Case Studies

Boy: J Aged 15 - Eating Disorders, Autism.

J arrived at Orchard School at the age of 15. There were a number of challenging behaviours J displayed, one of them being a limited, unhealthy diet. This diet consisted of crisps, chocolate, salt (eaten directly from the shaker) and milk to drink.

With dedicated staff who worked together with advice from the doctor and dietician J was gradually introduced to a balanced diet. Undoubtedly this eating habit affected some of his other challenging behaviours so it was vital for changes to be made to J’s diet immediately.

From the moment J arrived he was asked to sit with other students and staff at the dining table during meal times, which was a new experience for J.
As crisps were the main part of J’s diet when he arrived at the School, we tried to use similar textures to this, such as crackers and dry cereal. After offering different options on different days we discovered J enjoyed being given Weetabix dry and then he poured his cup of milk on top himself.
As a result Breakfast became easier for J but other meal times were still proving difficult. J was offered fried food (e.g. curly fries, cocktail sausages) along with a small amount of the food the other students were having at each meal. J was also given Vitamin tablets from his GP. This process continued and slow progress was made. With encouragement and praise J began to eat the skin of the cocktail sausage and the crunchy ends of the curly fries. His bites were so small that it sometimes took up to two and a half hours for him to eat these tiny morsels of food. We continued this process for about three months and eventually J would happily eat the sausages, curly fries and put the menu meal to his mouth.

We sought advice throughout these months from a dietician who helped staff become aware of the foods J vitally needed in his diet. These foods were then brought across from the menu meal and a small portion was placed on J’s plate. We reduced the amount of fried food J was having and began using a few Skip crisps as a reward when he tried and ate something new. For example he would be offered a Skip after he had eaten a pea. This worked well, although mealtimes were still taking up to two hours. In addition to his difficulties about food J struggles with change and needs a long time to adjust to new surroundings/routines.

At first J found it very difficult being brought down to the table at meal times, but after the first month of being offered similar foods he came to expect and accept it. J then had to tackle the huge change of eating different foods, and new foods being added every meal time as part of the menu meal.
J could accept the plate of food and the routine meal times but as the food on J’s plate changed every day this was something unpredictable. It was almost three and a half months before we were able to add new food to J’s diet that he wouldn’t refuse.

When J’s diet began to vary a little more the Principal worked with the kitchen staff to set up a menu which tried to include a little more of the other students’ menu meal. The menus agreed also took into consideration the advice from the dietician, who had explained J needed to sustain a healthy diet which included vegetables, meat and fruit.

We began to leave the Skip crisps in the kitchen and just try and encourage J to eat the new foods. Each new food he was now eating had taken up to a month for him to eat without constant encouragement. To monitor these new additions to J’s diet a food diary was set up and J’s menu was adapted to include this.
The amount of menu meal food began to increase on J’s plate and the fried foods decreased. This process continued until J’s meal was the same as the other students.

J now enjoys a variety of different types of food including vegetables, fish, meats and fruit. J can now finish his meal in thirty minutes and often, if he is offered crisps, he will choose something else instead.

The Orchard School, Middletown, Welshpool, Powys SY21 8EW
T: 01743 884145