I spend a lot of time writing and speaking about picky eating. When I say “picky eater” I am referring to a child who has picky behaviors but can learn to eat a broader diet and change the bad habits that are negatively impacting themselves and their families. However, when it comes to feeding disorders there is a continuum of severity. And many of you have children with more severe food aversions.
Approximately two-thirds of children on the autistic spectrum have severe food aversions which can impact their growth and development. While this population of children often has feeding aversions it is in no way limited to them.
Children with medical conditions that have caused pain when eating often have severe food aversions as do children with sensory integration dysfunction. Children with oral motor impairments may also have a severe fear of eating due to their inability to move food around in their mouth and safely chew and swallow.
Children with these severe food aversions are often referred to as resistant eaters or problem eaters.
The Wrong Advice Is Dangerous
As a feeding therapist who has worked with many children with severe food aversions it is scary to me to read information with no disclaimer that says children will eat when they are hungry and they will not starve themselves .
While typically developing children who are “picky eaters” will not starve themselves or make themselves ill, problem or resistant eaters might.
If there is any doubt whether a child is a picky eater or a resistant eater I always recommend seeking professional guidance from a feeding therapist.
Some Characteristics of Resistant Eaters
One of the characteristics of a resistant eater is the limited acceptance of food items. This is often the same with picky eaters but more pronounced and severe in the resistant eater. I have seen children with as few as 2 different foods in their repertoire. Often these children will start with more foods and begin to eliminate them over time.
They may suddenly eliminate a favorite food or bring back an old favorite. These children are also very aware of imperfections in foods, even their favorites such as dark spots, cracks, bumps etc. Some children will also eliminate whole food groups such as fruit and vegetables, or meats. However some resistant eaters will only eat from one food group they have chosen which is often carbohydrates, but can even be meat.
Children with oral motor impairments may only accept pureed foods that do not require chewing. These types of behaviors cause fear and frustration in parents and caregivers. It also causes judgment from extended family members and friends who have never dealt with a resistant eater.
Children who are resistant eaters may also gag and/or vomit when presented with new or disliked food. They may also exhibit extreme behavioral reactions which impacts everyone around them. For these children and their families any situation which food is involved can be scary causing avoidance and isolation.
Feelings Of Isolation
Parents have told me stories of feeling isolated in social situations when they are unable to explain their child’s food aversions to other parents. This often leads them to stop making these social plans in hopes of avoiding these awkward situations. They also express fear of leaving their child in a situation where food may be offered which can lead to social isolation for the child. And in many cases these children need the social experiences the most.
Just like picky eating, problem eating can be improved. However, the process is more complicated, ongoing and most often requires professional intervention with a feeding therapist. Children with severe food aversions will likely struggle with these aversions through adulthood.
However they can become healthier eaters with guidance. When parents begin to see early signs of picky eating and food aversions there are tips that will keep the problem from growing larger and out of hand. Often the best of intentions can unknowingly make a problem worse.
There is No Better Feeling
Just recently when in the company of a good friend and his child, watching his 2 year old eat broccoli and chicken, he exclaimed “There is no better feeling than watching your child eat a healthy meal.”
As I have said before, feeding disorders are all consuming to everyone involved. For those of you who have not had the experience of having a child with a feeding disorder, be supportive to those families you may come across in the future.
And for those of you living with food aversions in your family, change is always possible.
(if you would like your child to eat a broader diet and change the bad habits that are negatively impacting themselves and your family call (914) 488-5282 now to request a confidential consultation)