Picky eaters and problem eaters

picky eaters and problem eaters


Meal time.

For parents with young children, sitting down for a family dinner may not always be the quaint scenario they imagine. Parents may claim their kids are picky eaters, but in some cases, children can experience true food aversions. How's a parent to know if a child simply doesn't like a food versus having actual issues with the eating process?

Pediatric Therapy Partners Speech-Language Pathologist Stephanie Jordan says the line between those distinctions comes down to numbers; a "picky eater" will consume at least 30 different foods, but a child with a food aversion will consume fewer than 20.

"Sometimes, it could be as low as two foods," Jordan says.

Also, kids like to take breaks from food. In the case of a picky eater, a food can be reintroduced at a different time; for a child with a food aversion — often called a problem eater — he or she may never return to eating that food.

The response to a particular food may indicate something more than preference. Pediatric Therapy Partners Occupational Therapist Sharon Drewlo says a picky eater may simply make a face at food but someone with an aversion will have a much more emotional response, possibly running from the room or hiding under the table.

Drewlo says no "typical" aversions exist because kids are so different in their personalities and experiences. Sometimes, kids are avoiding entire food groups, textures or colors.

How does an aversion happen?

Aversions can take shape in a variety of ways, whether they develop from an oral issue or possibly a sensory one. Children who have difficulty chewing or swallowing typically work with a speech therapist to correct those actions whereas a child with fine motor development issues would engage an occupational therapist. Sometimes, both experts are needed.

"We look at the whole child and the many things that influence the eating process, from motor skills to postural control to cognitive and sensory properties," says Drewlo, who has 28 years of experience working with kids in a variety of settings.

People not realize it, but eating is a complicated process that involves 32 different steps; one bite requires 26 muscles and 6 cranial nerves.

"It's one of the most complex human tasks," she says.

What can parents do?

One of the most important issues to address is simply the act of meal time at home, Jordan says. When it comes to learning how to eat, modeling is best.

"We always encourage families to eat together and let the food become center stage by eliminating distractions," says Jordan, who has more than 10 years of professional experience. "Serve the food family-style so kids can participate in the act of taking food and putting it on their plate. Talk about the food in a positive way."

Drewlo pointed out that involving kids even before they can eat is a helpful way to expose them to a variety of food.

"We don't like the phrase, 'Don't play with your food,' because food play is often a part of our therapy," she says. "Let them get messy with food, especially if they have sensory issues ... Eating should be a fun, positive experience."

Drewlo points out that food involve many sensory components before it ever reach the mouth, so it's important for children to learn about them before consuming a food.

For parents struggling with a child unwilling to try a food, be patient. It takes 10-15 times of trying a food before a child can decide if he or she likes it, Jordan says.

And never punish your child for not eating a particular food, Drewlo says. Instead, say, "When you're ready, you can eat it." And being ready may not be at that meal time.

Kids may grow out of eating issues simply because maturity allows them to become more adventurous eaters.

However, if parents sense issues at a young age, early intervention is required to they won't balloon into more serious problems.

Jordan and Drewlo provided a few guidelines to help parents assess where a child falls on the eating continuum:

• By 10 months of age, a baby should be eating pureed foods.

• By 12 months, the child should have moved on to table foods.

• A school-aged child should be eating foods from each food and texture group.

• A child who eats fewer than 20 foods may require therapy. Make a list of every food the child will consume and a therapist can help categorize them by type or texture.

• A child who takes a very long time to eat may be experiencing an oral motor issue.

• Behavioral issues could stem from food aversions.

"Sometimes you hear the saying, 'If a child is hungry enough, they'll eat,' " Jordan says. "For a true problem eater, they actually will not eat."

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