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Food modifications

Selective or restrictive eating is the most common eating challenge faced by autistic children and their families.

Mealtimes can become difficult with foods often refused due to texture, taste or smell or presentation. As a result, children may consume a limited diet (e.g., only beige foods, only crunchy/soft foods or only certain brands) and reject most new foods.  

Understanding what might be behind their restrictive eating is an important first step in getting your child more comfortable with new foods and making mealtimes more relaxed. Before introducing changes to their diet, you should raise any eating concerns with your GP or dietician to rule out potential underlying causes such as Gastrointestinal problems and allergies.  

Before trying a new strategy to expand your child’s diet, it’s important to remember that eating issues are complex – what works for one child may not for another. Fortunately, there are many strategies for navigating eating challenges. One NHS recommended approach is food modifications: This strategy encourages gradual exposure and subtle variations to prevent food choices becoming too rigid. Below we have a quick guide with some example variations you could try introducing.  

Food modification guide

The goal of this intervention is to slowly create successful experiences, gradually building a more positive attitude towards eating and mealtimes. The aim is to encourage your child to be less rigid in their eating without making them anxious, introducing changes one step at a time.   

The table below was developed by the NHS to offer some examples of small modifications you can make at home:  

Favourite food Small changes
Toast/bread
  • Cutting a small corner off  
  • Slicing in two  
  • Cutting into different shapes using biscuit cutters 
  • Buying a different brand that is very similar  
  • Toasting it a little bit more or less 
Yoghurt
  • Serving it in a bowl rather than from the carton 
  • Adding a tiny bit of fruit purée, honey or food colouring 
  • Buying different brands that are very similar  
  • Freezing it to make a lollipop 
Cereal
  • Serving it from a plain container rather than the packet  
  • Crunching some of it up 
  • Buying a different brand that is very similar and adding a few pieces into your usual product
Chips
  • Cook them for slightly longer than usual  
  • Cut some into smaller bits 
  • Mash some  
  • Serve with different sauces on the side or a different plate  
  • Try sweet potato chips 

Source: Sheffield Teaching Hospitals NHS foundation trust 

Don’t be disheartened if this approach doesn’t work for you and remember that patience and persistence are key. Here are a few important tips to increase the likelihood of modifications being accepted:

Tips for success 

Keep them involved 

Try to make modifications (for example, cutting food into smaller pieces) with your child to help them feel in control and understand that changes are okay. This should also help to avoid ‘safe’ foods from being rejected in the future.  

Praise, praise, praise! 

When making changes, every step of progress should be celebrated. Reassure your child by heaping on plenty of praise. Phrases like, “good job!”, “I love how you tried something new”, “You did so well today!” or “Good job for saying no thank you calmly”, reinforce positive behaviours. Initially, you should offer praise even if changes aren’t consumed, by offering praise even if the change isn’t accepted it will reduce future motivation to escape the situation.  

Persevere 

For a typical fussy eater, it can take 10-20 times tasting a new food before it is readily accepted. For children who are particularly anxious around food this may take even longer. If your child refuses a food, try not to comment and make a fuss. Simply offer the food again another day and keep offering other preferred foods on rotation.  

Small steps 

Another approach for introducing new foods is to build on your child’s past successful eating experiences. Taking foods that are already liked and accepted, new foods are presented that may be similar in texture, taste or temperature. The goal is to use similar foods that link safe foods with a new food you are going to offer. As with any intervention, steps need to be small and take place with your child’s knowledge and consent.  

The graphic below shows an example chain

Food modifications example

Adapted from Food chaining: The proven 6-step plan to stop picky eating, solve feeding problems, and expand your child’s diet. Fraker, C., Fishbein, M., Cox, S., & Walbert, L. (2007) 

 

If you feel like food modifications might be right for your family, the NHS have created this helpful guidance sheet to help you get started.  

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