ABA

Strategies that can be reviewed and individualized during my picky eating consultations can help parents. Picky eating in children can vary significantly, ranging from mild avoidance of certain foods to more challenging behaviors during mealtimes. Understanding the spectrum of food selectivity is crucial.

The following is a brief overview of how food selectivity may present in children, as well as some resources that may present in children, as well as some resources that may be helpful in your search to support your child…

What is Food Selectivity in Children

Children develop selective eating patterns over weeks, months, and years. Multiple factors contribute to this behavior:

• Stemming from genetics, psychological influences, and triggering events like a choking incident.
• Even if a child seems to be more sensitive to taste, texture, or other sensory aspects, most children can broaden their food choices.

Defining Selective Eating

What is selective eating? Things to know: It occurs on a broad continuum!

Selective eating exists along a broad continuum. For parents, it might translate to statements like, “My child refuses new foods” or “My child eats very little!”

• Limited Diet: Children exhibit preferences for specific foods based on placement, closeness, temperature, or form.
• ARFID (Avoidant/Restrictive Food Intake Disorder): Fairly New – Children who are extremely picky eaters may get diagnosed with ARFID by a medical practitioner. ARFID may lead to poor growth and nutrition. Behavioral Intervention strategies may help increase eating behaviors in those diagnosed with ARFID, however, parents/caregivers should consult with a medical practitioner first.

Causes of Selective Eating

How did my child become a selective eater?

Understanding the origins of selective eating involves considering the following:

• Medical issues – this should always be ruled out before seeking behavioral consultation for selective eating.
• Patterns of eating that become increasingly restricted over time – when coming from a behavior analytic perspective, keep in mind what is known about the behavior and the history of reinforcement (positive and negative). If access to specific foods, attention, and routines were provided/removed over time (and functioned as a reinforcer for behaviors), then selective/restrictive eating behaviors were learned and reinforced over time.
• Problems with sleep – evokes irritability and lower threshold for variation and novelty when it comes to eating for some.
• Conditioned taste aversions – association of certain foods with symptoms of being sick or other aversive effects in the environment (e.g., smells, sounds, visuals)

Working on Selective Eating Behaviors

Identifying when selective eating impacts daily life.

• Impacts day-to-day functioning and the ability to participate in family/social routines without additional preparation and/or modifications
• Nutrient intake
• Evoking novel challenging and interfering behaviors

Effective Interventions

What are the most effective interventions for selective eating behaviors?

Effective interventions incorporate various elements:

• Positive Reinforcement: Utilizing reward systems, behavior contracts, and praise.
• Incremental Changes: Gradual steps towards expanding food choices.
• Multidisciplinary Support: Collaboration with professionals like dieticians and therapists.

Proactive Strategies for Success

Deploying proactive strategies is key to addressing selective eating habits.

• Timing and Location: Choosing the right time and place for introducing new foods.
• Visual Supports and Reward Charts: Visual aids and reward systems outlining expectations
• Pairing Preferred Activities: Associating preferred activities like music or TV with meals.

Food-related Strategies

Tailoring food presentation and choices:

• Type and Amount: Offering foods resembling familiar preferences in shape, texture, and color.
• Size Matters: Think about only placing the amount the child is expected to eat on the plate or table.
• Offering Choices: Providing controlled choices with clear boundaries and rewards for compliance.
• Script and Instructions: Plan out what will be said and shown to the child ahead of time.

If the function of the child’s eating behavior is access to tangibles and/or attention in the form of control around choices related to food, proactively build in choice while setting clear boundaries paired with a reward for making a choice – pick choices the family and providers are comfortable with!

• Examples: If rice and pasta are new targeted foods, can say: “Do you want rice or pasta as your side for dinner? When you make a choice and eat it, you can get ice cream for dessert” OR If the target for eating behavior is to increase the amount of food consumed, can present something like: “We are having meatballs with dinner – do you want 1 ½ or 2 with your dinner? When you eat most of the amount you picked out, you can have some dessert when dinner is done”

Navigating a child’s selective eating requires a comprehensive approach involving understanding, tailored interventions, and proactive strategies. By integrating these methods, parents can effectively support their children through the spectrum of food selectivity, fostering healthier eating habits and mealtime behaviors.

Resources for Parents

These books present behavioral interventions to successfully expand children’s diet variety and preferences.

• Broccoli Boot Camp: Basic Training for Parents of Selective Eaters
• Helping Your Child with Extreme Picky Eating: A Step-by-Step Guide for Overcoming Selective Eating, Food Aversion, and Feeding Disorders

Frequently Asked Questions (FAQs)

What Characterizes Selective Eating in Children?

Selective eating manifests across a spectrum: from mild preferences to Avoidant/ Restrictive Food Intake Disorder (ARFID), a more extreme form causing nutritional deficiencies. It encompasses limited diets, food preferences, and potential sensory sensitivities.

When should concerns about Selective Eating be Addressed?

Intervention becomes essential when selective eating impedes daily function, impacts your child’s nutrient intake, or leads to disruptive behaviors. Seeking help is necessary if a child displays extreme pickiness that affects their growth development and overall well-being.

How can parents encourage the exploration of New Foods?

Providing options within the child’s comfort zone, offering clear choices, and linking preferred activities to mealtime can motivate children to expand their food repertoire while creating a positive eating environment. Choosing a similar taste, color or smell is a good starting point.

What contributes to Selective Eating Habits?

Selective eating can arise from various factors, including genetic predispositions, psychological elements, and past experiences such as conditioned taste aversions or medical issues. In addition, challenges in sleep patterns could contribute to heightened food selectivity.

Written by Sudha Ramaswamy, PhD, BCBA-D, LBA

Proloquo2Go – Symbol-based AAC and Proloquo2Text

Proloquo2Go is a complete communication solution providing many natural sounding text-to-speech voices, three complete research-based vocabularies, over 10,000 up-to-date symbols, powerful automatic conjugations, advanced word prediction, multi-user support, ease of use and the ability to fully customize vocabularies to meet the needs of individual users from beginning symbolic communication to full literacy. The voices available are a more natural sounding male, female adult or child. The keyboard and picture/text grids can be used for novel sentence building. The images on the buttons are SymbolStix, although the user is able to use real pictures and some pictures are a more life-like cartoon drawing.

Children with Autism:

A visual schedule is a wearable picture-based scheduler designed with children and adults with autism in mind. Using the iPad or iPhone app, a caregiver can make a visual schedule for the wearer. There are icons that are already included and additional icons/photos can be uploaded to the app to make custom icons. The schedule can then be sent to the wearer’s Apple Watch and will alert them when he/she needs to change tasks or start a new task. The app also allows the user to check on what he/she is supposed to be doing at any point in time. Because this is a wearable visual schedule, the user has access to it at all times eliminating the need to keep up with a paper schedule or another device.

Pictello:

This is an easy-to-use application that allows teachers and caregivers to create social stories and schedules with their children. It can be used to recount what you did during the day or weekend by uploading photographs of those particular events.  This makes story-telling and recalling information much more powerful and fun with visuals and a voiceover. Pictello makes it easy to create a story step by step. It also makes them much more effective by letting you add realistic details like photos, videos, and audio recordings. The Text to Speech voices included in the app are also helpful if you want to use voiceovers.

Find My Family, Friends & iPhone – Life360 Locator:

This is a wonderful application for children and teens with autism, Family Locator by Life360 is an intuitive tracker app to keep family, friends and caregivers connected. Life360 runs on your mobile device and allows you to view your family members on a map, communicate with them, and receive alerts when your loved ones leave and arrive at home, school or work.

Behaviorsnap:

This is a great application for caregivers and therapists alike.  It allows for multiple behaviors to be counted simultaneously within one direct observation. Also four observation types: Interval, Frequency, Duration, ABC. This app is fully customizable for individual children for Frequency, Duration and ABC observations. It also determines frequent triggers and maintaining consequences of problem behaviors. It provides a sophisticated design and meaningful graphs that can be shared in a confidential PDF format.

Choiceworks:

Choiceworks is an application for helping children complete daily routines and tasks, understanding and controlling feelings and to improve their patience. Caregivers, teachers, and therapists use this app with students diagnosed with autism (verbal and non-verbal), ADD, and other learning disabilities to keep them on task and motivated.  There are four boards for Schedule, Waiting, Feelings and Feelings Scale.  An Image Library is preloaded with over 180 images and audio plus you can add your own images, videos and record your own audio for limitless customizability.  One can easily create profiles to personalize and manage multiple users and save an unlimited number of boards for multiple children or different routines.