Transcript The Challenge With Eating

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 of
foods children eat:
Tolerate
Interact with
Smell
Taste
Eating
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 food
Follow the procedures until the child is
comfortable with each step in the process
Warn your child before proceeding to the
next step in the process
Never 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 foods
by smearing it on their high chairs or in their
hair. Learning to touch new foods can be
introduced 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 vegetables
 Play 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 Smells
The 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 Smells
Smell 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 Art
 Use 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 mirror
 Model biting by leaving teeth marks in the food
 Encourage your child to participate in the bite art
activity
Activities for Tasting New Foods
4. Cooking
 Look through a child’s magazine or cookbook
with photos with your child
 Have your child choose a recipe
 Make a shopping list together; use pictures if
needed
 Shop together if your child can go to the grocery
store
 Make the recipe together allowing your child to
participate as much as possible
 Give your child the opportunity to serve the food
to others
Activities for Tasting New Foods
5. Bobbin’ for Foods
Have 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 bite
Let 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.
2.
3.
4.
Keep food on your plate
Use utensil to serve food from bowls
Remain in your seat until the timer rings
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/snack
 Offer at least one preferred item at every meal/snack
 Provide 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.