In my time as a pediatric occupational therapist, I’ve come to learn that fun is everything. My success rate in getting therapeutic benefit out of an activity is directly correlated to how fun I make it. If I am a kid- will I sit still and complete 10 reps with an arm weight? No. Will I complete a challenge on the rock wall to climb to the top? Absolutely. It’s our job every day to make therapeutic activity the most fun thing on earth, and when it comes to feeding therapy, it’s no different.
Each of us has a very unique sensory system with different thresholds of what our body is able to tolerate. It is biologically advantageous for us to go into protective mode in response to a toxic smell (we leave the area), a loud noise in the house late at night (our heart beats fast ready for “fight or flight”), or a taste of spoiled milk (we gag and spit it out instantly). However, input not normally offensive for the average person can be very insulting to someone with sensory processing difficulties. This is where our picky eaters come in.
Eating is one of the only activities in which we use all of our senses at once, so naturally children with sensory processing difficulties are going to have a harder time. If I’m a child with an oversensitive sensory system food may look, sound, smell, feel, or taste offensive. Imagine- if the touch, smell or even the sight of different textures enters my overly sensitive sensory system- my body might respond to a chicken nugget like yours would spoiled milk! Gagging, spitting it out, throwing it; altogether refusing to interact with it. The behavioral responses you may see are responses such as refusal, crying, throwing the food, or running away. But if you were a child who had an over responsive sensory system causing certain foods to be too much for your body to handle, wouldn’t you try to get out of mealtime too?
When we understand that our children have legitimate sensory processing difficulties that they are working against at meal time, we can start moving forward in helping them become more comfortable with food. We have to change their assaulter into their friend. We have to make food fun. Herein lies the most important part of feeding therapy, the best piece of advice I have to offer; if you want to teach your picky eater to eat, we must decrease the anxiety around food and mealtime first. We have to PLAY.
Eating is not the first goal, positive interaction with food is.
I put the chicken nugget on my head. Uh oh, it’s about to fall, here it goes! Ahhhhhh! Crashhh! Instantly, according to this two year old I am the most fun person in the world with the source of the fun being the food they won’t eat. But they’ll play with it. They’ll put the chicken nugget on my head, touching it, feeling it, getting crumbs on their fingers, smelling it, waiting for it to fall. They’ll squish it to see what it would do in their mouth; they’ll learn all about it. But more importantly they will laugh, play, and enjoy themselves. Suddenly this food isn’t so scary!
Feeding therapy is a slow progression but it absolutely has to revolve around play. We need to explore, play, get messy, and learn about our food before we can ever eat it. Only when we are comfortable and our body has gotten desensitized to the novelty or to the threatening texture will we ever gain any ground in starting to expand our diet.
So, that is why as an OT, I have had a chicken nugget: in a ball tower; in the bed of a toy truck; in a toy dinosaur’s mouth; on a fire truck’s ladder; in a dog’s food bowl; in a racecar; on top of a block tower; and- on my head.
*There are many sensory, motor, and medical reasons that a child may have a limited diet. If you are concerned about your child’s eating, please reach out to your pediatrician and look for an occupational therapist in your area who is trained in feeding therapy to help.*