While working through this process with Jake, I realized how intertwined each of his issues are with one another. Once I established a good footing on getting him to stay at the table for meals, I was able to address other items on the list. The time had come to work on desensitizing him to new foods.
Jake had self-limited his food choices down to only peanut butter sandwiches and chips. If I placed any other food on or near his plate, he would get extremely upset and run from the table. My plan to reintroduce foods in his diet included working backward through the foods he dropped off his 'willing to eat' list. For example, waffles, pancakes, and roasted potatoes were all well tolerated by Jake at different times over the last few months, but for some reason he began to refuse them. Since they are the most familiar to him, I felt like they would be easier to get him to accept again.
At this point, Jake was still eating peanut butter sandwiches for dinner. I placed a waffle next to the sandwich on his plate. He immediately got upset. I explained that he did not have to eat the waffle, but he did have to stay in his chair (building on that newly mastered skill). He was able to finish his dinner, never touching the waffle. I repeated this same technique with other foods at different meals. I did not force him to try anything. I just wanted him to get used to being near the new foods. After a few days, he was able to touch the new foods, but still refused to take a bite.
It became time to up the ante. Jake was becoming more cooperative and I think we began to establish a new level of trust. For whatever reason, food is scary for him. I made a point of praising each and every bit of success he had. I talked to him about how eating new foods would make him big and strong. I made sure that he knew that I was on his team and would help him through all of this.
Now he needed to actually ingest a new food. This took a bit more planning. One thing we had working in our favor is that Jake always comes home from school hungry and all he wants to snack on is chips. I changed up our routine a bit in order to get him to eat something new. Instead of coming straight home from school one afternoon, I drove all over town with him. We ran some errands, went by the beach and visited a local farm. When I was sure that he was really hungry, we went home. As soon as we got in the door, he asked for chips. I offered a waffle instead. This did not go over well with him.
Once I got him calmed down, I explained that he could have some chips after he took a bite of his waffle. I've tried this exact same technique before and it didn't work. I think it always failed because Jake was so 'in the moment'. A promise of chips in the future was not enough to motivate him. Now, he understands 'first and then', so it worked. He ate a bite of the waffle and I gave him a couple of chips. When he finished them he asked for more. To get more, he needed to take another bite of the waffle. We continued this process until he ate the whole waffle. Now that he understood that waffles weren't so bad after all, that's what I served him for dinner. At dinner time, he had to eat the whole waffle before receiving chips. Success!
We followed this same method everyday and I was able to reintroduce several of his old favorites quickly. In less than a week, we added waffles, pancakes, muffins and roasted potatoes back to his diet. With these successes behind us, it was time to move on to more difficult challenges.
I add protein powder, fruits and pureed veggies in most of my baked goods to help make up for his pitiful diet. Jake has not knowingly consumed anything resembling a fruit or vegetable in about 18 months. I decided to try a small piece of orange, since it was once his favorite fruit. This would prove to be much more difficult than the waffles. Instead of insisting on taking a bite, I just asked that he touch it to his lip the first few tries. Once he was comfortable with that, he was able to take a bite. The poor guy gagged the first time he ate a piece of orange. But, he was willing to try it again, as long as I kept the chips coming.
Reintroducing foods to Jake will be an ongoing process. It can be tedious and exhausting, but it is necessary. There is no chance that I will catch Jake voluntarily gnawing on an apple any time soon, but I am pleased with his progress so far. I should also mention that if he is having a really bad day, I do not attempt to get him to eat a new food. All of these new textures and tastes are hard enough on him and I want to limit failure as much as possible. So, I pick my battles carefully and do my best to introduce challenges only when I believe he is ready for it.
More to come...