How To Diversify a Diet When A Child Has a Significantly Limited Food Repertoire by Lindsey Biel, OTR/L

How to introduce new foods to a child who is a picky eater? The article, “How To Diversify a Diet When A Child Has a Significantly Limited Food Repertoire” appeared in the March-April 2011 issue of the Autism and Asperger’s Digest under the column Sensory Smarts: Happy Mouths, Happy Meals by Lindsey Biel, OTR/L.  It is reprinted with permission of publisher. Please note that we added the photos and added the words KidCompanions Chewelry in this article.

A mom asked Lindsey Biel, OTR/L for help in getting her child to try new foods because he only ate pasta, pizza, and  ice cream. Her child wanted to eat macaroni n’ cheese almost every meal, and it had to be one particular brand. This mom really needed help in introducing new foods to her picky eater. She needed help in understanding WHY her child was this way. This is the answer Lindsey Biel, OTR/L wrote for her column:

Sensory Smarts: Happy Mouths, Happy Meals

by Lindsey Biel, OTR/L

Do not withhold the few foods that are acceptable. If you take away that one brand of mac n’ cheese, you’re taking away one of the few sources of nutrition for your child, even if it is a poor one. Pizza can be healthy if you buy or make it with high-quality ingredients.

I start by identifying one food the parent would like to add to a child’s diet, typically a fruit or vegetable. If possible, the child selects the particular fruit or vegetable.

Here’s how we approached a similar situation with a client your daughter’s age. She and her mom identified bananas as a food she would consider eating “when she is older.” For about 10-20 minutes each session, we worked on bananas.

What Was Accomplished During Each Session:

• Session 1: We made a collage of banana pictures. Real bananas were within sight.

• Sessions 2-4: she learned to slice bananas and fed them to her mother, in a playful, unpressured interaction. She smelled and felt the banana and observed her mother enjoying it.

• Sessions 5-8: She touched one banana slice to her lips before either feeding it to her mom or throwing it away.

• Sessions 9-12: She touched the banana slice with her tongue and threw it away.

• Sessions 13-14: She nibbled on the banana slice and then spit it onto a napkin.

• Session 15th: she swallowed the nibble.

• Sessions 16-17: She ate one slice of banana.

• Session 18: She ate half a banana.

Now she loves bananas and has selected sweet peas as a vegetable she will eat when she is older.
While you do want to “work on”   just one food at a time, don’t give up introducing new foods. When it’s dinner time, go ahead and serve her favorite food but also make other food available on the table. One exception is if your child cannot bear the smell of a food such as brussel sprouts, which may be so nauseating that she will be unable to eat at all. Remember that it may take dozens of introductions before a food becomes familiar enough to try. Here are a few other ideas:

• Combine acceptable foods with new foods. While your sensitive child will immediately detect when you’ve snuck some peas into her mac n’ cheese, you may be able to get her to dip a “tree” (broccoli) in the cheese sauce. Many kids are willing to try new foods if they can dip them into a favorite sauce such as ketchup, tahini, or salad dressing.

• Try introducing a food that is similar to another food the child already eats, such as a different and healthier brand of frozen pizza or chicken nuggets. Remember, you may have to introduce the new food dozens of times. Change accepted foods slightly to present new textures, shapes, and colors. Break crackers into four pieces instead of two, cut bread into a funny shape. Experiment with food temperatures. A child might try frozen blueberries or snow peas for the novelty of it.

• Avoid empty calories. Don’t let your child fill up on high-sugar fruit juice during the day or snack on high-calorie junk foods like chips. Keep treat portions small. Rather than give a full bag of Veggie Booty (which doesn’t count as a vegetable), serve a small bowlful.

• Provide “oral comforts” that help normalize mouth sensation. These nonfood items are safe to suck and chew on and come in a variety of shapes and textures. Some favorites include: Chewy Tubes, Chew-Eaze, Dr. Bloom’s Chewable Jewels, and KidCompanions Chewelry. You can find these in most therapy catalogs and on the sensorysmarts.com website under Toys & Equipment/Oral Comforts.

• Above all, avoid food battles. Mealtimes are social time, not therapy time. Serve food you know your child will eat when your family sits down for a meal and focus on having a pleasurable family experience.

You may need to work with a feeding specialist (usually an occupational therapist or speech language pathologist) especially if your child has significant oral sensory issues, oral motor weakness, muscle tone problems, or extreme reactions to food. The feeding therapist will evaluate your child’s issues and implement a therapeutic program with a home component. Also investigate supplements such as multivitamins and essential fatty acids to make sure your child is getting the nutrients he or she needs to stay healthy.

End of article

Lindsey Biel, M.A., OTR/L  is a pediatric occupational therapist based in Manhattan, where she evaluates and treats children, adolescents, and young adults with sensory processing issues, developmental delays, autism spectrum disorders, and other developmental challenges.

Lindsey specializes in remediating fine and gross motor delays, visual perceptual skill development, enhancing daily living skills, and improving sensory processing issues. She also helps families and schools to make simple modifications at home and school to enhance a child’s ability to play, learn, and thrive.

Lindsey writes articles for both professional and parenting publications, and is a columnist for Autism Asperger Digest  She is the co-creator of the Sensory Processing Master Class DVD program.

She is a popular speaker, teaching workshops to parents, therapists, doctors, and others on practical solutions for developmental challenges and sensory strategies at home, school, and in the community.

Follow Lindsey Biel, OTR/L  Facebook and website. Read about her presentations.

Resource for helping a child with eating problems The Eating Game™ invented by Jean Nicol provides a very visual, structured, hands on tool that can be a fun way to plan healthy meals every day! The Eating Game was created for a little boy who has autism. He had significant issues with eating as many do, facing challenges that required him to self restrict his diet. It was after much observation that The Eating Game was created for him. He named it a “game” because it was fun!

Find more on eating difficulties and other sensory challenges

•  Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues, by Lindsey Biel, M.A.,OTR/L and Nancy Peske and at sensorysmarts.com.

•  Just Take a Bite by Lori Ernsperger, available in bookstores and online

• Happy Mealtimes with Happy Kids: How to Teach Your Child About the Joy of Food! Practical and Surprising Tips from a Pediatric Feeding Specialist   by Melanie Potock , MA, CCC-SLP available at MyMunchBug.com.

See Also:
Tips On Helping Picky Eaters Try New Foods and Enjoy Mealtimes