The Challenge With Eating

What is Normal?

Likes eating

Interested in food

Feels good about eating

Likes a variety of foods

Balances their food selections

Eats a nutritional diet over a period of time

The Picky Eater

Typically occurs between the ages of two & three years

Starts to fear new foods

Certain limitations and aversions

Eventually eats enough of a variety of foods to maintain a balanced, healthy diet

The Resistant Eater

Limited food selection (10 – 15 foods or less)

Limited food groups

Refuses one or more food groups

Displays anxiety or tantrums when presented with new foods

Gags or becomes ill when presented with new foods

Experiences food jags (requires the same food presented in the same way at every meal)

Diagnosed with intellectual disabilities or falls under the autism spectrum

Limited Food Selection for Resistant Eaters

May be limited to 3-20 different foods

Food selections have similar traits, such as color, texture, or easy to chew

May be limited to just one food group – breads and cereals

Most resistant eaters love carbohydrates & omit foods from the fruit and vegetable group

Adverse Reaction to New Foods

May include tantrums and/or gagging

Fear of new foods

Developmental stage for typically developing two- and three-year-olds

Resistant eaters usually have extreme reactions (won’t come into the room when food is presented)

Food Jags

Eating the same foods in the same manner over long periods of time

Limits opportunities for experiencing new foods

Can be a part of normal development but should be cautious if the food jag continues for more than a few days

Developmental Delays and other Medical Concerns

Neuromuscular disorders, developmental delays, and medical diseases can interfere with chewing, swallowing, and digestion

A large % of resistant eaters have health related concerns

Children that have been tube fed as infants or young children are frequently resistant eaters

Always check with your Doctor and Speech Pathologist to make sure your child has adequate oral motor development

Eating is a Learned Behavior

Eating is both physical and sensory

The most complex behavior children engage in

Takes every muscle and organ to eat

It is a 25 to 32 step process (up to 100 steps for children with autism)

Oral/facial movements are difficult in children with autism and developmental delays

Feeding and Eating is a Process

Five Major Steps to increase the variety offoods children eat:

TolerateInteract withSmellTasteEating

Understand that feeding is a process

Getting a child to accept new foods is a process that must be broken down into steps

Steps to Tolerating New Foods

1. Willingness to be exposed to new food

2. Willingness to be in the same room as the new foods

3. Ability to allow a new food on the table

4. Reduce anxiety of new foods

5. Increase awareness of food groups

6. Increase knowledge of the mouth and the digestive system

Keep it Fun!Continually reassure your child that they

will not have to eat the foodFollow the procedures until the child is

comfortable with each step in the processWarn your child before proceeding to the

next step in the processNever put large quantities of food on

the table or on your child’s plate

Keep it Fun!

Talk about and watch videos about healthy eating and healthy foods

Go through food magazines and check food books out from the library to look at with your child

Save food boxes and cans for your child to play with

Steps to Interacting with Food

Increase willingness to touch a variety of foods

Reduce anxiety when touching food

Explore new foods with hands, feet, and other parts of the body

Increase awareness of various textures of new foods

Provide an environment that encourages exploration of new foods

Steps to Interacting with Food

Interacting with food by touching is the next sensory stage for acquiring a taste for new foods. Babies often learn about new foodsby smearing it on their high chairs or in theirhair. Learning to touch new foods can beintroduced in many fun and exciting ways.Wearing food is as much a part of the process as eating food.

Fun Activities to Help Your Child Interact with New Foods

Painting with fruits and vegetablesPlay Hot Potato with a variety of different food

items (apples, oranges, squash, boiled eggs, so on)

What is in the Box? (put different food items in a box and have your child try and guess what is in the box)

Finger paint with foods such as pudding, yogurt, whip cream and food coloring, or cake icing

Fun Activities to Help Your Child Interact with New Foods

Use gummy bears, fish crackers, fruit loops, dried pasta, and other foods to make art projects.

Check out food counting books from the library such as The Cheerios Counting Book, The Raisin Counting Book, The Fish Cracker Book & The Gummy Bear Book. Use real food when reading the books with your child.

Use rollout dough to make cookies and other shapes.

Tolerating Food SmellsThe sense of smell is closely linked to successful eating

Willingness to bring food closer to the mouth

Experience a variety of new food smells

Identify food by smell from different food groups

Produce a calming effect by smelling foods

Positively link smell with eating new foods

Tolerating Food SmellsSmell is an essential component of eating

and can bring strong reactions

The resistant eater may have more anxiety

at this stage because it requires them

to bring food closer to the mouth

Continue to reassure your child that

they don’t have to eat the food

Reducing Food Anxiety through Smell

Select foods that have a calming effect for your child such as apple, cinnamon, and vanilla

Present food in non-threatening way by using small containers with porous lids

Only present one to three items at a time when introducing smells

Once the child has been presented with the scent then open the lid of the container for the child to visually inspect the food item

Use lemons, oranges, and other foods that can be squeezed and played with

Reducing Food Anxiety Through Smell

Use scented markers, stickers, and glue to complete art projects

Play games involving matching scents

Help your child cook items such as cinnamon toast, popcorn, and cookies to serve to friends

Make scented play dough with your child

Tasting New Foods

Tasting new foods begins with licking the item, holding a small bite on the tongue and finally chewing a small portion

Allow the resistant eater to spit food out by providing a place for the child to spit the chewed food into

Combine familiar tastes such as sauces or dips with new food items to help in the transition

Tasting New Foods

Begin by selecting foods close in texture and taste to the new food item. (For example: french fries & tator tots)

Always try several new fruits such as a slice of peach or banana

Select foods that are child friendly

Tasting New Foods

As the child becomes more successful then begin to vary the flavors and range of tastes

Have ice water to assist in waking the mouth and cleansing the tongue after tasting a new food

Activities for Tasting New Foods

Write rules for tasting and spitting out new foods, review before each session

Have the bucket available for all activities

Activities for Tasting New Foods

1. Hide the Food Use small food items such as raisins, peas,

fish crackers, & grapes Have your child hold it in his mouth, and then

spit it out in the bucket Model this for your child Encourage your child to hide the food in

different places in their mouth such as under the tongue, or between their cheek and gums

Activities for Tasting New Foods

2. Use music and songs for eating Use the tune of “Hokey Pokey” with the

words, “You put the pea in, you take the pea out, you put the pea in and you shake it all about.”

Repeat the activity several times using different types of food.

Activities for Tasting New Foods

3. Bite ArtUse 3 – 5 food items that are hard enough to

bite (apples, carrots, cheese, lunch meats, cucumbers)

Discuss the different types of teeth and how they are used

Look at teeth in a mirrorModel biting by leaving teeth marks in the foodEncourage your child to participate in the bite art

activity

Activities for Tasting New Foods

4. CookingLook through a child’s magazine or cookbook

with photos with your childHave your child choose a recipeMake a shopping list together; use pictures if

neededShop together if your child can go to the grocery

storeMake the recipe together allowing your child to

participate as much as possibleGive your child the opportunity to serve the food

to others

Activities for Tasting New Foods

5. Bobbin’ for FoodsHave a shallow dish with a small amount

of water in the dish, place slices of cucumbers, apples, & carrots in the tray

Model picking up the food with your teeth and dropping it into a bucket

Model picking it up and taking a biteLet the child try to pick the food up and

drop it into the bucket

Addressing Food Jags

Provide structured choices by having your child choose from a list of foods (provide choices for plates, utensils, and cups)

Make slight changes in the presentation of the food (mac & cheese - use different noodles & different brands)

Include your child in food preparation & presentation.

Expect appropriate behavior during meal time

The Meal Environment

Should be supportive & the child is not forced to eat

Have a set routine for transitioning to the table Wash hands Select plates and

utensils for the meal Put food items on the

table Pour drink

The Meal Environment

For escape behavior (tantrums) set the time and remove the child when the timer rings

The child may leave when the timer rings but no computer access until the meal is completed by the family

If your child leaves the table due to behavior, do not allow him to return or eat until the next scheduled meal or snack

If your child throws food, he must help in the clean up after the meal is completed

If your child is consistently being removed from the table, your rules may need to be adjusted

Rules for Meals & Snacks

1. Keep food on your plate

2. Use utensil to serve food from bowls

3. Remain in your seat until the timer rings

4. Let an adult know when you are done (Use your words or finished card)

5. Place all unused food items in the trash

6. Written or visual rules should be posted and reviewed before every meal or snack

Meal/Snack Schedule

Have a schedule that is understandable and predictable to your child

Use a timer to indicate when the meal/snack will begin

Use a timer to indicate the length of the meal/snackOffer at least one preferred item at every meal/snackProvide only water between the meal/snack times

Eating New Foods

The goal for everyone is to enjoy a meal!

If your child has successfully completed all the developmental stages, they will be able to eat a balanced diet without fear of new foods.

Your child will not like every food and that is OK.

Working with resistant eaters is an ongoing process, and returning to the strategies given may be required several times as your child gets older.