ABA for food

[Littlemisssunshine72]

Another ABA 'discussion'.
My DS is 7 with ASD and was diagnosed at 3. Since then I have done a lot of reading on different therapies,approaches,etc.
I also home educate my DS and have not used ABA directly (although I realise I have indirectly on all sorts of occasions) for academic purposes because I have managed to motivate him through his interests i.e. stuck pictures of 'disney planes' characters on word cards or made a toy story number line to name a couple. This way he has completed the task without requiring a reinforcer/reward.
However, food is the only area where I have not had any success.He has a very limited diet and eats the same foods everyday. In the past, I had hoped by being exposed to different foods he would build his tolerance levels up.Unfortunately, this has not happened. Therefore, we have started an ABA program for his food aversions. The consultant comes very highly recommended who has had a lot of success in the past with acquaintances whose children had similar food aversions.
We have only had a handful of sessions so far and I must admit it has been extremely stressful. I remember seeing the child on the TV program doing ABA for food issues and I always thought I wouldn't let my child get into that state but he is in that state every week and the only thing that keeps me going is thinking about the long term outcome and what the alternative could be.
My DS is a very anxious child and we have done so much work on reducing his anxieties and keeping him calm that I feel like I am going against everything we have worked towards by letting him get that worked up. He doesn't become aggressive, just very anxious, very desperate and pleads with me. I do understand that in order for results, there will have to be some element of stress as I realise to a certain degree this is learned behaviour that needs to be unlearnt.But I also believe that the underlying causes should be dealt with and my DS is extremely tactile defensive and has major sensory issues. He gagged when my partner just offered him some raisins.
He doesn't seem to cope well in the 'artificial' setting of having the food set out on the table and then being told to follow the set of instructions.Last week it took him 4 hours to put a crumb on his tongue.
But, I have recently started putting different food textures on trays and let him walk in it,put his hands in it, etc and this way he has licked and tried a couple of new foods. I don't doubt that this probably would not work for many foods but providing the opportunities in a 'fun' environment does seem to have a more positive effect.
Also, by the time my DS has put a crumb in his mouth, he has forgotten about any 'motivator'(last week a Tom and Jerry DVD) and the only motivator was for the consultant to leave.
I suppose I am 1) looking for reassurance to continue with the program as the results will make it worthwhile, 2) I have heard that ABA is not for everyone, so how do you know if it is not for your child without seeing it through?
I honestly feel when I see my DS in this much stress-if someone is being tortured, they will submit finally but then on the other hand, I liken it to moving to a foreign country where to begin with, you may not be able to tolerate the local food but after a couple of years, you wonder what all the fuss was about.
I know so many of you have had so much success with ABA but I guess I would just like to hear some food ABA related success stories.
Thank you if you have got to the end (lol), if nothing else, it has been therapeutic just writing it all down.

It did work for DS but we tried a few times, stopped and came back to it before it worked.
But we only ever worked on it for a minute or so at a time (certainly not 4 hours!!), then came back to it later in the session / day. It was part of a broad ABA programme so just slipped it in as another task, not make a big deal of it. And if he wouldn't do it we just took the food & reward away and did something else after a minute or so.
We also had a strict hierarchy - touch food with hands, touch to lips, touch to tongue, put in mouth, eat it.
DS didn't really get upset or anxious although he did hurl the food across the room a few times.
We also started with similar foods so he ate houmous and we had different flavour / colour houmous just a tiny bit on the end of a breadstick. Same with cereal etc just presented a food which was slightly different to what he ate already
I think the first new food we tried was soup and just a tiny bit on a breadstick or bit of bread.
Fruit was the hardest and in fact he still doesn't really like it (unless it hidden in smoothies)
We didn't make him sit at the big table - just at a small play table or on the floor.
I would say the approach you are using is too formal, too intense and way too long.
Food is so tied in with control that you have to do it in a way that shows you couldn't care less if he does it or not, its no big deal.
By making it a long formal session all about food you would be making it highly stressful.
So maybe I'd try a different consultant?

Thank you. That's definitely 'food for thought' (excuse the pun). My DS doesn't seen to mind all the touching aspects but as soon as we get onto placing on tongue he starts getting very stressed. Even the kissing, he will do.
It makes sense to do food similar to what he is used to- think I will mention this to the therapist as up till now we have just done a whole variety of different textures.
As mentioned, I feel as if I am between a rock and a hard place as this therapist comes highly recommended and people locally refer to him as their 'guardian angel'! He is also very busy and hard to get hold of.
One aspect I didnt particularly like was when my DS was trying to get off the chair he was holding his arm across the chair so he couldn't get out and pushed the chair in more-which then freaked my DS out even more. He doesn't use force and does reiterate every time that he will never force him to eat anything but as this is my first and only experience of 'official' ABA , I'm not quite sure what to make of it. Thanks again for your reply.

I couldn't do that. It sounds like abuse to me, but I'm not knowledgeable about ABA techniques.

Thank you.
I hope I haven't made it sound worse than it actually is but I don't think I have exaggerated. He is allowed to ask for a break whenever he wants (but he was asking as soon as he was back at the table every time). He does also have fun with the consultant at non-food time I.e.if he follows the instruction he gets an 'electric shock ( funny arm wave thing) which he loves, but as soon as good stuff is back the fun disappears.
Thank you for giving me some persoective as I don't feel comfortable either but I think as everyone 'loves this person' so much, I have been 'blinded'. I have to make my own decisions I guess.
Therefore, how the hell am I going to get him to try other food and not grow up unable to either want or be able to
make himself a meal ( as at the moment we hide vegetables and chicken in his rice) and I don't want to have to hide things as i want him to know what the ingredients are so even if he does live off this for the rest of his life, he can prepare it himself !!

'food stuff, not 'good stuff'

I'm not saying that the restrictive diet should go unchallenged, but I do think that restraint is a step too far.

The reason I'm asking so many questions is that I agree with what you are saying but feel that I am letting my son down if I don't continue with this.(although I also feel I am letting him down if I do continue with it). I must just point out he has never actually been physically restrained. Yes, the chair was blocked so he couldn't climb over and I guess this is a firm if restraint. The therapist did then 'let' him get up and go to the sofa and then he would walk over to him and without touching him get him back to the table. It was very gradual and my son did calm down each time and walk back to the table himself. He did in the end put the crumb in his mouth but as mentioned before, wouldn't you if there was no escape and that was your only way out. The therapist said that you have to see it through to the end and that if you stop cis he's screaming then he knows 'he's won'-he didnt actually use these words but that's what he meant.
He also said he would stay there all evening if need be to see it through to the end. Must say, in a session a couple weeks ago I did end up in tears myself. Sorry to go on about it.

Breakfast- dry rice pops
Squeezy yoghurt, babybel cheese and innocent smoothie.
Snack-baby goodie cereal bar
Lunch-dry brown bread roll, squeezy yoghurt, babybel cheese, innocent drink
Snack- biscuit or flapjack
Dinner-white rice with blended chicken and cauliflower -he does not know the 'crumbs' are chicken and cauliflower as he will not eat these if given whole.
Fruit-banana( under duress) and apple peeled and cut/strawberries. Everything he has to eat with a fork as doesn't want to touch them.
I know compared to a lot if people, this isn't too bad but my issue is that we are hiding ingredients so how will he ever prepare food himself if he doesn't know what's in it.
I did ask for a referral to a dietician but it got lost!! :0 I need to chase that up. Drs don't think he looks anaemic and I give him liquid vitamins mixed in his drink but this is not go usher everyday- need to make sure this is done.
Oh and as an aside, therapist said DS is a dream to work with as he compared him to others who self injure, attack, etc. Not the point as far as I am concerned.
Oh gosh, now feel guilty have let my DS endure this. He has been perfectly fine straight after though. Can't see how it is helping his relationship with food at all.

Thank you for reassuring me that maybe I do know best after all. Don't feel comfortable with the sessions and tbh, I dread them which I'm sure my DS can sense. I think I'll take the pressure off, go for that dietician referral again and do a load of fun sensory food stuff and we do cooking every week anyway which is sometimes successful, sometimes not. Thanks again peeps!

I did something along these lines with ds, though it was before he had autism dx and before I knew of ABA - he would have been about six at the time we started. We were very gentle about it though, picked the times carefully and discussed the plan with ds before proceeding. I felt it was important that he understood why it was necessary to extend his food range (nutritional, social, convenience etc) and worked on one or two foods at a time.

I used his interests a lot, eg he was wild about Walking with Dinosaurs at the time so we spread lots of foods on the floor and pretended to be carnivorous or herbivorous creatures and had to fight each other for the food (like on the telly - the role play really helped and he tried lots of new things. What I found hardest was having the time to work on it as intensively as it needed - like all autistic children he had lots of other issues that needed equal attention and there just weren't enough hours in the day.

Ds is 15 now and still has a comparatively narrow range of foods, but he does ok. We can at least take him out for pub food and some restaurants, which was impossible before (not so bad when he was very young as all eateries would serve some form of nuggets and chips, which were beige enough to suit him ), but he still doesn't like combined foods like pasta with sauce, pizzas etc. Plus a big issue for him is that he can't get to grips with some foods being just 'ok', and always has to have things he loves.

Overall though, as with anything to do with autism, it's very individual and no two children will have the same experience and range of issues, or solutions for that matter.

Hi,

I do think that ABA techniques can be used to widen the range of food eaten but I have to say what you describe sounds extreme. I can see that once the consultant had started down that route he didn't want to give up as your son would have just learnt that if he doesn't comply for long enough then he will eventually not have to do what is asked but I think that when starting with this food aversion issue you should make it much easier for you DS.
So as you have said he finds the whole table setting more stressful then start elsewhere, sofa, garden, picnic blanket on the floor etc.
Also as Agnes suggested use food very similar to food he will eat.
Perhaps use a ice cube tray and have very small amounts of new foods and a reward system whereby he gets a reward for just having the food near him, then for smelling it, touching it with his hands, putting it on his lips, putting some in his mouth etc..
Make sure the reward is immediate and something he really wants - I would suggest something like a sweet (if he eats them), just a small amount though.
If you think he is getting too distressed then stop before you present the next demand.
This will be a long process but I think in your case taking a longer time and not making your DS too anxious is the way to go. Your idea of getting him to touch food in a more fun environment sounds like a great way to start.
Don't be afraid to discuss your concerns with your consultant if you want to continue with him and if you're not happy but still want the guidance of a BCBA then try and get another consultant. I definitely think that some consultants can be a better fit for a family than others.
Good luck.

I bet I coukd name that Consultant. Get rid. Get someone kinder and less busy to have the time to work WITH you.

I would not continue like that with my child. I WOULD use ABA but NOT like that. Also, I wouldn't be going straight to food but to good instructional control through relationship and trust building first too.

I have a real problem with forced compliance to that extent. I'm not talking about parents telling a child that they are the parent and if they say 'coat on' they expect a coat to go on, but this level of forcing compliance, I think, stores up big trouble for later.

A child who becomes overly compliant without engaging, because they have no choice and no alternative, is heading for an adulthood of vulnerability.

One of my biggest fears for DD1, at the moment, is that due to her willing nature she will do whatever someone tells her to do. That is the thing that is most likely to prevent her from independence as an adult, because she has no sense of boundaries in that way.

Now imagine that a child has been forced to comply - they aren't being motivated as Moondog explained ABA, but simply finding themselves in an intolerable situation with no way out except to comply with the demand. They are being conditioned to accept a command with no decision making process.

I was on a course recently where they were showing how to tackle food. Each session was limited by the child's ability to cope and no two sessions were the same as although the plan was for the child to eventually eat the food, as much as possible the food wasn't the focus.

For example, one child loved game shows, so he had to spin a spinner to see what food he should eat. 4 foods there were his favourite and 1 was a new food. When the spinner showed each food he had to nibble it.

The whole thing was done in 'game show' style with video recording and commentary. He kind of got caught up in the momentum and only momentarily hesitated to eat a food that before had triggered all-afternoon meltdowns.

The food we saw was a grape and we were all in tears (we'd witnessed the tantrum way as the parents had captured their own attempts) because the boy was 8 and after he'd eaten the grape said with sadness 'I've been missing out my whole life. Grapes are delicious'.

THAT is how you do ABA.

This is what I do in all other areas to motivate my son- use his interests. And yes it works. It's just that I came to a brick wall regarding good. I have got a lot of good ideas now-thank you.
Starlight-am intrigued-dont think you would know this consultant, although might be wrong. Am on South Coast btw and surname rhymes with 'door ran'. Lol

Aargh-food!

Yes. It is good parenting but with some science injected into it, like a requirement to look at things objectively and stick to the target, measuring and recording improvements to show you are moving in the right direction and to tweak. The game-show stuff isn't important to the target, it's just the desire and determination to meet the target out one in the most efficient and effective way possible without ever giving up. It's faster to reach the outcome the more willing the child. ABA is all about how to get the most 'willingness'.