Picky eating is a common difficulty that we as Occupational Therapists address regularly. Picky eating affects many aspects of a child, including their school performance, social skills, as well as their functioning at home. 

What do we commonly observe with picky eaters?

  • Unwilling to try new foods
  • Unwilling to eat
  • Strong preference for certain foods
  • Prefer to drink most of their calories
  • Lengthily eating times
  • Emotional responses to eating
  • Physiological responses to eating such as gagging and vomiting

As a child, I was unwilling to eat in public which caused me numerous difficulties. School camps were especially difficult for me, as we were all expected to sit around one table and eat. I remember crying in the bathroom during school camps, when it came to meal time. Movies were also extremely difficult, as I could not tolerate the smell of popcorn and the sound of people chewing. After much patience and  techniques implemented by my mother, I overcame these difficulties and can now enjoy a meal with others. 

Picky eating can be influenced by many factors such as:

  • Sensory reactivity/modulation – Sensory reactivity/modulation refers to the way we experience sensory input around us. We can be over-responsive (which means we are sensitive to the sensory input), typical, or under-responsive (meaning we don’t respond to sensory input and need lots of sensory input to function). Children that are over-responsive to tactile input, olfactory (smell input) and gustatory (taste input) are commonly picky eaters.
  • Praxis/motor planning – Praxis is the ability to form motor plans and execute these actions. Eating, chewing and swallowing, all require motor plans and differs for each type of food or texture we eat. Very often children with this difficulty find it difficult to tolerate different types of food. For example they will only eat Woolworth’s nuggets and not another brand (as the texture differs). By eating only a known brand, allows them to implement pre-existing motor plans.
  • Traumatic experiences – Traumatic experiences with foods such as pressure to eat, emotional connections to certain food or observed behaviours (for example mom doesn’t like fish), commonly influence picky eating.
  • Oral-motor functions – This refers to the movements of the muscles in the mouth, lips, tongue and jaw and influence sucking, biting, crunching, licking and chewing.
  • Medical conditions can also have a significant influence on picky eating. 

Picky eating (depending on the cause) can be treated by Occupational Therapists, Speech Therapists or Psychologists. As an Occupational Therapist (trained in Sensory Integration), we treat any underlying sensory difficulties, praxis difficulties and modulation/reactivity. The intervention is presented in a playful manner, where children are exposed and treated relating to the underlying difficulty and no pressure is elicited to taste food. The children love this playful approach ta  learn to tolerate foods and to be open to try a variety of food.

Written by Ashley Brecher (Jones)

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