Hi BTL Fam!
Turkey, stuffing, sweet potatoes, pumpkin pie, YUM! I’m dreaming of it now! With all the delicious food around, how could you not be “stuffed” after dinner time?!
For some individuals with ASD, Thanksgiving may not be on the “Favorite Holidays” list. Many individuals with ASD have difficulty eating a variety of foods. Parents may often term these kiddos as “Picky Eaters”. Being a picky eater can make things more difficult, especially around the holidays. In ABA, we utilize a technique called Food Pairing which helps expose kiddos to new foods to help them truly decide if they like the food or not. Many times, we have success with increasing the different foods an individual will eat as well as increase their tolerance to try new foods!
Food Pairing consists of several steps to ensure we are “pairing” the food to other foods. Pairing, similar to what we utilize in everyday ABA sessions, consists of working with a highly preferred food object and slowly work towards trying and consuming lesser preferred foods. Just as we “pair” ourselves to preferred games and toys, we work to “pair” the lesser desired food to a highly preferred food.
Let’s break down what pairing looks like!
Create a Food Log
To start food pairing, we will be creating a list of the most preferred foods, medium preferred foods and lesser preferred foods. This list will give us a foundation of different foods that we can increase consumption of as well as possibly decrease the resistance to only eating highly preferred foods. For example, some highly preferred foods many kiddos enjoy are chicken nuggets, cookies, chips, etc. Whereas, those lesser preferred foods may be vegetables, fruits, soft/crunchy foods, etc.
Beginning the Food Pairing Process
Moving forward, we start to introduce those lesser preferred foods. One very important note is that we stick with the same food throughout the pairing process and do not change until reaching the final phase! When starting food pairing, we want to start small. This may mean only placing the lesser preferred food on the table at first. In conjunction with this, we provide lots and lots of verbal praise and provide access to highly preferred foods. If we have success of compliance and no problem behaviors arise during the presentation of the food, we move on!
Increasing Compliance and Complexity
We start to increase the difficulty of compliance as we move through food pairing. Once we gain toleration of the food on the plate, we work to tolerate touching the food. Advancing, we start working to pick up the lesser preferred food, placing the food on the tongue, holding food in the mouth, chewing the food, and lastly chewing and swallowing the non-preferred food. Although it is a quick explanation, this process often takes awhile to complete!
Introducing New Foods
After working through one non-preferred food, we begin introducing other non-preferred foods. When we present one new food item at a time, we can help slowly pair new foods one by one. This process may be long, but will pay off in the end! After pairing several new foods, we often find it easier to introduce new foods. Some success stories are followed by consuming a wide range of different foods while other programs have success finding 2-3 new food items. Regardless, success is success no matter what the end may look like!
Although this may seem like a quick and easy process, there are several steps utilized to ensure the success of pairing a new food.
Here are some important tips we use when working through food pairing:
- A food pairing session involves nothing but that activity. Sessions can last for a few minutes to 30 minutes. We are sure to take cues from the child, in order to only continue pairing as long as the child is engaging in the process. *We don’t want to make this process aversive!*
- We do not try to force-feed the patient the non-preferred food item. Gentle physical prompts can be used to assist the patient to touch and pick up the food item; however, we again, want to make this a fun and positive experience!
- Food aversions can be based on texture, smell, visual appearance, past experience or a combination of all of these. Aversions can also be deeply embedded for a patient, so the process of food pairing will most likely be a marathon, not a sprint. Seeing results can take some time depending on the child and most definitely the approach!
- We do not reinforce escape behaviors during this process. However, we discontinue the food pairing if the patient is highly upset. When shifting to different activities, we will begin by placing easy demands and intertwining other activities to smoothly transition out of the food pairing activity. If behaviors do occur, it is important that we follow the written Behavior Intervention Plan while also ensuring that the food pairing activity remains as positive as it can. After a short break or working through additional tasks, we can come back to food pairing with a nice calm body and ready to work attitude!
Food Pairing is a fun and useful tool when attempting to increase food consumption. If your kiddo is having a difficult time enjoying the Thanksgiving festivities, reach out to your consultant to discuss a food pairing program or contact BTL to discuss our food pairing programs in more detail!
Be sure to also check out our family resource A Thanksgiving Menu For Success to learn more about helpful tips to use Thanksgiving Day!
Heidi Mann, BCBA, Outreach Consultant