Do any of these statements remind you of your child?
“Mia will only eat a certain brand of chicken nuggets!”
“Nicholas won’t eat anything green!”
“Tracy likes fruit and plain yogurt, but will not eat yogurt with fruit in it!”
“David gags at the smell of cooked broccoli!”
Your child may refuse to eat foods based on their color, smell, texture, and taste. They may also want to play at the table or get distracted by electronics and not want to eat. Picky eating is common for ages 2 to 5 years. However, picky eating may be caused by additional underlying factors. Below, I have gone into the different kinds of picky eating, potential causes, and some tips and strategies to make mealtimes a better experience for you and your child.
Kinds of Fussy Feeders
Current research breaks down finicky eaters differently:
According to Boquin, Smith-Simpson, Donovan, and Lee (2014), there are four kinds of picky eaters:
- Sensory-Dependent Eaters are children who will not eat or touch foods because of how it tastes, smells, or how it feels.
- Behavioral Responders are children who need their food to be prepared the exact way every time, such as crust cut off sandwiches, white not yellow cheese, etc.
- Preferential Eaters are children who do not like to try anything new or mixed together.
- General Perfectionists are children who have very specific needs, such as food cannot be touching each other.
On the other hand, Toomey (2010) compared “picky eaters” to “problem feeders”:
- Picky Eaters – Eat a decreased variety of foods, usually around thirty foods. They can eat at least one food from each food group textures (crunchy, soft, puree, etc.). They usually will eat a food after being exposed to it around ten times. After they get “burned out” on a particular food (they get tired of eating hot dogs), they are generally incorporated back into their diet after about two weeks. Picky eaters also can tolerate new foods on their plate and will even touch or taste a new food even if they are not particularly excited about it.
- Problem Feeders – Eat a more restricted diet usually less than twenty foods. They refuse entire food group textures. They will not try a new food even after ten or more exposures. They can get burned out on a food they ate over and over again, but will not eat it once it has been re-introduced. They will also cry, scream or even melt down if a new food is on their plate and will not touch or taste it.
Causes of Picky Eating
- Sensory Processing Disorder (SPD) – A disorder in which the brain has trouble receiving and processing different sensory stimuli. As you may already know, our senses include vision, touch, hearing, smell, taste, proprioception, and vestibular. A child with SPD may have trouble organizing and appropriately responding to the senses associated with mealtimes. These may include the smell of the food, the texture of the food, the way the food looks, if the food is crunchy, if mealtimes are noisy, etc.
- Autism Spectrum Disorder (ASD) – In addition to the sensory processing difficulties listed with SPD, children with ASD may have disruptive mealtime behaviors such as a short attention span, self-injurious and aggressive behaviors, and repetitive and rigid behaviors (Lukens & Linscheid, 2008).
- Oral defensiveness or hypersensitivity – Those who are overly sensitive to oral stimulation, even a light touch may be uncomfortable or even painful to these children. This can lead to texture and food aversions.
- Avoidant/Restrictive Food Intake Disorder – Those who have an apparent lack of interest in eating or food, avoidance of eating or food based on the sensory characteristics of food, or concerns about negative consequences of eating to the point of malnutrition or significant weight loss (Kreipe & Palomaki, 2012).
Tips and Strategies
- Have them participate in cooking! They will learn about food and get excited about tasting the food they helped prepare. Have them add ingredients, scrub veggies, or help stir. Children are much less likely to reject foods they helped make.
- Offer the child to choose a food (broccoli or cauliflower?).
- Make eating fun! Cut foods into fun shapes with cookie cutters, make faces out of fruits and vegetables, decorate a pizza.
- Set a good example. Try new foods yourself!
- Repeated exposure may encourage them to eventually try a new food. Research says that some children need up to ten exposures to a new food before eventually accepting it.
- Don’t offer dessert as a reward.
- Minimize distractions such as an iPad and the television.
- Talk to each other as a family and include the child in conversations about fun and happy things so that they associate meal times with positive thoughts.
- Have them participate in grocery shopping. Have them be the produce pickers at the grocery store
- Allow your child to explore and play with their food. This allows a kid to explore the foods through their tactile system first. They may feel “safer” exploring different textures through their hands first rather than their mouths.
- Offer only one new food at a time. More than this may overwhelm them. Offer them one or two of their preferred foods during these meals so that they feel more comfortable with their plate.
- Offer the new food at the beginning of the meal when they are the most hungry.
- Keep a routine (snacks at a particular time, meals particular times) to keep their appetite normalized.
- Offer the same foods to the whole family.
- Describe foods you are eating to your child. This may be how it tastes, the texture, the temperature, etc.
- Be patient!
How we can help at Play2Learn
Our team of occupational therapists can help you address the concerns you may have with your child when it comes to their feeding and mealtimes. Aley Babb-Keeble, one of our beloved OTs, specializes in feeding difficulties. She has completed over 100 hours of continuing education in feeding therapy and is certified in the Beckman Oral Motor Protocol as well as the SOS Approach to Feeding program. Schedule an appointment with us so that we can help make mealtime a better time for you and your child!
Boquin, M. M., Moskowitz, H. R., Donovan, S. M., & Lee, S.-Y. (2014). Defining perceptions of picky
eating obtained through focus groups and conjoint analysis. Journal of Sensory Studies,
Kreipe, R. E., & Palomaki, A. (2012). Beyond picky eating: Avoidant/restrictive food intake
disorder. Current Psychiatry Reports, 14(4), 421-431.
Lukens, C. T., & Linscheid, T. R. (2008). Development and validation of an inventory to assess
mealtime behavior problems in children with autism. Journal of Autism and Developmental
Disorders, 32, 342-352.
Toomey, K. A. (2010). Picky eaters vs. problem feeders. Retrieved February 26, 2017, from SOS
Approach to Feeding website: http://sosapproach-conferences.com/resources/