My Child is a Picky Eater: Part 5
Behavior Modification Strategies
This article will highlight some specific strategies you can use to help your child overcome picky eating. Hopefully you have had the opportunity to do some self-discovery about how your reality is created by your thoughts, words and unconscious use of language as discussed in the personal awareness article.
There are so many reasons a typically developing child will reject food. Up until the age of about 5, children are developing and learning about food—texture, taste, temperature, flavor, color, smell and variety. As you are all too aware, the pressure is on for you to provide adequate nutrition and have your child eat it in a timely manner.
,Let’s say your child has a refusal to try a food because of the way it looks or smells and immediately refuses to eat it. Developmentally, toddlers are learning all about control in a variety of ways like bowel and bladder control, expanding on fine and gross motor skills and control, choosing what clothes to wear (or not) and choosing what foods they will eat and drink. Inconsistency is a common pattern in toddler behavior. The reality of the food refusal is all about control—and an expression of feelings, including fear.
Nicole Schwarz, a parent coach has some great tips for developing and keeping your relationship with your children and partner strong and vibrant. She talks about positive parenting, which is about keeping calm so you can connect and help them through those big feelings so you can teach lessons effectively. It is more about looking at your child’s behavior instead of punishing it away. As the caregiver, awareness of your child’s age, developmental stage and brain maturity, and the ability to take appropriate action during each situation of “acting out” behaviors is key to all aspects of your child’s development—including eating. You will then be gaining greater insight into whether your child is sleepy, overwhelmed, being fearful or testing limits.
I really like her statement that self-regulation is the most important skill for children to learn in early childhood. Remember, a toddler up to about five or six years old is learning this vital skill, and children are not “miniature” adults. They are developing, not small developed humans. During this stage of life, you are helping set the foundation to learning about self-regulation and it is the foundation which will be built on as your child grows into a young adult. It is current belief that our frontal lobes in the brain do not fully mature until around age 25 or so and self-regulation is a process. Here is a link to and great article by Nicole Schwarz: https://imperfectfamilies.com/3-things-about-child-development-every-parent-should-know/
Behavior modification
A basic concept of behavior modification is that you will pair a wanted activity with something pleasurable (reward) to encourage the desired behavior. This involves understanding what motivates your child—for some it is a tangible item such as time with electronics or a particular toy. For others, it might be praise or one-on-one time with a beloved caregiver. For still others, especially with food, they might only eat a certain color of food (orange/brown) or eat only crunchy foods.
If you do not know what motivates your child, especially if your child is displaying developmental delays and troublesome behaviors such as that of those on the autism spectrum, take some time to observe what they gravitate to and how/why they interact with others. Write down what is motivating for your child during a typical day. You will then begin getting clues and be able to begin creating a strategy for increasing eating behaviors. The book “Food Chaining” has great ideas to help with introducing foods AND helps with behavior strategies.
One strategy a mom I work with began using is to pair taking bites of food with the reward of walking outside. This simple strategy has motivated her (developmentally delayed) child to actually put something in her mouth that is food related. Mom is thrilled and small gains are being made.
Another strategy used often is to completely withhold electronics until mealtime is over and the desired new food is at least tasted and swallowed, and build on increasing food intake with the reward over time.
The list below details more strategies. The list for strategies on your role (the adult) is more extensive than your child’s role. This list is by no means comprehensive. This list is to get you thinking about ideas you can use at mealtimes. You can also use these strategies for dressing, getting ready for bed and a number of other activities during your day. It is the concepts I am attempting to impart to you.
Strategies on your part:
- Understand where your child is developmentally, not in chronological age
- Understand power struggles are a typical part of development at this age and struggles at the dinner table are a perfect place for power struggles
- Understand that self-regulation skills are being developed at a young age so you will observe tantrums, high energy, impulsiveness, inconsistency and extreme mood swings
- Understand that children can and do have times when they eat a lot and times when they eat not at all
- Understand that most children only need about a tablespoon of food per food group per year of age per meal
- Understand that children might have to be exposed to and taste a new food 10-20 times before accepting it to eat a lot of it
- Understand that this is a process
- Expose your child to a wide variety of foods
- Create a relaxed environment for eating as best you can
- Have the expectation that your child will eat what the rest of the family is eating
- Do not become a personal short order cook everyone eats the same meal
- Avoid adult arguments about your child’s behavior at the table
- You and your partner agree to back each other up and support each other (in private)
- Calmly encourage your child to taste a new food using the verbiage “you don’t have to like the food, you just have to taste it”
- Be gently firm and consistent with your limit setting
- Address food refusal as a behavioral, not a feeding issue
- Decide what it is you are willing to accept as food intake at any particular meal
- When you set a goal and the child meets that goal, do not ask for “one more bite”
- Please do not reward your child with sweets if they eat what you want them to eat—in fact, don’t offer sweets at all, they don’t need it
- Offer vegetables with every meal, including breakfast
- Offer your child choices all during the day—it provides the child a sense of control to be able to choose, it is under your control what your child is choosing
- “Do you want green beans or broccoli?” (both are green)
- “Do you want green beans or carrots?” (a green and orange color choice)
- “Do you want 6 or 10 green beans?” (Understand your child doesn’t know how to count yet and it is offering a choice and giving the child power)
- “Do you want special sauce on your eggs or regular sauce?”
- “Which plate do you want to eat out of?”
- “What fork do you want to use?”
- “Do you want to walk or bear crawl to your chair?”
- “Do you want the blue cup or the red cup?”
- “Do you want carrots or sweet potatoes?” (both are orange)
- Provide casual intermittent praise during the meal—i.e,: “You are eating like a big girl” or “Wow, what a great eater”
- Ignore crying, disruptive and tantrum behaviors at the table and praise those behaviors you want (don’t overdo the praise though or you will have a child expecting praise for everything they do)
Anytime you attempt to change or modify a behavior, bear in mind that the behavior will probably become worse before it becomes better. The reason is simple: your child has no idea what it is that you actually want and it is human nature to revert to a comfort level of known behaviors. By being clear with your words, consistent with your expectations, praising the wanted behavior and ignoring the unwanted behavior you will be able to “shape” the new behavior. It might take multiple meals to do it. Consistency is the key.
If you have tried multiple strategies and you are not successful, or your child has medical needs or suspected deeper eating issues (sensory based, etc.), please seek professional help. Look for occupational therapists or speech language pathologists that specialize in feeding/eating disorders.
If you have a problem feeder, the main goal is to create a positive feeding environment where reinforcement of normal, healthy eating patterns occurs. One of the keys to food acceptance is food exposure and keeping yourself cool, calm, collected and following through. Another key is having the understanding that feeding issues are usually about control and is a behavioral issue. Keeping mealtimes positive really helps. Frustration, discipline, and too much pressure won’t make the problem feeder eat better or more—and it may make the child shut down and eat poorly.
Consider seeking professional help if your at-home efforts aren’t working, your child is losing weight, failing to grow well, or is getting ill frequently—a sign of poor nutrition. Trust your instincts, especially if what you have tried has not been successful over the long term. Look for occupational therapists or speech language pathologists that have specific training in eating and feeding disorders. The sooner you address the issue, the easier it is to address.
I could literally write a novel about strategies you can use. In fact, there are several great books on the market written for challenging eating situations. The one that really stands out in my experience and that is easy to read and implement is: “Food Chaining” by Cheri Fraker, CCC-SLP, CLC, Mark Fishbein, MD, Sibyl Cox, RD, LD, CLC, Laura Walbert, CCC-SLP,CLC. It is my “go to” book.
As I was surfing the internet, I discovered these nice blogs:
https://www.bundoo.com/articles/is-your-child-a-problem-feeder/
https://imperfectfamilies.com/set-firm-limits-without-power-struggle/
Hopefully you gained some insight after reading this blog series and have implemented some of the strategies I listed.
I am available if you need me.
Rosemary Slade, PLLC, OTR, NC is a practicing occupational therapist and mineral-nutritional practitioner. She can be reached on this website. This article is not in any manner, shape or form intended to be considered or construed as medical advice or providing a medical diagnosis. This article is for entertainment purposes only. Please see your medical doctor for medical diagnoses.