Jamie D. Bleiweiss, M.A. Advanced Doctoral Candidate, SUNY Stony Brook - December 2007

Jamie D. Bleiweiss, M.A.
Advanced Doctoral Candidate,
    SUNY Stony Brook
         December 2007

 Ali’s   story

 Nate’s    story

 Assess   the situation
  Why is it difficult for your child to eat in restaurants?

  What are some possible contributing factors?

  Try to pinpoint specific parts of routine causing
   difficulty

 Effective   interventions are derived from
           comprehensive assessments

Communication       difficulties
Insistence      on sameness; difficulty with
 change
Tendency       to be rule-bound/rigid
 Difficulty   with new/unfamiliar environments
Low   frustration tolerance
Anxiety,      obsessive-compulsive behaviors
Low   tolerance for waiting
Difficultiesin over-stimulating, crowded,
 noisy environments
Sensory sensitivities

   Crowds                    Smells
   New/unfamiliar            Overly stimulating
    environment                environment
   Elevated noise level      Having to wait
   Constant commotion        Lack of predictability
   Sudden sounds             Difficulty with
                               transitions
   Change in normal
    mealtime routine          Limited ability to move
                               around
   Highly distracting

 What    type of restaurant?
     Kid-friendly

     Quick     service; understanding wait-
        staff

 When    to go?
  Initially, go during less crowded or “off”
   times
       Less noise & distraction

  Avoid going during “prime times”
       Weekends, holidays

Gradually expose child to
 more structured restaurants
 Start with fast-food
      Quick, very kid-friendly

 Next, try casual dinning eateries

Slowly desensitize your child to
 more challenging environments

 Check    the menu ahead of time
   Do they have items your child will definitely eat?

   Are there items on menu that everyone else will
   be happy with?

   Look online or call restaurant for menu

 Call   ahead to make reservations
   Keep your “wait time” to a minimum

   Ensure your child’s preferred item will be
   available that night

 Create   a visual activity schedule
 Flow of the day

   Listing restaurant as activity in early
    evening

      Providecalendar depicting
       upcoming restaurant trip
        Looking   forward to approach!

 Use   priming techniques
 Practice in relaxing setting
 Prepare them for things they may experience at the
  restaurant
                                        Play Pretend Restaurant

 Create   Social Story about eating out
 Read it with your child several times
  prior to going out

            Develop a Power Card
               Using   child’s preferred hero,
               special interest
                  Describe  how hero handles
                  going to restaurants

Sometimes I go out to eat at a restaurant with my family.

   Sometimes we go to a big restaurant. Sometimes we go to a small
           restaurant. Other people eat at the restaurant.

    When we go out to eat, it is important to listen to adults. It is
                 important to follow restaurant rules.

 At the restaurant, we find a table. I sit on my chair at the table. I
     think about what I want to eat and drink and tell my mom (dad,
  babysitter) about it. Sometimes I tell the waitress what I want to
                    eat or show her a picture of it.

  We have to wait for our food. When I am waiting, I can talk to my
  family. I can look at one of my favorite books. I can play with a toy
  that my mom let me take to the restaurant. I will try not to make a
         lot of noise because that may make other people upset.

I will try to wait patiently and use my best manners when I am eating in
          a restaurant. We can have a good time in the restaurant!

When going out to eat in a restaurant, remember
 what Winnie-the-Pooh says:

When I’m rumbly in my tumbly, I like to eat at a
  restaurant with my friends.
 If I start to get upset, because my food isn’t ready
  yet, I can listen to my music, color a picture, or
  read a book.
 If it gets too noisy or crowded, I like to take slow
  deep breaths and think about some of my favorite
  things (honey, of course!).
 Eating out with my family can be fun.

 Teach   relaxation skills
 Deep breathing
  E.g., Blowing out the candles

 Muscle relaxation skills
  Squeezing stress balls

 Teach   coping thoughts
  Distraction (think about
  favorite topic/toy/movie

 Position   of your table
               Try to sit away from major distraction
                 areas
                    Bathrooms
                    Kitchen
                    Serving stations

Preferable  to sit near a door in case you need to
gracefully exit in a hurry

 Request   a booth if possible
 Child can sit next to adult & wall

   Limits distraction & commotion

 Locate   bathrooms
 Find most direct route

   Ideally, go before leaving home to avoid difficulties

 Hide/remove              Ask for extra
 condiments from table      napkins &
                            utensils

 Bring hand sanitizer     Ensure that server will
     Avoid  unneeded       bring out child’s food
       trips to bathroom    first
       to wash hands!

Ask for the check when food
              comes out
                    Limits waiting time after meal
                     is over & child nears his/her
                     “end point”

 Askfor containers to wrap up
 leftovers to be brought to table
     If   needing to exit quickly, you
        can wrap it up and go!

Visual   supports

Incorporate    child’s interests

 Bring   along a bag o’ tricks

  Catch   them being good!

Benefits:
  Enhances predictability      Individual task-sequence
  Reduces anxiety               boards
  Makes routine less            Displays steps involved in the
   overwhelming                  restaurant routine

                             Variety of formats:

First  Then Boards
   •Simplified visual schedule

Sample task sequencing folder

Bring your            Visualreminder cards
social story           (“quiet voice” “hands
                       down”)

        Take along
        power cards

                         Use timers &
                        advanced warnings

Incorporate       child’s area
 of interests
 Engage in conversations about
  child’s preferred character/movie,
  special interest (e.g., trains)
  Socially interacting with family
  Effective distraction while waiting
   for food!

Bring a bag o’ tricks
 Distracter items
  Books, iPod, music/headphones, video
   games, coloring books & crayons
  We want them to experience this as a
   fun place, so let them use their
   preferred items while waiting (which is
   difficult for them)

“Catch     them being good” approach:
 Provide lots of frequent, specific praise throughout the
  meal!
  Tell them what they are doing well!
     E.g., “George, I love the way you are sitting and listening to your
      music while we wait for the food!”
     E.g., “Paul, you are coloring that picture so beautifully! I love it!

If child becomes upset or rumbling behaviors occur:
           Encourage use of relaxation skills
          Deep breathing
          Muscle relaxation
          Acknowledge his/her distress; provide physical
            reassurance
            Gently rub his/her back; pressure to shoulders

          Use   sensory based items
          Fidget items
          Headphones, music

                          If needed, take child for walk outside
                           (maintain safety)
                             Engage in physical activity

 Know   your child’s limits & tolerance levels
 Don’t push your luck…try to end on positive note!
  Start slow…set reasonable & attainable goals

 Overallgoal is to make this a fun routine the
 family can enjoy together
 We want to make this a positive experiences for
   EVERYONE involved!

Jamie Bleiweiss M.A.
    Doctoral Candidate
    SUNY Stony Brook
jamiedawn8893@yahoo.com