Strategies to Improve Feeding at Home

Perspectives on sensory, texture, and environmental control factors: tips for picky eaters, feeding problems, and expanding your child’s diet.

Eating is a developmental process which changes over time as the child becomes more confident with his/her eating skills. Many children between the ages of two and three years old are picky eaters because they are going through a state of development where they fear new foods. This state may occur at a later stage in children with developmental delays. The fear of new foods generally improves during childhood. These changes in childhood are normal and most children balance their food selections and eat a nutritional diet over a period of time. Children with special needs sometimes are described as “picky eaters”, meaning they may have limited food selection, show anxiety or tantrums when presented with new foods, and/or require one or more foods be prepared in the same manner. Solving the feeding dilemma is not a quick fix.

Feeding Development: Texture Perspective

“Texture” refers to how smooth, lumpy, thick or thin the food is. This chart describes textures, examples of food, and the age the child generally is expected to handle a given texture:

0 – 13 months	breast/bottle
6 months	thin purees	stage 1 Baby Food
7 months	thick purees	stage 2 Baby Food
9 months	meltable hard solids	Graham crackers, Fruit Loops (foods which dissolve with spit only)
10 months	soft cubes	Gerber Graduates fruits, boiled potatoes, bananas
11 months	single textured soft mechanical	muffins, soft pasta, thin meats in small rectangles
12 months	mixed texture soft mechanical	macaroni and cheese, fries, spaghetti
16 months	hard mechanical	pretzel sticks, ritz crackers, chips

When working with your child with chewing and/or swallowing difficulties, there are a few general principles to keep in mind:

Often times, a child with swallowing problems is able to handle thicker foods and liquids best (e.g. applesauce in apple juice, yogurt, etc).
Chewable foods that maintain a solid mass are often easier to handle (e.g. banana, pancakes, etc).
Food with more than one consistency are more difficult to handle (e.g. soup with veggies/meat).

Feeding Development: Sensory Perspective

Children developmentally learn to accept new foods through their senses such as smell, touch, and taste. Providing children with experiences to learn each new food from its’ sight, smell, and texture often increases their tolerance and acceptance. Here are some guidelines and ideas to promote your child’s sensory development in feeding:

Activities for learning about new foods can be implemented either at the end of the meal or a separate scheduled time dedicated to “learning about new foods”
Graded sensory input (such as background visual and auditory stimuli) to fit the child’s level of sensitivity
Keep it fun without any coercion to explore a new food and maintain a positive and supportive attitude
Activities to “touch” new foods
Painting with food
Stamping with food
Stringing the food items onto yarn to make food jewelry
Activities to “smell” new foods
Placing a food item in the container and have your child smell it through the hole on the top then guess the item
Activities to “taste” new foods
Tasting a new food item begins with licking the item, then holding a small bite on the tongue, and finally chewing a small portion
Allow your child to spit out a new food item during the beginning of the exploration or have ice or water on hand for your child to use
Have your child to make a “teeth mark” on a food item
Invite your child to join the cooking process

Environmental Control Perspective for Picky Eaters

Environmental factors play a key role in developing and maintaining food aversions and problem eating. Environmental controls include scheduling meals, selecting an appropriate setting, creating a supportive climate, designing meals and portion sized, and addressing food jags.

Guidelines for creating the meal/snack schedule to help with consistency and predictable routines:

Write a schedule that is understandable and clear to the child
Use a timer to indicate when the next meal/snack will begin
Use a kitchen timer during the meal to set the pace and length of the meal
Make sure the mealtime schedule includes snacks
Offer the child at least one preferred food item at every meal and/or snack
Provide only water to the child between the scheduled meal/snack time to limit grazing

Mealtime setting should be a comfortable and supportive setting to help your child relax and focus on learning new skills to eat:

Eating and drinking should be done at the table for proper stability and posture
The child should sit in a chair with feet resting on the floor
The number of distractions at mealtimes should be kept to a minimum
Parents, siblings, and peers play an important role during the meal for socialization

Guidelines for creating a supportive mealtime environment for a child to feel supported, safe, nurtured, and trusted to explore new foods/skills:

Respect the child and do not invade his/her mouth without permission
Role–play and demonstrate eating techniques
Never discuss the child’s eating habits or how much he/she eats during the meal
Discuss the taste, texture, and smell of new foods

Portion size and food selection should be presented in a manner that allows a child to be successful.

Provide your child with an age-appropriate sized plate and utensils
It is better to start the meal with smaller portion sizes as it allows the child to see the results when taking a few small bites
A good rule of thumb for controlling portion size is to consider one tablespoon of each type of food for each year of the child’s age

Food selection should take into consideration the child’s age and eating habits. Keep in mind that new and exotic foods can be scary for your child.

Select only one menu for the entire family and include a variety of foods familiar to the picky eater as well as some new foods
Select foods that are child-friendly
Consider texture, color, and smell when introducing a new food
Include a piece of bread or roll with meals since child is often successful with this
Be flexible since the goal is for long-term changes it is ok to miss one balanced meal or not to always have the family eat the exact same meal

Food Jags refers to the insistence on the same food, serving utensils, or even the same setting over long periods of time. Guidelines for addressing food jags:

Create opportunities for structured flexibility and choice making allowing the child to have some choices (foods, dining ware etc) while maintaining the structure of the schedule and healthy choices
Do not cater to the child’s rigidity in wanting only the same foods. Make slight changes in the presentation such as changing the noodle shape for insistent mac-n-cheese eaters
Include the child in food preparation and presentation

Guidelines for implementing appropriate mealtime behaviors:

Resistant eaters often exhibit challenging behaviors during mealtimes due to their persistent food aversions. Be patient and take the time to extinguish challenging behaviors and replace with appropriate behaviors
Set up a routine for transitioning to the table
If the child exhibits noncompliance or tantrums during the meal, calmly remove them to a safe area away from the group
If the child throws food or destroys food, he must clean it up
Analyze your judgment about the child’s behavior in terms of cultural beliefs, messiness, and expectations