Autism Spectrum & Eating Out

Introduction:

Dining out can be an incredibly stressful experience for someone on the autism spectrum (or simply someone who has debilitating anxiety), whether they are a child or an adult. It can be overstimulating and confusing to step into a new environment without any idea of the social rules that dictate how they should act and the strong sensations (light, noise, cold seats/air) flying at them from all directions. Social expectations can also restrict an autistic person’s ability to use coping strategies that work for them in private. Common accounts from adults on the autism spectrum detail the loss of appetite, difficulty to speak, and the general extreme discomfort felt eating around others in a public space (Park-Cardoso & da Silva, 2021). This blog will detail strategies on how you can help your client acclimate to restaurants, find more accessible locations, and help families how to set their child up for success.

Families:

The main goal in preparing for a restaurant visit is to give your client (and your client’s family) a clearer picture of what to expect during the meal. The following tips can be mixed and matched to start that acclimation process early and minimize the amount of surprises your client experiences once they arrive (Marcus Autism Center, 2021; Kazek et al., 2021).

Preparation

• Look at the menu: Are there any preferred foods on the menu? Non-preferred foods? By planning out potential choices with your client beforehand, the stress of choosing a meal while in a high-sensory environment is avoided.

• Scope out the restaurant: How loud is the restaurant? What’s the lighting level? When are non-peak hours? Where is the bathroom? Are there seats they will be comfortable in? The actual scoping out can be anything from an in-person visit to looking at information online (ex. Google’s “Popular Times” feature that details peak hours and wait times).

• Roleplay: This can be a time to review expectations, go over social etiquette, and roleplay sitting down at the table (looking at menu, ordering, waiting for food, etc).

• Make a reservation: This can help reduce the waiting period between entering the restaurant and sitting down.

• Create a plan: Where can parents or the client go if they are too distressed to stay at the table (ex. outside, bathrooms, car).

During the meal

• Bring an object of interest: This can be anything that can distract your client from all of the sensory information being sent their way in the restaurant. It could be a book, coloring pages, a stuffed animal, a puzzle/stim toy, or any object that gives them relief.

• Request a booth: There are many different sensations an autistic individual can feel sitting in a regular chair (ex. air hitting their legs, gaps in the back of the chair) that might leave them feeling exposed from all angles. A booth reduces the sensory load that your client experiences and helps them focus on social expectations.

• Use positive affirmations: Encourage the family to compliment their child when they do something expected of them (“Thank you for sitting so calmly”, “I like the way you have both feet on the ground”). Caregivers or friends can also reflect on how it might be stressful for them (“You’re working really hard to do a good job eating food with us”).

• Request a check early: This will give you a way to leave the restaurant quickly, especially for single caregivers who may not be able to leave without paying first.

Adults:

Autistic adults may already have lifelong experience creating coping strategies for themselves to participate in public outings. Some of the following suggestions may be redundant, but are aimed to provide additional options left out of guides tailored for families (Park-Cardoso & da Silva, 2021).

• Bring earplugs: The usage of earplugs can reduce the amount of sensory input in public spaces. This can be achieved through noise canceling headphones, basic earplugs, or more long earplugs (ex. Loop Earplugs).

• Locate a safe space & exit strategy: Find a quiet space that you can move to if you need a break during the meal. This can be as simple as locating the bathroom before sitting down to reduce the stress of searching for it in the moment. Ask servers if you need a seat closer to the bathrooms or entrances.

• Plan out alternatives: If the meal you planned to get isn’t available, or the restaurant you were going to is unexpectedly closed, have a backup choice/restaurant prepared ahead of time.

• Ask for preferred seating: If you need specific seating (such as a corner booth/seat), talk to or prepare a written note to give to the server at the front stand stating your accommodation needs. Check online beforehand for locations that expressly mention understanding for accommodations.

• Practice social skills & coping strategies: With a family member or clinician, adult clients can ask to practice social skills and coping strategies that will enable you to navigate restaurants with greater ease.

• • • Interaction scripting
      • Requesting a seat
      • Ordering
      • Signaling for help
      • Asking for the bill
      • Leaving
    • Asking server/bartender for food/drink information.
      • What ingredients are in this food?
      • How much alcohol is in this drink?
    • How to survive the wait for the food/seating
    • Giving a tip
    • Speech and general restaurant etiquette
    • Consult with a clinician for finding strategies specific to your needs

• Order pickup and eat in a quieter public space: If you want to engage in the social activities associated with eating out but the venue is too overstimulating, an alternate setting might help reduce the mental load. Your client can talk about this possibility with friends, family, or clinicians.

Restaurants:

Restaurant owners and staff can post signage for contact information about potential accommodations in their restaurant or on their website. This information can include: off-hours, preferred seating, ingredient information, accommodations that can be made by servers. Owners may also be able to offer a short visit to the restaurant before dining hours begin to give the person a chance to acclimate in the restaurant environment without all of the extra stimulation first (Marcus Autism Center, 2021).

Conclusion:

Clinicians, caregivers and autistic adults can mix and match the above strategies to more smoothly transition from a private space to a public one. There’s no requirement to implement all of these strategies at once; pick and choose the ones that feel like the right fit! Adjusting to new spaces can be a slow process, but with patience and experimentation you can find what works best and continue brainstorming from there.

References:

Brzóska, A., Kazek, B., Kozioł, K., Kapinos-Gorczyca, A., Ferlewicz, M., Babraj, A., Makosz-Raczek, A., Likus, W., Paprocka, J., Matusik, P., & Emich-Widera, E. (2021). Eating Behaviors of Children with Autism—Pilot Study. Nutrients, 13(8), 2687. https://doi.org/10.3390/nu13082687

Kazek, B., Brzóska, A., Paprocka, J., Iwanicki, T., Kozioł, K., Kapinos-Gorczyca, A., Likus, W., Ferlewicz, M., Babraj, A., Buczek, A., Krupka-Matuszczyk, I., & Emich-Widera, E. (2021). Eating Behaviors of Children with Autism—Pilot Study, Part II. Nutrients, 13(11), 3850. https://doi.org/10.3390/nu13113850

MSW, M. W. (2020). Mealtime and Children on the Autism Spectrum: Beyond Picky, Fussy, and Fads: Articles: Indiana Resource Center for Autism: Indiana University Bloomington. Indiana Resource Center for Autism. https://iidc.indiana.edu/irca/articles/mealtime-and-children-on-the-autism-spectrum-beyond-picky-fussy-and-fads.html

Park-Cardoso, J., & da Silva, A. P. S. (2021). Preference to Eat Alone: Autistic Adults’ Desire for Freedom of Choice for a Peaceful Space. Autism in Adulthood, 3(3), 257–265. https://doi.org/10.1089/aut.2020.0066

Tips for Dining Out. (2021). Marcus Autism Center. https://www.marcus.org/autism-resources/autism-tips-and-resources/tips-for-dining-out

Garcia, A. (2019, April 19). Read this if you don’t know how to talk to someone who has autism. Healthline. https://www.healthline.com/health/autism/dear-neurotypical-guide-to-autism#3.-Listen-carefully

Herbert, Anthony. (2016). The Role of Euphemisms in Healthcare Communication. Journal of Healthcare Communications.