Goldfish.
Chicken nuggets.
French fries.
This was the diet of the majority of my students when I was a special education teacher.
I’m not talking sometimes they ate these things… or these were their favorite foods.
I’m talking, this is ALL they ate.
And some of them wouldn’t even allow other foods to come near their plate.
Try to put a carrot near them… scream.
Stick an apple slice on their plate… head on the table crying.
Hand them a sandwich to eat… total meltdown.
It was frustrating and exhausting and perplexing to try to figure out what was going with these students and how we could help them expand their diet.
Trust me, we tried everything we could think of…
- Praise and positive rewards for trying a new food
- Sticker charts and token boards
- Taking away preferred activities until they tried new foods
- Coaxing, begging, pleading
All I remember thinking was, if they were hungry enough, they would eat.
If only it were that simple…
Only when I started to dig a little deeper to understand why some children have difficulties with feeding did I begin to understand some of the underlying sensory and oral-motor concerns.
I’m happy to report that after learning and trying some of the techniques from feeding guru Kay Toomey, I finally had a breakthrough.
I’m not gonna lie and say that my kiddo went from eating 4 yellow, bland-flavored foods to enjoying some gourmet dishes.
BUT, he did go from eating French fries and crackers to start enjoying chicken nuggets, peanut butter-and-jelly sandwiches, and cheese pizza.
Is she for real??
Now some of you may think I’m exaggerating, but for others of you out there, this is your everyday norm.
We’re not talking about kiddos who don’t like vegetables or won’t eat fish (I mean, how many four-year-olds actually eat sushi??)
I’m talking about those little ones out there who we consider problem eaters or resistant eaters.
The children who eat less than 20 different foods, refuse entire categories of food textures, cry or have tantrums when new foods are introduced, and almost always eat different foods than what their family enjoys.
Let’s push PAUSE for a second to chat about WHY in the world I’m even talking about eating.
For one, think about how long you can pay attention and maintain conversations with others when you’re hungry.
They don’t call it HANGRY for nothing….
And most of us have the means to get our hunger needs met on our own.
But imagine a little one who might be hungry but has some competing underlying sensory challenges that make it difficult for them to eat a variety of foods to maintain proper nutrition.
Also, consider how much FOOD and EATING is a central part of our social activities.
- Family dinners
- Parties
- School lunches
- Eating out at restaurants
- Classroom celebrations
So much of how we interact with others and form friendships involves food and eating.
In addition, for those children who eat a limited variety of textured foods (or maybe even only pureed foods), they might have some structural or functional concerns with their jaw, lips, tongue, or cheeks… and that means speech production is going to be even more challenging for them.
Ok, but NOW WHAT….
If you’ve got a little one who you suspect might be considered a problem eater, know that there is HOPE out there.
Feeding specialists (also known as feeding therapists) are professionals who specialize in working with children who have swallowing, chewing, or eating difficulties. They are typically an occupational therapist (OT) or speech-language pathologist (SLP) who has specialized and received additional training in the area of feeding.
Like most other professionals, they should first conduct an assessment to get a clear picture of her needs, including:
- their current food/drink inventory (typically over a 3-7 day period of time)
- behaviors observed during meal times
- any swallowing difficulties (e.g. choking, trouble managing liquids, excessive drooling)
- any instances of pocketing food in their lips/cheeks
- what your child does when new foods are introduced
- strategies that have been previously tried
- any oral-motor problems or muscle weakness
- medical history
Depending on the results of the evaluation, the feeding therapist may recommend either a home program (things you can do at home) or direct therapy (bringing the child into a clinic setting). They could also recommend a combination of both. Feeding therapy typically occurs on a weekly or monthly basis, either in a group or individual setting.
In my experience, feeding therapy can take some time to see results.
Sometimes progress is small and slow.
Most times it takes a big commitment from the family to carry through on the recommendations from the therapist during daily routines.
But in all cases, with an experienced therapist and committed team, for problem or resistant eaters it’s worth it to pursue feeding therapy as an option.
If nothing else, it can provide some strategies to gain some PEACE and HOPE for your child and family around mealtimes.
ACTION STEPS:
- Download this checklist to see if your child is considered a picky eater or problem eater.
- If your child seems to be a problem or resistant eater, look up feeding therapists in your area. Hospitals or private clinics would be your best bet, as these services are typically NOT done through the schools except in the case of children with more complex medical needs.
- Call the feeding therapists to ask about waitlists, their approach toward feeding therapy, and what next steps you need to take to schedule an assessment.
- Determine how you will pay for the services. If going through insurance, call your insurance company to see if they cover feeding therapy. It might fall under occupational therapy or speech therapy services depending on the discipline of the feeding therapist.