The Cooking Connection Food preparation can be a powerful way to counter eating restrictions among children with autism spectrum disorder. Features
Features  |   April 01, 2017
The Cooking Connection
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Swallowing, Dysphagia & Feeding Disorders / Special Populations / Autism Spectrum / Features
Features   |   April 01, 2017
The Cooking Connection
The ASHA Leader, April 2017, Vol. 22, 46-52. doi:10.1044/leader.FTR1.22042017.46
The ASHA Leader, April 2017, Vol. 22, 46-52. doi:10.1044/leader.FTR1.22042017.46
“This is your child. Love the child in front of you. Encourage his strengths, celebrate his quirks, and improve his weaknesses, the way you would with any child. You may have to work harder on some of this, but that’s the goal.”
— Claire Scovell LaZebnik, autism awareness advocate and author
I once had a client with autism spectrum disorder (ASD), age 10, who had a history of picky eating and feeding difficulties. He also had an affinity for movie production logos, from the iconic roaring lion that represents MGM to the letters and swing-arm white desk lamp that form the Pixar logo. Based on my experience with tackling such feeding difficulties, I sought to merge his interest in logos with exploring new foods.
I bought some inexpensive wooden letters at a craft store and brought in a white lamp from home that resembles Pixar’s. Each time we tasted a new food, we added a letter. The pièce de résistance was the final addition of the lamp. The sheer joy on that boy’s face was heartening, matched only by his urgent requests to “Do it again!”
This is a key aspect of my approach to treating the food restrictions and feeding disorders that are common in ASD: I connect with clients via their passions and tie that interest to treatment sessions. This starts a relationship that I parlay into one of my major passions: cooking.
Inevitably, clients become interested in cooking too, and improved eating often follows.
Given that there is a high incidence of feeding disorders in ASD, a common interest in food may seem to be an unlikely means of connecting. Consider that cooking, like music, drama, dance and other forms of creative expression, is an art. Art is a form of play. Helping children learn to play in the kitchen, exploring various textures and temperatures as they measure and mix ingredients, is often the first step to eventually tasting new food. Play is a form of communication and a means to connect with children with ASD. Let’s further explore how cooking and play can help children with ASD to try more varieties of food, while also accommodating their sensory issues in the kitchen.

I connect with clients via their passions and tie that interest to treatment sessions. This starts a relationship that I parlay into one of my major passions: cooking.

Finding an ‘artistic carrot’
The key to addressing food issues is tapping into a child’s creative passion—as Stephen Shore (an Adelphi University special education faculty member who has ASD) once advised, find that “artistic carrot” to “open a door to possibilities beyond your wildest imaginations and dreams.” Such a carrot certainly changed the lives of Chase Bailey and his mother, Mary.
Chase was diagnosed with ASD at 2. A highly selective eater, he ate only five foods. It was a sudden interest in cooking shows on television that sparked a willingness to explore new foods. That interest grew to such heights that not only was he cooking and eating new foods, but he began to create cooking videos, appearing with celebrity chefs on a variety of television shows, including “The Chew,” “The Meredith Vieira Show” and “CBS News.” Now 15, Chase just released his first cookbook, “The Official Chase ’N Yur Face Cookbook.”
Mary explains that Chase’s interest in following recipes, which began when he was 9, gave her an entry point into helping him cultivate a new relationship with food. “First, we sat down together, and discussed and wrote down his recipe ideas,” she says. “The next step was going to the store to buy the ingredients, and the final step was making the recipe, which included his favorite part: the taste test!”
Many children with ASD take years to become more flexible about food, but Chase’s keen interest in cooking greatly accelerated the process.
“Once he committed to trying foods, it didn’t take him long to open up, dive in, and start trying most food items,” Mary says. “He still had specific dislikes for certain foods. For instance, he’s never warmed up to egg dishes or raw tomatoes or hot dogs. But Chase wanted to try countless foods that he saw prepared on cooking shows and to eat at places he saw on TV. It became just as much about the experience as it did the taste of the food.”
In line with peer modeling, Mary says, “Chase wanted to experience what others were experiencing with food: the social and atmospheric elements that accompany eating, which many of us who don’t have food and communication challenges take for granted.”
Mary advises other parents of children with ASD who want to try this approach to connect their child’s interests with food. For example, if it’s puzzles, try food-related puzzles. If it’s geography, try learning about foods that grow in different parts of the world. If it’s sports, study foods athletes eat to help them excel.

There’s a bit of math, science and language in every recipe, but above all else, there is the opportunity to connect with another human being.

Getting started cooking
Parents may not realize that cooking is about the process, and not necessarily the end result. The art of cooking can be divided into a multitude of interests and goals in speech and language intervention. There’s a bit of math, science and language in every recipe, but above all else, there is the opportunity to connect with another human being.
Keep in mind that all people, regardless of whether they have ASD, have varying levels of skill and abilities. One child may be able to connect via the rhythmic sound of spoons tapping on empty bowls, while another may find common ground stirring cookie dough. Another may enjoy lining up each dollop of dough on a baking sheet with expert precision. Understanding each child’s baseline of participation creates the foundation because, of course, no two children are alike.
To help parents begin introducing their child with ASD to using cooking to achieve feeding goals, consider what skills are already in place. Develop strategies to build on existing skills and begin to branch out to more challenging activities. Break each recipe into steps, encouraging kids to participate wherever they can. And remind parents that cooking offers a great opportunity to model language, elicit productions and converse.
  • Step one: Assemble all equipment and utensils for the recipe, using child-safe knives whenever possible.

  • Step two: Assemble all foods, measuring and pouring into individual bowls. Professional chefs call this “mise en place” (everything in its place).

  • Step three: Following the recipe, assign specific tasks like stirring or pouring to each child. Teach tasks as needed, breaking each one into tiny steps. For example, one of my clients did not have the attention span (yet) for mixing dough, but enjoyed lining up the spices by color and handing them to me as I called out the name and color of the spice: “Green oregano! Black pepper!”

  • Step four: Clean up. Rinsing dishes and loading a dishwasher is part of the cooking process. No dishwasher? Try a bucket of soapy water and a bucket of clean water, plus a few towels. Break down the sequence of scraping, washing and rinsing (or loading the dishwasher) into smaller steps, or help kids work on sequencing the steps together.

Creating a sensory-friendly kitchen
When introducing children to cooking, it’s important that parents discern how their child is perceiving and experiencing the world of food. As speech-language pathologists, we are well aware of the sensory issues these children experience, and food engages all our senses—sight, smell, taste, touch and even hearing—while we prepare, cook and eat it. (See the ASHA Practice Portal for more information on feeding and sensory issues in ASD.)
All this can be overwhelming. Each child’s distinct sensory system may require adaptations to make the kitchen more welcoming. To gain insight into each child’s individual needs, I ask parents (or older kids) to provide a brief description of those needs by downloading and filling out the Sensory Challenge Questionnaire. The questionnaire highlights which sensory experiences the child enjoys and which are more challenging.
Consider a child’s needs according to each sense, and how we might alter the kitchen to accommodate them:
Sight: Past experiences with food will determine how easily a child with ASD adjusts to new experiences. Consider the effects of a kitchen’s blinking lights, digital timers, unusual blinds or overhead fluorescent lighting. Can anything be adjusted, softened or moved to make the kitchen more welcoming? Consider visual cues to help a child adapt to the new routines, such as a visual schedule that illustrates six steps to handwashing before handling food: 1) Turn water on; 2) Soap hands; 3) Rub; 4) Rinse; 5) Turn water off; 6) Dry hands. Starting every cooking session with a familiar routine like handwashing is comforting to children with ASD—they need an element of “sameness” or familiarity before encountering new experiences.
Taste: Part of the cooking process is tasting as we cook. To help a child with food aversions, start with small tastes. Use tiny tasting spoons to dip and taste, then season before grabbing new spoons to repeat the process until the food is to their liking. Keep a small cup of tiny tasting spoons within easy reach as you cook together—it’s quick and they can control how much they put on the spoon. Plus, you’ll be modeling these tiny tastes frequently throughout your time together in the kitchen. By sampling foods, you’re helping your child build a relationship with a new food via positive input. So, be sure to smile if it tastes good, and if it’s not quite to your liking, model how to improve the taste by adding other ingredients, like seasonings, and taste again. I tell kids that every taste doesn’t have to taste good, but we still need to taste it so we know how to change it from yucky to yummy.
Hearing: A child with ASD often reacts to auditory stimuli, especially sounds echoing on the hard surfaces of the kitchen. Countertops, appliances, and tile or wood floors cause the sounds of electric appliances to reverberate into highly sensitive ears. Just the tin-like sound of a whisk in a cold metal bowl may be uncomfortable for a child with auditory hypersensitivities. When using blenders, food processors or other large motorized appliances, pull the appliance away from the wall. Place the base of the appliance on a folded kitchen towel to absorb some of the vibration. A set of headphones can add an extra level of comfort when appliances go on. Playing favorite music in the background or via headphones can also help regulate sensory systems and refocus the brain.
Touch: A kitchen’s multiple surfaces, objects and foods can provide both pleasant and unpleasant tactile sensation to the skin before tasting. Consider the following questions when gauging your kitchen’s tactile-friendliness: Would this child feel more comfortable with soft cloth towels or stiffer paper towels? Would this child have immediate, easy access to the sink to wash their messy hands? Would a spoon with a longer or shorter handle be better suited for this child? For kids with tactile sensitivity, a longer-handled spoon may provide just enough distance from the texture of the food to allow them to interact in a comfortable manner with the spoon.
Smell: In our book “Raising a Healthy, Happy Eater,” my co-author—pediatrician Nimali Fernando—and I explain the emotional connection between food exploration and the sense of smell: “The olfactory nerve is near the amygdala, the emotional center of the brain, and the hippocampus, the brain’s memory center. For young children exploring new foods, just one unpleasant olfactory experience—the sulfur-like smell of rotten hard-boiled eggs, for example—can influence future interactions with that same food.” This sensitivity may be magnified for a child with ASD. When scents in the kitchen are more than a child can tolerate, consider the following strategies: Allow the child to hold a small soft cloth with a preferred smell to their nose, sip water through a small straw, or chew a fresh piece of gum.

Celebrate small victories and know that the path to more flexible eating takes time.

Building body awareness
While trying to help a child eat a more balanced diet, keep in mind that the child’s sense of balance comes into play too. Biting, chewing and swallowing are fine motor skills, and every child needs a sense of being grounded, feeling adequate balance and stability in their world, to practice those skills.
For children who have poor vestibular processing, standing still in the kitchen can be difficult, so provide opportunities for them to move about periodically. Many kids need to move to pay attention and regulate their body. The vestibular system works closely with our sense of proprioception: awareness of where various body parts are in space and how much effort it takes to move each part effectively. Tapping into a child’s vestibular and proprioceptive receptors can be integral to calming and organizing them. Relevant activities include stirring thick dough, carrying heavy cookbooks to the counter, and rolling out pizza dough with a rolling pin.
Another consideration is that people likely taste differently based on their individual biology. For all of us, taste and smell interact to produce our perception of flavor. But research indicates that approximately 25 percent of the population are “supertasters” who taste more intensely and 25 percent are “nontasters.” The rest of the population falls in the middle of the spectrum, with 50 percent happily tasting foods without hypo- or hypersensitive tongues.
Research has revealed that supertasters have an extreme olfactory experience too. When trying new tastes with a hesitant eater, remember to keep samples small, deconstruct more complicated flavors into individual components first, and consider texture, temperature and other sensory components of each individual food.
Using cooking as a tool to help children with ASD requires creativity to discover the artistic carrot that will tempt that child to explore new foods. Celebrate small victories and know that the path to more flexible eating takes time. When children are invited to join us in the kitchen, they can explore math, science, language and so much more. We have the opportunity to teach the whole child—brain, body and soul—and make the connection. Who will you invite into the kitchen today?
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April 2017
Volume 22, Issue 4