Let’s Eat Out! Strategies to Help Make Dining in Restaurants More Enjoyable!

1. Let’s Eat Out!Strategies to Help Make Dining in Restaurants More Enjoyable! Jamie D. Bleiweiss, M.A. Advanced Doctoral Candidate, SUNY Stony Brook December 2007

2. Restaurant Nightmares: • Ali’s story • Nate’s story

3. Determining where the difficulty lies? • 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

4. Why is eating in restaurants so difficult? • 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 • Difficulties in over-stimulating, crowded, noisy environments • Sensory sensitivities

5. Things that make dining out difficult for children with ASDs: • Smells • Overly stimulating environment • Having to wait • Lack of predictability • Difficulty with transitions • Limited ability to move around • Crowds • New/unfamiliar environment • Elevated noise level • Constant commotion • Sudden sounds • Change in normal mealtime routine • Highly distracting

6. Factors to consider before going out to eat… • 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

7. Where should you begin? • 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

8. Do your homework: • 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

9. Advanced preparation:Things you can do before going out to eat! • Create a visual activity schedule • Flow of the day • Listing restaurant as activity in early evening • Provide calendar depicting upcoming restaurant trip • Looking forward to approach!

10. Advanced preparation:Things you can do before going out to eat! • Use priming techniques • Practice in relaxing setting • Prepare them for things they may experience at the restaurant Play Pretend Restaurant

11. Advanced preparation:Things you can do before going out to eat! • 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

12. Sample Social Story:Eating in a Restaurant 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!

13. Sample Power Card 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.

14. Preparing your child: • 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

15. Be back in a bit!

16. Things to consider when you get to the restaurant… • 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

17. 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

18. Additional tips to ensure a successful restaurant experience! • Ask for extra napkins & utensils • Ensure that server will bring out child’s food first • Hide/remove condiments from table • Bring hand sanitizer • Avoid unneeded trips to bathroom to wash hands!

19. Additional tips to ensure a successful restaurant experience! • Ask for containers to wrap up leftovers to be brought to table • If needing to exit quickly, you can wrap it up and go! • Ask for the check when food comes out • Limits waiting time after meal is over & child nears his/her “end point”

20. Strategies to use during the meal: • Visual supports • Incorporate child’s interests • Bring along a bag o’ tricks • Catch them being good!

21. Using Visual Supports: • Individual task-sequence boards • Displays steps involved in the restaurant routine • Variety of formats: • Benefits: • Enhances predictability • Reduces anxiety • Makes routine less overwhelming

22. First  Then Boards • Simplified visual schedule Sample task sequencing folder

23. The Power of Visual Supports • Bring your social story • Visual reminder cards (“quiet voice” “hands down”) • Take along power cards • Use timers & • advanced warnings

24. 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!

25. 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)

26. “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!

27. 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

28. Final words of advice… • Know your child’s limits & tolerance levels • Don’t push your luck…try to end on positive note! • Start slow…set reasonable & attainable goals • Overall goal is to make this a fun routine the family can enjoytogether • We want to make this a positive experiences for EVERYONE involved!

29. Any Additional Questions/Comments, Please Contact: Jamie Bleiweiss M.A. Doctoral Candidate SUNY Stony Brook jamiedawn8893@yahoo.com