer associated breakfast/eating first thing with a tantrum. So you could try that as an OUT OF THE BOX solution to what you may find is a deep seated problem. It's not a question of spoiling her, just restoring her sense of good humour about hersel first thing and about food.

The other meals had a pattern of coming to table, not eating and having a tantrum or in some way disrupting. This was a form of attention seeking.
So we turned up the attention in other departments. And gave her meals in a separate room. Not as a punishment, more as a way of getting her off the attention seekign bandwagon. A nice little tray with food she liked, a chance to gather her wits, that sort of thing. Someone pointed out to me that CORTISOL/stress dramatically reduces your appetite, so the mere sight of us all sitting down to dinnner used to reduce her appetite, as she had a knee jerk reaction of this is time for everyone to cross with me. It was a negative learnt response to mealtimes/food. About an hour after not eating anythign of course she was hungry again, once the cortisol response to family meals had disappeared, so the vicious cycle of being in a bad mood started again...

So break the cycle, reduce badgering/worrying, with whatever special treatment you need, and then you might find she will eat with everyone else and not strop at mealtimes. It worked for us. She is still fussy about some food, but healthy and wellgrown and eats a completely normal diet.

HTH. (For us this was a serious problem, and it has completely resolved)

davidsotherfalf - Made me chuckle that one. I can just picture it!!

She has a visual timetable that I constructed after going on an ASD course. Velcro pictures on the top which she moves to bottom velcro strip when done. It does work really well apart from the length of time to consume breakfast. Often the last couple of "jobs" are very rushed as time doesn't allow for longer. Can't do much on that though as she has to clean teeth after breakfast cos of the brace and after breakfast is usually the last few mins before we have to leave the house. I would imagine if I tried the not being ready myself she would just stand and laugh hysterically but still not get why or she would for that day but them be totally back to square one the day after.
Fun this parenting isn't it!!??!!

Presumably it is about controlling the situation, and that's what is happening when she is not eating, and she likes that feeling of being in control, when she possibly feels a bit of out of control in lots of other ways.
Could she have a delicious excitign snack to eat on her way to school for example, instead of breakfast? Could you take her to the shop and plan her week's "breakfast snacks" and put labels, days of the week on them? Or her meals out of the lunchhall in a quiet place? If you have ASD large, fluorescently lit, noisy canteens can be very very offputting. Might she rather buy her school dinner (with assistance), and choose what she has and feel in control that way, rather than reject something you have prepared for her? Could she help put her own lunchbox together, even if it had weird ingredients, at least she would feel it was her choice.

I'm just thinking of some of the ways a reluctant eater might forget some of their issues and perhaps be more interested in the idea of eating.

Thank you swanriver. You clearly have been where we are at! Very interesting, thought provoking ideas. Glad it worked out for you, will add your ideas to my "idea bank"

Submitted then read your post.

She does eat lunch at school in a small room with TA support.

The other things that my ASD son (who eats well incidentally [confused} and my daughter liked doing before meals and definitely made them enthusiastic eaters was
Laying table in special way with candles, flowers, tablecloth, napkins every so often...(being in charge of makign table nice "their" way)
cookign with me - ds2 (a fussy eater although eats loads) made special macaroni cheese with ingredients he usually rejected and is now v. keen on it

might be worth a try lol.....i even sat in kitchen with slippers on, dd saying hurry up wheres your shoes why haven't you put them on.....me saying i dunno where they are (just like she did) her running around looking for them, she even put them in front of me and i just sat there, my friends ds would have a tantrum everytime she took him shopping so one day he lay on floor kicking and screaming in the shop so my friend joined him, he was so shocked he got up off the floor and stopped screaming and tried to stop his mum. thats what gave me the idea for sorting dd out

The "whys and strops" of your dsd are because she gets attention when you negotiate with her. It is like a toddler might behave, or even like you are I might behave when we pick a fight with someone because we are in a bad mood.
I think my dd wanted to be "babied" ironically at the very point when we were expecting her to be more grownup. I think once she had been back in the baby stage she was able to become more independent again of own volition. Very odd, but true.

I forgot to say that for ASD children, sensitivity to food can be not just a question of "bad" behaviour. It is a bit like asking a NT person to eat something they consider absolutely horrid like tripe or beetroot, or pig's liver to get an ASD child to even touch something with the wrong texture or ingredients.
People have said to me that the mere smell of something can make their ASD child physically sick. I think you have to take this into account with her perceptions of mealtimes.

Also if she has been used to being with her mum at w/e and that has ceased she may be reacting massively to the change in her life/carer. I think ASD children are acutely sensitive to whether people love/like them or not, even when they are not on the surface likeable/loveable.

It is so hard for you, even with a child I loved very much, my dd, I could go to the white knuckled stage very quickly. I suppose I really had examine why she was reacting to situations rather than holding her to account for her bad behaviour all the time. With my ASD child I sort of knew all along that he needed x and y to manage (even before he was diagnosed) so made lots of allowances that I never gave dd.

I think the whole "Bonding" malarkey cannot be overemphasised, especially with ASD. I think once they know you are on their side, unconditionally, and not going to shout, they begin to find it easier to a)be calm b) express their needs. When you tell an ASD child off angrily, they usually can't take your emotions as well as their own.
Ds2 can behave apallingly, and dh shouts at him, and it often makes things much much worse. Whereas having a place to calm down, and a quiet boundary setting helps much more. "When you shout/hit, you have to leave the room and sit here instead" That works very quickly for strops. Boundaries, but unconditional love continuing.

I've thought of another tip: what about small meals at small intervals, and with one other person her own age, a sort of buddying up, rather than big meals three times a day? Again, it seems like special treatment but might make a difference to her perception of food. I'm sure if I was a 13 year old sitting with a TA on my own, watching how much I was eating, like a hawk, I would probably not feel particularily hungry either just leftout and grumpy.
I forgot to mention that dd was always fine in other people's houses and at school, even when she never ate in ours, it was a pyschological thing to do with family meal times, so not quite relevant to an ASD situation in some respects. For example she loves school dinners, and big canteens.

She isn't just her and a TA. It is the support unit (in a mainstream school) where lots of sn children attend for different things. She knows lots of the children who go and doesn't know the TA is there for her so isn't a "big brother" situation.

Thanks Swanriver. More food for thought.
I do try to be calm with her (and manage it much more than her Dad does) and thinking about it I very rarely shout at her, but I do feel I have to be much more held back with her than the others as she is very much "give an inch and she takes a mile" I was very very soft with her when DH and I first met as I felt sorry for her and it took a long time to get any respect or co-operation etc from her. Now it feels like I have really really tried but am still not making alot of progress. I prob am but its very very slow.

Hi there,

Sorry to hear about your ordeal but i have ADHD and i must admit i was a Litlle S**t in the morning i still am if i am honest lol this could just be a teenage thing mixed with ADHD. You could use what my mum did not the nicest thing in the world but it worked she would spay me in the face with Cold water.

As regards the eating problem that is commom with people with ASD as they can have obsessions and a type of OCD in her head does she have to count how many times she has chewed a certain amout of times before she swallows her food and if miscounted has to repeat the process?

Does she having a fear of choking? Has the been an incident of choking in the past that has encouraged a fear of swallowing?

Hope this has helped?

I think if you had ASD this would be the worst possible punishment. Ds2 who has ASD quite happily goes for a swim in the coldest lake, if he choses, but even flick the tiniest bit of cold water on him when he's not expecting it, andhe would go berserk

So please OP don't try the cold water trick on someone with ASD, it sounds like the worst sort of treatment with any mental health issue.

I have to agree with swanriver on the cold water thing. DS2 would be horribly upset over that. I think it's rather inhumane personally.

Don't worry everyone I won't be squirting her with cold water!! Must admit it made me chuckle at the thought and boy are there days I could easily, but no I won't try it.
I had a long chat with her Dad and we think maybe the reason she is messing me about so much at the moment is because I have been too soft with her recently, like I was at the beginning, and I need to revert to the Step Mum she normally has. Guess I feel sorry for her cos of whats going on with her Mum at the mo but thinking about it she needs me to be the normal person I am with her.
We are trying the early morning drink incase it is a low sugar issue first thing, plus as she has a visual aid to help her with what has to be done in the morning and it seems to work well her having something to look at, I have made her a bedtime chart too. We decided she is partly behaving as she is at meal times because of the ASD but as she is border line ASD the bigger problem may well be the attention (ADHD??) she is getting herself with her behaviour at meal times. So as we have tried lots of positive "bribes" etc in the past, we have decided instead to make her more responsible for her own behaviour. (We know she can eat at a reasonable speed when there is a reason to do so. ie going out somewhere she wants to go.)
So she has a chart with times on and for every ten minutes she spends eating after everyone else has finished and left the table she loses 10 minutes off her bedtime. She has a laminated chart and a little laminated bed that she moves along the chart. She seems very accepting (and excited) by it and it certainly worked last night. Time will tell if it lasts. We felt it teaches her to take responsibility abit for her actions.