First, let's delve into what exactly picky eating is. Picky eating can be typical of a normal developing child. For typical developing children, the onset of picky eating can begin starting at age 18 months until up to three years of age. This kind of picky eating is more about control and choice rather than the food itself, as shown by the ability to eat once they are hungry enough. I'd say that ageless classic line of, "A child won't starve themselves. They'll eat when they're hungry" might ring true for normal picky eaters. The shining light at the end of the rainbow is for them, the picky eating gets to leave around age 6 or so. On the opposite side, how to know your child has a selective eating disorder is more obvious. Onset of the eating habits are typically birth but can wait until four years of age before showing. The "obvious" part of the disorder is that the child doesn't reject certain foods. They reject entire food groups. Meats and vegetables are the usual suspects. Eating socially is typically avoided. The stress of having to eat foods in an over-stimulating place is too much work. Likewise, the stress of even touching or smelling new flavors and textures can result in meltdowns. And sadly, these behaviors do not stop; they continue into adulthood. Selective Eating Disorders are prevalent among the special needs community with a wide variety of disabilities like autism (ASD), oral-motor delays, swallowing difficulties, gastrointestinal problems and Obsessive Compulsive Disorder (OCD). These are just a few difficulties, not all. Author's Notes: Before reading my research, please keep in mind that parent reports are all relative to their own personal struggles. What worked for them may not help your child at all. Before taking any advice, please keep in mind that other parents are NOT experts in the field. All feeding struggles should be mentioned to your child's therapists or doctors so they can give you advise on what suits your child's needs. I've included much information for many different types of children struggling with feeding struggles so it can apply to a wide range of parents or caregivers struggling with it. Any equipment recommended in this article should be brought to the attention of a speech or occupational therapist before purchase. All the resources I can list will be included at the bottom so that other parents may find where I am investigating. Parent report resources will NOT be provided since it is all anonymous. And I put a great deal of effort into researching (like actual studies and research papers) to find this information on what works and what doesn't. Please, excuse the length but it is important to include all information of this nature since there are so many in need of it's help. What professionals adviseThe Parents AttitudeIt is important to be calm and collected when dealing with feeding difficulties. If you are taking total control and being demanding, your child will shut down rather than open up. So lead with a smile, don't raise your voice and let your child have some feeling that it is their choice whether to try it. ExposureTo start off, parents should be exposing their children to new types of foods. One at a time. The repeated exposure, by placing it in the child's space, will lower their sensitivity to the food itself because they have seen it before and tolerated it. Experts advise to start with placing the object in it's own separate bowl. Peeled, cooked, smashed, however you eat it. But make sure it has a place near your child's own eating space. Do this at every meal so they no there are no expectations of the food itself. They don't know it but you are slowly desensitizes them to the food. (If you are confident in your child, you may set it on their plate. Some children do not like it to be on their plate, others don't mind.) After two to three weeks of daily exposure, the child will be more apt to taste or "try" the new food. Modeling by family members and social stories (stories about other people trying the food and liking it) increase the chances that they will taste the new food. Experts make a point to say that children on the autism spectrum need plenty of exposure to increase the intake of unfamiliar foods and to keep the consuming at a constant rate, some children were given positive reinforcements. Add-in: My son's occupational therapist who I have a wonderful relationship with has given wonderful advise on the subject of exposure because it truly is the first step. And the first, of the first steps, before a child is going to be okay with eating something, they are going to need to explore it. Touching it, cutting it, squeezing it, mashing it all around their tray. If you can get your child to play with their food, the chances of them actually trying to taste it with increase drastically. This is hands-on exposure. If your child was nervous or anxious about the texture or the color, if you let them explore it on their own, their fears of that food might just dissipate. So give them food on a tray and model how to explore it. Or, if your child is interested, let them help you cook. Watching how eggs break, or meat cooks, can relieve some of the curiosity behind what the food actually is. If Exposure isn't enoughDon't get discouraged if exposure and modeling isn't enough. Feeding therapy often takes more work (sorry!) and a lot more patience. But by no means is this the end of the road for your child. Again what is suggested is having two different types of food: one that is loved and coveted like gold and the other that you are trying to get your child to taste. Offer one big bite of the desired food, followed by a small bite of the undesired food. Make sure to remember the "Parent Attitude" paragraph even though you're probably ready for a glass of wine right about now (or a beer!) but keeping a positive environment at the dinner table will make eating a positive experience, making it much easier to have your child eat meals or sit at the table with the family. Side note: It is momentous to your success if you have sit-down together, family meals. Be vocalI know plenty of us special needs, autism and speech delay moms know that talking to our children, even if they don't talk back, is very important for their development and word formation but for any other mom who is navigating new waters, it can feel strange to excessively talk and label things. Personally, I had the hardest time with it! But after a while, it becomes second nature and no one thinks you sound like a crazy lady. Trust me. Your feeding trials at home should be vocal in the labels, colors, smells, etc. Part of the desensitization should include explanations to your child. Explain where it comes from, and why it's good to eat, and what you love about it. This can be sort of like a social story. Moving on to if the exposure part hasn't been enough. To help the process of tasting or consuming the new food, it helps to give instructions. Give your child a friendly suggestion of how they should continue. For example: "First let's eat a bite of our chicken nuggets. Oh, so yummy! Now lets take a bite of a pea. Num num num. Now lets eat a chicken nugget again..." Your tone should be light and happy, and seem fun to a child. You might distract them into having so much fun they'll take a bite, or they'll comply with your wishes because they are receiving more of their favorite food and less of the undesirable one. The "Tricks" rabbit
Sitting at the tableI had made a quick snippet up at the top about eating family meals together, and I'm sure plenty of you were almost insulted because it is proven to be impossible at your house. MINE TOO! My son runs around, comes to take a bite, and then runs around some more. The only place Hilo sits down to a whole meal is at a restaurant. How pathetic is that?! But there are ways to help assist your child in sitting through a meal at the table to eat more!
In studies, it was shown that keeping a child at the table increased their food intake. Hands down. So if you keep your child at the table, they are bound to eat more regardless but if you couple escape prevention and rewards for their effort (like having a fruit snack or favorite toy for each bite they eat) children would eat more and display less behaviors. Parent reportNow comes the time where first-hand experience puts expert opinions into play and reap the rewards, or deal with the consequences. It is important to remind you these are just parents doing what they can to get their children to eat. Sometimes it works for them, but it might not work for another child. Remember, we are the first line. We don't have therapists in our food 24/7 with the willpower of a stubborn mule to focus so intensively on feeding. Parents do what they can with what they've been told, putting in a huge amount of effort, and praying that it will take. It can be heartbreaking to see our children struggle with feeding difficulties, and even more heartbreaking to worry about their future. So don't judge the parents who reported their styles, or who told the honest truth about their struggles. A mile in their shoes, and whatnot. One mom reported that her son (diagnosed with ASD) was an extremely picky eater. A "hard core picky eater" is how she described him, which to her report, sounded pretty accurate. However, she had a Board-Certified Behavior Analyst (BCBA) recommend presenting her son with the same meal. No favorites, or preferences. The BCBA assured her that he wouldn't starve, though he'd wait out longer than other kids. So each meal, he was given the same meal as the rest of the family was. No special treatment. 3 days he survived with basically nothing. Mom reported that it was very hard and she was a "wreck" during these three days watching him pick at a few bits and pieces. On the fourth day, he started eating all sorts of different foods. Since she has gotten the good footing, she allows him to reject food since he will always have foods he doesn't like. However, she doesn't allow seconds on his favorites unless he is "hungry enough for all the food". "I am so happy I did it. I think he cumulatively would have experienced so much more stress over a lifetime of restricted foods. He loves so many foods now... He likes fish, asparagus, super spicy food...The three days were hard and I know some people would disagree with the method, but I think it was one of the best things I ever did for him." Another mom reports that her son is so picky, he's going to be given a feeding tube just to sustain him while they do his therapies to encourage more eating. This is a cause that rings true for some children. Sometimes eating is just too much. Mom reports he isn't even interested in food, at all. Most days he survives off of chocolate milk and perhaps, one goldfish. Per day. Supplements into the milk have a reverse effect on his as well, making him silently starve himself and refuse to drink anything. Once every four or five months, there will be a day or two that he will suddenly eat all in sight, then be right back to surviving on chocolate milk. "Nothing has worked for us. Feeding therapy actually seemed to make it worse...We do ABA feeding therapy, sensory based feeding therapy, MNRI, oral motor exercises. He made the most progress with MNRI but they all say he's one of the worst cases of picky eating they've seen. Even the special clinic we spoke to for intensive treatment said he'd have to have a feeding tube first just to try to sustain him during their treatment." Other moms swear by hiding foods and using special recipes to hide foods. Some believe that gluten-free and casein-free diets work for their children, improving their behavior and reducing their need for sensory stimulating items. One diet called Specific Carbohydrate Diet (SDC) has reported 80-85% success rates for children with autism. The creator and author of the diet believes that starving the body of certain carbs and then introducing them, helps the gut heal and autism behaviors go away. Information on the diet will be provided below in the resources. Most moms are at their wits-end or have completely given up on trying to find a way to get their children to eat. No one can blame them if they are! Other techniques if none have worked thus farIn many studies that I have read, stimuli or "texture" fading have been shown to work with children with selective eating disorders. Children with autism tend to respond quite well to the technique. But what is this texture fading? How do we do it? Well it took me no short amount of effort but I finally found an explanation and example that might be the key to your child's mealtime success! In Katja Rowell's book, Helping Your Child With Extreme Picky Eating: A Step by Step Guide, I found a little excerpt about what she coined as "fading". She says that fading is taking a preferred item like vanilla yogurt, and by making minuscule changes to the yogurt by adding in small parts of something like peach yogurt, a picky eater might not notice the difference because of the small, diluted amount of peach yogurt. Then over time, adding in more and more peach yogurt to where they are gradually getting used to the texture/taste/smell of peach yogurt all while still having their preferred food. This is a very small amount of information to go on, I know. But I did find an unusual place to find some tips on "fading" for picky eaters: A food blog! Yes, Momables.com posted a mini-series of blogs to assist with picky eating to which she applies texture fading to help children gradually get used to foods by presenting it in a different form. It is a very unique approach, indeed. She doesn't have a background in feeding techniques, or occupational therapy; her expertise is food. So, she might know a thing or two? My son doesn’t like crunchy anything or meat texture, so much of his food takes a trip through the mini food processor... Many foods get mixed with whipped cream cheese (to introduce taste slowly) or hidden in tomato sauce, and he eats lots of warm “dips.” Taco night? He eats “dip” and chips. Everything cooked that you’d put inside a taco is now a delicious dip! Want to have more sandwich options? Make chicken salad, tuna salad, and egg salad in a mini chopper; you’ll get a creamy consistency this type of kid tends to like. With a kid who complains about food being “slimy” or “squishy,” you need to modify items so they have the texture they need: crunch. Instead of mashed potatoes, try baked wedges or baked potatoes. Soups? Chunky... The next part of her mini-series is related to picky eating based on color. Click here to check it out and see her tips on how to change up the game for your child! In closingHopefully I haven't lost everyone with the length of this post. There is just so much out there to read through and decide whether it is good, helpful information or just a waste of time. I tried to deliver information I thought would help real parents or caregivers everyday, in the home, in life. It isn't right to give advice on feeding techniques if it isn't applicable to real-world. There are going to be many professionals who recommend this and that, stating that it almost always works with stubborn eaters, etc. but the advice is too far-fetched that it isn't possible. Most of us have other children to raise, a job perhaps, a partner to love, and ourselves to take care of too! But any amount of trying, in my book, is still commendable. Any effort, even if it is unsuccessful, is worth praising. ANY. Your are an awesome parent for trying, and not giving up, or giving up and trying a new approach. I'm convinced nothing is ever fool-proof, nor is it going to work for every single child that comes through. However, these steps will only give you a bridge but you have to build the island by either copy and pasting ideas for other places or creating your own. Whatever works for you and your family is the right way to go. Resources
2 Comments
Elizabeth Domino
7/9/2017 09:56:44 pm
Thank you so much for this! Stumbled across your beautiful family and blog through Instagram.
Reply
1/13/2021 12:21:34 pm
Great! This blog post is really useful for the kids who are going through sensory disorders. Pediatric therapists helps a lot to improve this. Thanks for sharing this amazing information!
Reply
Leave a Reply. |
AuthorGabrielle Rae is a special needs, stay at home mommy of two boys. She enjoys reading and writing novels in her spare time. @onbothfrontsArchives
August 2018
Tell me. |