What Sensory Therapists Can Teach Us About Feeding Picky Kids
Do you find yourself preparing 2-3 meals for lunch or dinner? Do you feel that your child is a picky eater and is incapable for expanding his/her horizons? Well, this article could help.
Parents of young children commonly commiserate about their kids’ eating habits. Complaints often relate to a child’s exceedingly limited “kid food” diet, rejection of anything green, refusal to try anything new or the explosive mealtime battles that make dinnertime stressful for everyone. I frequently encounter exasperated parents who – convinced they’ve tried everything – come to the conclusion that their child is constitutionally a “picky eater” who is incapable of expanding his horizons.
So I decided to roast-test this hypothesis with two experts in the field of feeding challenging eaters: Jessica Piatak, a pioneering occupational therapist, and Kristina Carraccia, an innovative speech therapist, both at The Center for Discovery, based in New York. Piatak and Carraccia specialize in working with children with severe developmental disabilities, autism spectrum disorders and medical frailties and have developed an approach dubbed “Food Exploration and Discovery,” or “FED” for short. This approach has been used to successfully transition children with severe sensory and behavioral disorders from extremely limited diets comprised of two or three processed foods to varied, nutritious, whole foods-based diets. While some children take longer to transition than others, the duo has yet to meet a “picky eater” whose diet couldn’t be broadened with their gradual, personalized and flexible approach.
Piatak and Carraccia’s FED approach is grounded in a single, fundamental principle: The goal is not to simply get food into a child at any given meal, but rather to reach a point where a child eats because she or he is intrinsically motivated to do so. This is a long-term goal for lifelong behavior change, and as such, may take a long period of time to achieve. Progress is gradual and taken in very incremental steps.
Within two weeks, new residential clients are typically already eating whole food-based versions of their preferred foods, but it can take closer to three to six months until more variety has been added successfully. For clients living at home and attending outpatient feeding therapy, the process often takes longer, as the home environment is less controlled than at the center. There have been cases on both ends of the extreme as well. One client took just ten days to go from 10 foods to 35; another client took closer to two years. But to date, every child has eventually gotten there.
Think the eating habits of your little neophobe – who fears trying anything new – are hopelessly unsalvageable? Piatak and Carraccia beg to differ. With a flexible approach, the right mindset and a lot of patience, you can turn things around at the dinner table. Here are some of their tips to get you started:
Never force a child to touch, taste or eat a food. Many schools and families employ tactics like having a child take a “no thank you bite” – just a taste, with the promise that if they don’t like it they can say no thank you – or withholding rewards unless a child eats certain dinner foods. These approaches undermine the goal of helping children become comfortable enough to try – and accept – new foods, by placing pressure on them and making mealtimes stressful. Think about how you might feel if, while visiting a foreign country, you were forced to take a no thank you bite of fried insects or calf’s brain! That’s what confronting a plate of unfamiliar greens can feel like to some children – particularly to those on the autism spectrum.
If you’re committed to raising a more varied eater and having harmonious mealtimes, then creating a pressure-free mealtime is essential. To do so, commit to staying on your side of the division of feeding responsibility and resist the urge to force, coerce, bribe or cajole food into your child’s mouth. As the world’s foremost authority on childhood feeding practices, Ellyn Satter, teaches: You decide what to serve and when. Your child gets to decide whether to eat it, and if so, how much.
Set guidelines and expectations for mealtime. Children can become anxious when they don’t know what to expect, and often do best when routines are predictable. Dinnertime is no different. Kids may worry that there won’t be something they want to eat, or perhaps that they’ll be forced to try something scary. Piatak and Carraccia use various mantras tailored for such situations to help place children at ease. An example of such a mealtime mantra, according to Carraccia, might resemble this: “We sit with our family. If there’s something on your plate you don’t like, you may put it on another plate. You can eat it if you want to, but you don’t have to. Everyone helps clear the table when we’re finished eating.” Repeating these ditties help make mealtime comfortable, and reduces the pressure that can lead to dysfunctional mealtime dynamics.
Disclaimer: The views and opinions in this article are those of the authors and do not necessarily represent the views of Edmonton and Area Fetal Alcohol Spectrum Disorder Network.