“Picky Eaters” Presented by: Molly Pierce, OTR. Sensory Feeding Challenges Food aversion Picky...
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Transcript of “Picky Eaters” Presented by: Molly Pierce, OTR. Sensory Feeding Challenges Food aversion Picky...
“Picky Eaters”
Presented by: Molly Pierce, OTR
Sensory Feeding Challenges
• Food aversion
• Picky eater
• Small appetite
• Oral sensitivity, hypersensitive gag reflex
• Food Phobia
• Infancy/Toddler, preschool, school aged children
Infant Toddler
• As infant may present with poorly organized suck, swallow pattern.
• Reflux, medical complications
• Poor state regulation
• Sensory sensitivities to touch, sounds, oral, tactile, movement
• Early satiety
Strategies for the Infant
• Sensory oral preparation• Non nutritive suck• Nipple modifications• Flow adjustment; thickening vs nipple change• Positioning; swaddling, side lying• Environmental changes• Treatment of Reflux• Feeding Schedule
Strategies for the Toddler
• Tactile Oral exploration; finger foods, sensory spoon; oral stimulation
• Lateral placement of foods
• Offering variety of textures; puree, fork mashed, building texture
• Recovery bites of smooth after texture, alternate.
• Offer flavorful foods
Strategies for Toddler (cont)
• Modeling eating, biting, chewing• Drinks offered at end of meal.• Shared control; First – Then, All Done Bowl• Meal schedules; 3 meal and 3 snack, G-tube
feeding after oral feeding.• Sensory Behavior strategies; First – Then,
Motivation
• Daily oral hygiene
Strategies for Preschoolers
• Sensory Behavior Program– Introduce the “My Plate” program; small serving
for each food group– 1-2 bite rule; All Done bowl– Repeat presentation of foods (up to 10-15
exposures)– Creating consistency, structure and mealtime
routines (3 meal, 3 snack) – Tactile exploration of foods– Can use drink to help swallow foods
Strategies for School Age and Older
• Kids often have anxiety, sensitivities to food tastes/textures, and may have history of dysphagia and/or reflux.
• What works:• Scheduled meals and snacks• My Plate – tool to expand the diet and teach the
importance of eating a balance of foods. • Www.myplate.org
My Plate
• My Plate is FDA’s program for balanced nutrition
School Age (cont)
– Offer 1 small serving of food from every category; 2 Bite rule
– “All done" or “Learning” bowl – Food rating chart It can be empowering for kids to
rate taste/texture of foods. – Keep track of new tastes/foods on a sheet of paper
and monitor changes over time.
Food Rating Chart – Tool for Empowerment
Foods Tried
Date I like it It’s OK I don’t like it
School Age (cont)
• Develop reinforcement options - so many bites of new/non-preferred foods earns a sticker, screen time, etc.
• The Sneaky Chef: Simple Strategies for Hiding Healthy Foods in Kids' Favorite Meals
– It is better to develop a child’s palate for eating the healthy fruits and veggies.
• Parents decide WHEN, WHAT and WHERE foods– Child decides whether or not to eat, and how much.
Avoid Power Struggles.
• Treatment for Anxiety – CBT, medication