When my son was about 5 years-old, we noticed that each time he went back to the Pediatrician he weighed the same amount.  This happened for nearly a year and we knew we had to do something different.  Having been born with endocrine issues he was small for his weight and we initially considered exogenous growth hormone partially due to the fact that he had to have cortisol administered three times a day every day for the previous four years.  When we were told growth hormone required a shot in the abdomen every day, we immediately sought other solutions.


Switching his diet was the ultimate solution we decided on.  But how would we introduce foods that were basic to every other neurotypical kid, but completely unappealing to my son.  He would smell and then taste the offending food with the tip of his tongue before politely, but firmly pushing it away.  To complicate matters, he had chronic constipation and we were not sure which foods were contributing to this.  It took consulting a multidisciplinary team including a Gastroenterologist, a Feeding Disorder specialist, and a Behavioral Psychologist to develop a plan to address my son’s feeding and gut concerns.


Here’s a synopsis of what we learned, what worked, and how we are able to maintain success long after we graduated from the program.

  1. Get on the Same Page

Regardless of what diet you feel is best for your child, make sure that every member of the team is on the same page.  The doctors and providers make an assessment based on information provided to them and then help you create a treatment plan.  If you are concerned that the providers are not clear about the problem, or you are not clear about what is expected of you, ask questions until you get clear.  This is especially true for parents.  Parents are like the players on the field.  They have to help make the plays happen.  If they are not in agreement, it will be hard to send a clear message to your child.


  1. Remember Same but Different

The winning strategy for us was the use of the “Five Bites” rule.  We started out each feeding session with the same foods my son ate at home.  He was allowed to eat these at his own pace after doing a small task followed by a reward.  Then each time we returned to the feeding clinic, he started with the same favorite food, and one new different food.  He needed to eat five bites of the new food before getting a reward.  Over time, we greatly increased his repertoire of healthy, and in his case, very high calorie foods.  Although his last session at the feeding clinic was over two years ago, we still use “Five Bites” to encourage eating foods.



  1. Consistency is Key (at least initially)

Once you have outlined your plan and you begin slowly introducing foods to the diet, keep in mind that nutrition results take time.  This is one area that cheating isn’t a good idea, at least not initially.  Because nutrition impacts every area of your body and gains can take considerable time, you need to be consistent until you achieve the results you desire.  Once you are where you want to be, “cheat” days can be acceptable.  But as with any nutritional lifestyle change, you make the greatest gains initially with a consistent commitment.


Next Steps:

Here are some questions for you to consider:

  • Who is a part of your team to help you maintain adequate nutrition for growth and success?
  • In what ways can you use “same but different” with feeding and nutrition?


 Want to Learn More?

Bergina Isbell, MD is a Mayo Clinic trained and Board Certified Psychiatrist specializing in the clinical treatment of patients with history of Special Needs and Trauma.  She is the mother of two children with special needs, including a son with a diagnosis of Autism.  She serves as a consultant and Autism coach for those who want to transform their lives by developing a growth-promoting mindset.


To join the Autism Alignment Movement and get access to free live interviews about topics of interest to you, click here https://bit.ly/autismstrategist.


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