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Key points
- For children with sensory issues, anxiety, or autistic spectrum disorder, the main concern is a limited menu emphasizing carbohydrates.
- Parents of picky eaters are often concerned that their child is not gaining the proper nutrition needed for brain and body development.
- Using systematic and hierarchical graduation of non-preferred foods parents would like their children to consume helps build a varied palate.
As mothers, we can bear multiple children from the same womb, yet each is so different. Let’s take eating, for example.
I have three children with three very different preferences and aversions right from the start; just because one child enjoys certain foods, another one may find the smells, appearance, and textures of that very same food offensive, “gross,” or even vomit-inducing.
For our children with sensory issues, anxiety, or autistic spectrum disorder, the main concern is a very narrow menu with an emphasis on carbohydrates. For example, the top contenders tend to be macaroni and cheese, pizza, chicken nuggets, pasta with sauce or butter, goldfish, etc. The aspects of food that can turn a child away from certain foods or food categories can be taste, color, smell, and texture.
Many parents become highly concerned that their child is not gaining the proper nutrition needed for brain and body development. It also creates a high level of tension when the food of choice is not available. Families are restricted in where they can eat out of their home, which creates stress and resentment by other siblings. It also creates stressful mealtimes, fighting, and difficulty eating a meal together as a family unit.
Dana Blumberg, an occupational therapist in Livingston, NJ, starts by asking the parent to create a list of all the foods that a child will eat. Most parents share that their child will eat the same food repeatedly and then stop. They become bored and switch to another food they consume repeatedly, and the cycle repeats.
Blumberg reported that she creates three categories:
- Foods that the child eats.
- Foods that the child used to eat.
- Foods that the parents wish for their child to eat.
Picky eaters also tend to have a strong preference for a particular brand and will notice the small differences if there is a brand change. These subtle differences can result in rejection of the food, crying, a meltdown, or even physical aggression.
Children who are picky eaters also tend to eat “clean” where they don’t like spices or condiments. They also may prefer soft bread with butter which are all mild flavors that are predictable. Food that is crunchy or contains spices can be “alerting” which can lead to sensory overload for many children.
It’s also important to rule out gastrointestinal issues that may be leading to strong food preferences by looking at foods that may be contributing to discomforts such as reflux or constipation. Additional consultation may be necessary with a nutritionist to help children gain weight appropriately and the nutrients needed for growth.
Another factor to evaluate is oral motor strength, said Blumberg. She emphasized the importance of the physical ability and strength to chew and crunch down on foods that require more pressure to break them down. Once that’s ruled out, she reviews the textures and smells of the preferred versus the non-preferred foods.
Some children are also aversed to foods of a certain color; for example, green. When this is the case, she will bring in green items and place them all over the treatment room in order to decrease the child’s sensitivity to the color. She asks her parents to do the same at home. The goal is to help the cd to un-do the association and learn to tolerate the color, impacting eating green well.
Her treatment plan consists of systematic and hierarchical graduation of non-preferred foods that parents would like for their children to consume. For example, fruits or vegetables.
- Play with the food.
- Kiss the food.
- Lick the food.
- Place the food in the child’s mouth and then spit it out.
- Take a bite.
- Chew and swallow the food.
Blumberg encourages parents to set the expectation that the child will come to the dinner table, sit on a chair with feet on the ground. “The child needs to feel the ground so that he knows where his body is in space and time.” The child can set up their plate for himself, and the expectation is that the child will remain seated, eating or not, for a specific duration of time.
It’s also important to maintain consistency in meal and snack times each day. Avoid eating in front of a screen such as an iPad or computer. Also, avoid eating in the car as much as possible. Your child can help to set the table and clear the dishes from the table in order to build a clear routine around mealtimes and build the expectation that meals are an uninterrupted time of eating and joining together as a family.
Parents who have picky eaters can also use reward systems to encourage their children to build their tolerance to certain foods. The goal is to build a varied palate for your child that ensures nutrition. The use of multi-vitamins or smoothies can also be helpful as parents can hide fruits and vegetables and cover up their flavors and smells.
