Once we understand the many reasons a child in our care may struggle to eat, and we understand that selective eating may be a red flag for an underlying neurodevelopmental or sensory integration difference. Then as caregivers, we ask what can I do next? Which practical strategies can I use at home or in school to support a child who is struggling with eating?
The first and most important step is to have a child evaluated by a trained and registered medical professional, it is important to rule out medical conditions. A specialist speech and language therapist will be able to check that a child can swallow safely.
An occupational therapist can assist with feeding and eating difficulties because both feeding and eating are occupations, and so this is their area of expertise. The therapist might look at how eating can be broken down into smaller easier steps that a child can manage, or suggest that you change something in the environment such as finding more suitable seating, reducing noise, smells or distractions. An occupational therapist with post-graduate training in Ayers’ Sensory Integration will be able to both assess and treat any underlying sensory integration and processing difficulty which can be interfering with eating. In this post-Kath Smith (OT) talks about how a child’s gross motor movements, seating and posture can interfere with eating, and how these can be addressed by an occupational therapist.
But what next? what can we do at home and in school to support therapy? How can we transfer the things we have learned from the therapist to our own environments and to the (at least) 6 opportunities a day we get to interact with our kids to support them to become confident, adventurous eaters.
Here are some of the strategies we have tried, every child is an individual and so some ideas will work and some won’t. I also say, its best to take baby steps in the right direction, big changes that happen quickly are not helpful for anxious children. Just make one small change, as they say, Rome was not built in a day!
- Keep an open mind, Listen to what the occupational therapist is saying, you are the expert in your child, but she is the expert in supporting our kids to overcome the difficulties they face. It is very likely that your therapist has seen and treated other children with similar issues before. This works best when we collaborate.
- Ditch the rewards, punishments and star charts.
- Think about seating
- Reduce sensory overload from the environment
- Reduce stress and pressure
- Pick your battles
- Use a visual support
- Try to understand how your child views food
- Make it fun
- Serve a buffet
- Model Model Model…
For more ideas have a look at these blogs and websites
From the Empowered Educator – 15 Strategies to encourage SPD toddlers to eat!
From Ellyn Satter Institute – The Division of Responsibility in Feeding