Mealtimes are about connection

We get so focused on getting dinner made and getting everyone fed that sometimes we forget the importance of eating together - it is more than just food. Mealtimes are about connecting. It does not not have to be perfect. It does not have to be pretty. It does not have to look like how other families’ mealtimes look.

Division of Responsibility Feeding focuses on structure, routine, and relationships. It's based on the philosophy that kids eat best when there's less pressure and they have more control. When we think about eating healthy we usually think about nutrition. Nutrition is important, but one of the main reasons we don't eat well as adults is because we never learned how to listen to our bodies as kids. Learning to listen to your body can be even trickier for kids on the spectrum...but you don't have to be an dietitian to know that one of the biggest problems at mealtimes is power struggles. Division of Responsibility Feeding helps eliminate a lot of those struggles. This is how it works:   

So the basics are easy. You're responsible for the what, when and where of eating. Your child is responsible for whether and how much.  Try to make sure there's at least one option that you know your kiddo will like and try to keep things as healthy as you can, but besides that - there are no restrictions. This gives your child a sense of control. A sense of control motivates them to eat a wider variety of foods. It also teaches them how to control their intake so they get enough food but don't overeat.  

Grown-ups make sure meals and snacks are provided around the same time every day. At different periods of time, you may have to adapt based on your child's hunger cues (adjust the times or quantities of snacks), but you set the schedule. The key is no eating or drinking between snacks and meals (except water). Children learn that their hunger and satiety is predictable. This helps them feel safe and secure. It also helps them learn how to regulate their hunger on their own. Because kids decide how much to eat, they can eat more when they're hungry even if that makes "after school snack" the biggest meal of the day.

Sitting is important because it helps your child to stop and focus on eating. This will help them pay attention to their body. Having designated places for eating helps cue your child - they start to associate a specific place with specific expectations. For kids on the spectrum, we think kids avoid the table because they're afraid of the food - they're afraid you're going to make them eat it. 

At first, it seems like a no brainier, but we realize it's harder than that. These are the biggest problems parents have with this plan:

• It feels wrong to let your child skip main components of the meal. They should at least have to taste their vegetables - right?

• When they try something new, wouldn't rewarding them, or at least saying good job motivate them to try more new things? Or at least eat the same thing again?

• It's too much of a struggle to get everyone to sit down at the table.

• It feels wrong to let my child eat dessert when they didn't eat any of dinner.

• We have so much going on. We're always eating on-the-go.

Let's talk about each of these.

Not eating much at dinner. Why this isn't a problem - because you're proving your child with predictable meals and snacks so even if they don't eat a lot now, they will eat something later. As adults, we're actually not that good at predicting how many calories a child needs or even how many we're offering. As long as there is one option your child likes, they won't go hungry. Just letting your child choose whether and how much to eat is going to alleviate most of your power struggles - although it might take them a little bit to adjust to the snack schedule at first. Over time, they end up getting exposed to more foods in a way less stressful way which actually sets up the environment to being the most condusive to trying new foods. 

No praise or rewards. We know this seems unnatural, but kids put a lot of internal pressure on themselves to please adults. With kids on the spectrum, they're often trying really hard in a lot of different areas in their life. All that pressure can lead to anxiety and unhealthy eating habits. It's not that praise and rewards are always bad - they can be effective instructional strategies. But feeding is one of the most complex integrations of physical, environmental, emotional, sensory, and relational systems. Because it's so complex it's really sensitive to pressure. It's may not be enough to let go of the negative pressure. You may have to let go of the postive pressure too.    

Sitting at the table is too hard. For kids on the spectrum, this might be a skill that takes extra time to acquire. Getting them to believe you're really not going to try and make them eat food they don't want to will help a lot. If your child has a hard time coming to the table - have a "reset" period where the family meal is a preferred meal of your child - this isn't going to last forever. Maybe just a week or two while you establish your routine. During this time, use a social story about shared responsibility feeding, "At snacks and meals you have choices of what to eat. From those choices you decide what to eat.  You decide how much to eat. You are responsible for your body. You know best what your body needs." You might have fidgets on the table or a sensory cushion on the chair. A visual timer can help them know how long you would like them to sit for (start short). Sometimes dangling feet can be a problem for kiddos and a foot stool or junior chair helps them feel a lot more comfortable at the table. Try a sequence like the one pictured. Mealtimes on the Spectrum has an entire section on managing mealtimes.    

Dessert with no dinner? This is a problem if it happens every day, but making desert non-contingent will help you rethink about how often you offer treats. Treats are a problem when they are a main source of calories on a regular basis. Treats are also a problem when children don't know how to control eating treats. When we withhold treats until after dinner we are training our bodies to over eat. This is how treats work with Division of Responsibility Feeding - every once in a while, make treats an available choice during meal or snack time. When you do that the treat follows all the same rules. Your child chooses whether to eat it and how much. Do you let your child eat an entire cake? - no. But if cake is part of dinner, then serve a slice of cake to each person with everything else. Maybe for snack, you set out a plate of cookies and let your child decide how many cookies they want to eat. It may sound kind of radical, but for most kids, this will help them eat less sweets - not more.   

On-the-go families have to be creative. Create a sit down meal or snack type setting where ever you are. Try to get there 15 minutes early and have a picnic. When you are at home, have sit down dinners. Be patient with yourself. When your routine breaks down - it can take time to reset. If it's too stressful to sit down together at dinner, try breakfast instead. You don't need to create an idealistic experience - just regularity.

Division of Responsibility Feeding is the stress free way to eat more healthily. Here's a great blog post of a family trying to implement the plan with real video of their family meal. Not all parents are super strict following every element of the plan, but it's a really good starting place for re-establishing your family's feeding habits.  Division of Responsibility Feeding lets you focus on making mealtimes  meaningful and your family's health.

References

All content is original to Mealtimes on the Spectrum, but is based on the following scientific literature:

• Engle, P. L., & Pelto, G. H. (2011). Responsive feeding: Implications for policy and program implementation. The Journal of nutrition, 141(3), 508-511. doi: 10.3945/n.111.150094

• Flynn, M. A. T., McNeil, D. A., Maloff, B., Mutasingwa, D., Wu, M., Ford, C., & Tough, S. C. (2006). Reducing obesity and related chronic disease risk in children and youth: a synthesis of evidence with ‘best practice’recommendations. Obesity reviews, 7(s1), 7-66. doi: 10.1111/j.1467-789X.2006.00242.x

• Satter, E. (2000). Child of mine: Feeding with love and good sense. Bull Publishing Company. 

• Sherry, B., McDivitt, J., Birch, L. L., Cook, F. H., Sanders, S., Prish, J. L., ... & Scanlon, K. S. (2004). Attitudes, practices, and concerns about child feeding and child weight status among socioeconomically diverse white, Hispanic, and African-American mothers. Journal of the American Dietetic Association, 104(2), 215-221. doi: 10.1016/j.jada.2003.11.012