Note: The following blog post is based on a Bierman Caregiver Webinar.
In this blog post, we are going to discuss the potential causes of picky eating and provide tips that you can try at home to improve this behavior.
Eating and feeding is a complex set of skills. There can be some medical issues surrounding picky/selective eating. Therefore, it’s essential to contact your child’s physician first regarding any feeding concerns you might have. Potential medical conditions must be ruled out before beginning a behavioral feeding treatment so they can determine if there are possible underlying medical conditions. If your child does not have any medical conditions regarding selective eating, then we welcome you to try these intervention techniques to expand their diet!
First, you should identify the common issues you are experiencing at home. Ask yourself “why are they avoiding trying new foods?” You might also notice your child only eating the same small set of foods. If they’re not adding new foods into their diet, the number of things they’re eating will continue to get smaller. Other issues may be selectivity around brands, texture, or color. They might only want to eat Cheez-Its or yellow-colored foods, limiting the number of foods that your child can eat and things that they’ll try. Another common issue found is a lack of variety across food groups. With a lack of trying fruits or vegetables, kids may avoid things that may have a different texture or taste bitter. The final issue to watch out for is the behaviors exhibited during mealtime. Examples are refusing to sit for meals, refusing to sit without preferred items or activities, or engaging in challenging behavior while at the table.
These issues can result in a lot of different challenges for your family. One of them is creating separate meals. Becoming that “short-order cook” where your child doesn’t want to eat what everyone else is eating and now you’re having to make a second meal for them. Going out to restaurants can be challenging because your child will only eat a certain brand of french fries or only eat pasta prepared in a certain way and therefore, they’re not going to be able to be flexible enough to eat meals prepared differently at a restaurant. Going out in general might be cumbersome, such as going to parties or other family members’ houses. You might have to prepare food or snacks to bring so you can feel confident that your child will be able to eat when they’re there.
After you have ruled out any underlying medical issues, you want to set up some consistent mealtime routines and expectations. To start, try some behavioral interventions to incorporate some new foods. You can also reach out to speech and occupational therapists, as they can be really beneficial in helping you work on fine motor and oral motor skills.
Good Mealtime Behaviors
To limit “drive-by” eating and snacking, you will want to set-up a schedule of only allowing a few snack times per day and avoid having snacks out that are easily accessible at any time. This is because if they have access to food all the time, by the time dinner rolls around, they’ll no longer be hungry. You also want to set up consistent mealtimes. This helps them figure out how to follow their hunger signs and eat when they’re hungry and stop when they’re not hungry. You also want to limit distractions at the table if possible. If you already have an iPad or something to help keep your child at the table, that can be helpful. Additionally, you want to avoid making separate meals after refusal. If they refuse to eat the original meal and you make them a new one, then they are more likely to continue to do that in the future. To avoid this from occurring, try and get them to continue to sit at the table, and over time, there might be less refusal.
How to Incorporate New Foods
There are five categories here of behavioral interventions that you can use to try and get some new foods involved and the categories are to make it fun, start small, integrate slow changes to texture, color, and shape, combining new and preferred foods, and reinforcement.
Make it Fun
It can be really hard to get a kid to eat something that they just don’t want to eat, so trying to make it fun and engaging can be helpful. Playing with their food and making it fun and exciting can help make the experience more enjoyable and encourage them to try new things. For example, you can take french toast sticks and have them jump into a syrup swimming pool. Whether or not your child eats or doesn’t eat french toast, you can still get them to touch and interact with those things by playing around with it. You can also add food coloring, cut food in interesting pieces, buy food in fun shapes (e.g dinosaur nuggets). Most importantly eat with them and model good behaviors.
Taking a piece of food and cutting it up into tiny pieces can help make the response effort really small. Eating a tiny piece is going to be a lot easier than the whole fruit. This reduces the effort, it makes it seem less scary, and is an easy to get some progress going and try something new.
The first change you can make is color. You can start by buying some foods that naturally come in different colors (e.g., multi-colored goldfish). Shape and packaging can be tricky as well. Some kids are going to get really stuck on the packaging, they’re going to know exactly what the package looks like that they’re familiar with, and they’re going to want to stick to that package. You can incorporate different brands by putting them into neutral containers.
Combine New and Preferred Foods
When it comes to this technique, you’re taking something they really like and adding something a little bit new to it. A lot of our kids like mac and cheese and so if they’re okay with different colors, such as, seeing a little bit of green, we recommend chopping, tiny bits of broccoli and putting that into mac and cheese.
Depending on what you’re working on or what the issue is, you can provide reinforcement for anything that you want to see an increase. You can also reinforce any positive mealtime behaviors that you’re seeing and make sure they keep occurring in the future. This could be sitting for long periods of time at the table or tolerating new foods sitting on their plate (even if they don’t eat it). If we can’t immediately start with taking bites of new food you want to work on all of those little skills that work up towards it. Skills like smelling, touching, licking new foods, anything like that as long as they’re making independent contact and they’re moving along and making progress. We also recommend starting with just a single bite, that bite can be followed by a bite of food that they really enjoy. You can do that several times at one meal, it doesn’t have to be just one bite and then you’re done for the day.
It can take anywhere from seven to eleven exposures to develop a preference for new food. So don’t give up if you offer it once or twice and it doesn’t go well! Doesn’t mean it won’t be food that eventually your child will come to really enjoy. If you need more help and you need a more individualized plan or need some feedback on where to start but you’re not sure exactly where to begin, reach out to your BCBA at Bierman Autism Centers and they can help you develop a more individualized plan.