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Parent Tips: Picky Eaters

Bethany Fenhaus, MA, OTR
Occupational Therapist / Feeding Specialist, STAR Center

Eating is such a common part of all our lives that most of us don't think twice about what a complicated process eating truly is. There are actually 7 different areas of human functioning involved in the process of being able to eat a diet balanced in nutrients with a variety of proteins, starches, fruits, vegetables, vitamins, and minerals in order to be healthy and strong in body and mind. On paper this concept sounds great, and simple to put into action. Unfortunately, when you have a child who is a , it is a constant struggle just to get in enough calories to maintain your child's weight. The bonus of having a balanced and nutritionally complete diet is not always an option.

For many children with Sensory Processing Disorders and their families, and often become a battleground. Many parents become short order cooks preparing a separate meal for their child and/or cooking something else during a meal when their child rejects the first option. Other parents become experts in re-creating a meal prepared in the exact same way and even served on the exact same dishes (the blue Thomas the Train plate with the dividers so none of the foods will accidentally touch, but not the new one Grandma bought. It has to be the tired old one with a crack in the side).

What could cause anyone to be that picky about eating? We don't realize it, but eating is actually one of the most complicated things we do as human beings. It requires us to take in and process information from all of our senses simultaneously. Eating begins with our eyes as soon as we look at the foods (visual). We then need to explore the foods and touch it with our hands, body and face in order to transport the foods from the plate into our mouths (tactile). As food comes closer to our face we unconsciously explore how it smells (olfactory). Once food is inside our mouth we experience how it tastes (gustatory) and listen to how it sounds (auditory). In addition, we have to use our 'hidden' senses to know how much force is needed to chew (proprioception) and to keep our body upright and balanced while we eat or feed ourselves (vestibular).

As if that wasn't enough, we also have to coordinate a wide variety of different muscles in order to be effective eaters. Our core muscles help keep us upright in the chair. The muscles of our arms and hands need to work in a coordinated manner to get food to our mouth. The muscles in our neck keep our head stable while we chew. In order to swallow one bite of food it takes 26 different muscles and 6 cranial nerves working together. Your sensory and motor systems are an essential foundation to effective eating but are just the tip of the iceberg!

When one or more of your systems (sensory, motor, or organ) aren't functioning properly, eating is an unpredictable and daunting task which assaults you at every turn. It is no wonder that children with Sensory Processing Disorder want to control every aspect of mealtimes and may insist on eating the same foods prepared in the exact same way every day or even at every meal. It is much easier to complete the complex task of eating if all the sensory and motor demands of eating stay the same.

The problem with eating the same food prepared in the exact same way every meal or every day (food jagging) is that eventually children get bored or burned out on those foods. Once a child with feeding difficulties burns out on a food it is most often lost from their diet permanently. Without the skills and abilities to add a new food to their diet, children with feeding difficulties continue to eliminate foods until they have very few options left in their repertoire.

The good news is that there are simple ways to prevent food jagging, thus preventing the loss of foods from your child's diet. One simple way is to instill a family rule of, "If we eat a food today, we cannot eat it tomorrow." You can reinforce this rule by making a visual board of your child's food choices and posting it on the refrigerator. When it is time for a meal or snack your child can select foods off their food board. After a food is chosen it is removed from the list and placed in an "all done" bucket until the day after tomorrow. Then, when your child makes their food choice for the next meal or snack, their prior selections are visually not even an option.

If your child does not have a wide enough food range to eat different foods at every meal of the day or across two days, start with a smaller goal. Change ONE sensory property of their preferred food every time the food is served. Sensory properties of foods include shape, color, taste, and texture. To start, begin with changing the food's shape. Cookie cutters will be your new best friends! You can cut their favorite peanut butter and jelly sandwich into a train one day and a car the next. Once your child consistently tolerates changing a food's shape you can move on to changing the food's color. Food coloring works great for this. One day their applesauce is yellow, the next day it's green. "It looks different, but it tastes the same!" After changing a food's color is tolerated, then move on to changing the taste just slightly by adding a small amount of spice, Jell-O powder, syrup, etc. Keep in mind that the goal is to change the taste first, not the texture. A change in texture is usually the most difficult thing for kids to tolerate, so save this step for last. Adding a thickening agent or an extra egg while cooking can create small changes to a food's texture.

At first your child may be extremely opposed to any type of change to their preferred foods. It makes their sensory and motor systems work hard! They may notice even the smallest differences. The goal is not to change the food completely, but to change it enough that your child perceives a "just noticeable" difference. This difference should not be so large that your child has a meltdown and refuses to eat. If this happens, then the change was too big. Some children need to start with a change as small as leaving most of their goldfish crackers whole, but adding one or two with their tails missing (change in shape). There are endless choices for subtly changing the way you prepare your child's food, but choosing the "just noticeable" change for children with Sensory Processing Disorder takes time and practice on the part of a parent. Making small changes together with your child can open the door to food exploration and expand your child's repertoire of foods he/she will eat. It may even spark a love for cooking!

For additional information on problem feeders visit the on the STAR Center website.

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