Does your child go way beyond “picky” when it comes to eating? Is he down to an extremely small range of acceptable foods? Gagging on certain foods? Or eating in patterns (no red foods, or only foods that are wet, or only dry) that do not make sense to you?
These are symptoms of various kinds of feeding problems, usually labeled behavioral, sensory, or a combination of the two. Feeding problems have many other symptoms as well – but they can be addressed, by things you can do at home and ways we can work with your child here at CTS to address both the symptoms and the underlying issues.
Sensory Feeding Problems
Children have heightened senses compared to those of adults, and this is most obvious when it comes to food. Things that taste great to many of us now – spinach, green olives, spicy foods – were not appealing to us as children. Taste and mild sensory preferences often account for children’s pickiness that lead children to avoid certain foods and for their mothers, for example, to shred zucchini into the pancakes in an effort to get their child to eat vegetables.
But some children have sensory issues that lead them to severely limit the variety of foods they will eat. The look, the smell, the taste, or the texture of food is a major problem for them. They have trouble moving from one food texture to another, or eating might make them gag or throw up.
Behavioral Feeding Problems
Behavioral feeding problems have more of an emotional than a physical basis, and include all the disruptive or problematic behaviors that can come up at mealtimes. They can include things like throwing food, crying or screaming to get out of eating, stealing food from others, or refusing to eat.
Other Feeding Problems
Oral-motor and digestive difficulties can also lead to some of the behaviors listed above – if your child has trouble swallowing or moving food around in his mouth because of weak or uncoordinated muscles in the mouth, surgery, trauma, or birth defects, then eating will of course be difficult. Or if certain foods spark an allergic reaction or disagree with him in some other way, he won’t want to eat them. Reflux and constipation can also interfere with the enjoyment of eating, as can neurological disorders such as cerebral palsy or muscular dystrophy.
Then there’s food selectivity. Typical picky eaters are selective, but usually eat at least one food from every food group. Selectivity goes beyond pickiness to reject entire food groups, or colors, or textures. Food selectivity is a common problem of children on the autism spectrum and with children with other sensory processing challenges.
How can I help my child with a sensory, behavioral, or other feeding problem?
If mealtimes are very stressful for you and your child because your child is extremely selective about what he will or won’t eat, a feeding assessment may be helpful. Please call CTS at 630-444-0077 to schedule or to talk with a therapist. The speech-language pathologist will review your child’s birth, medical, developmental, and feeding histories and may decide with you to conduct a feeding evaluation.
The speech-language pathologist may ask you to keep a 3- to 5-day log of your child’s food intake in the days leading up to the evaluation. You’ll need to list the time of day, and what and how much your child has eaten and drunk.
Comprehensive Feeding Evaluation
CTS’s speech-language pathology feeding assessment evaluates your child’s:
- Oral, facial, and throat muscles, and how well they aid feeding and swallowing
- Posture and positioning while eating and drinking
- Behaviors, social interactions, attention, and awareness during feeding
- Feeding environment
- Food selection and response to different textures, smells, colors, and temperatures
- Ability to use a cup and utensils, bite and chew, and get various consistencies of food through her mouth and down the hatch
The evaluating therapist may suggest that you consult with a pediatric registered dietician who will assess and monitor your child’s caloric and nutritional intake, making specific suggestions based on nutrition needs.
Managing and treating oral-motor and sensory-behavioral feeding difficulties is a team effort here at CTS. We typically include:
- Your child’s physicians: primary care and gastroenterologist
- Our speech-language pathologist
- Our occupational or physical therapist, if needed
- Your child’s registered dietician, if needed