If you’re a parent with a very picky eater at home, meals can easily become a dreaded time of day for both you and your child. Over the years, many parents have reported to me that the dinner table transforms into a battleground when green veggies are present or if the pasta is elbow shaped instead of curly. The walls become scarred with alfredo sauce, the floor littered with the skin and seeds of exploded cherry tomatoes, and you’re frustrated by the crater that the spoon left in the ceiling of the breakfast nook when it hit with the might of Hercules! At this point, the parent begins to wonder, “how does my child continue to have so much energy, despite eating so little?” Eventually, it’s easier to avoid the battle, give the child the junk food that they are demanding, and know that they are at least getting something in their stomach.
Many feeding therapy programs fail to include parents in treatment. However, your child is unlikely to change their eating habits at home, even after working extensively with a therapist, if caregivers aren’t specifically taught what to do at mealtime. Many programs offer a fun solution to picky eating that involves turning food into artwork, learning about good nutrition, or just having to tolerate being in the same room with the food item in question. These programs lack support for the child actually eating new foods at home. Sometimes, they make the problem worse by not setting the expectation at the beginning of therapy that bites of food are to be taken, chewed, and swallowed. A clear set of mealtime rules needs to be outlined so that parents can follow these rules at home.
Effective feeding programs focus on the child’s specific behavior and require parent involvement. Parents should be a part of the assessment process, allowing for mealtime intervention to be tailored to the child’s needs. From there, parents may observe therapist-led meals and sometimes be a part of those meals. Once the child begins achieving goals, parent training is an integral part of shaping desired mealtime behavior. It doesn’t end there. It’s common that outside of therapy the reformed healthy eater, with their newly adopted ways, will try to test if they can get away with not eating foods that were added to their repertoire in therapy. Thus, follow-up appointments are key and caregivers who are with the child at mealtime should attend these appointments. Effective feeding intervention requires a time commitment. But that time is better spent early on rather than on the consequences of an unaddressed feeding problem which could include health problems, time spent worrying, and continued frustration at mealtime.
Written by Ben Sarcia, MA, BCBA, LBA