Selective eating in children

Selective eating in children

Hello Josiane,

In my home-based daycare, I have a three year old boy who is very selective in regards to food. Meals and snacks are therefore quite challenging. He does not like to see foods mixed together and he has a problem with several textures. I need help. Another early childhood educator told me that occupational therapy could help this little boy by working on "stimulation zones".

Please provide information about this.

Annie

Hello Annie,

Eating represents a very complex activity since it involves a child's motor skills as well as a sensory experience. The best way to support a child who is selective about what he eats greatly depends on the cause of the problem. Here are a few factors that can lead to food selectivity.

1. Medical problem (breathing, reflux, digestion, allergy, intolerance).
   
2. Motor impairment (poor muscle tone affecting posture, developmental delay affecting movement of lips or tongue, etc.).
   
3. Sensory problem (hypersensitivity to certain textures, tastes, smells) or hyposensitivity (cannot feel his mouth or food in his mouth).
   
4. Sensory problem (discrimination: cannot distinguish sensory characteristics such as tastes or smells).
   
5. Difficulty managing an overly stimulating environment and eating at the same time.
   
6. Conceptual problem (difficulty recognizing food if it is presented differently). Mixed foods make the child particularly insecure if a conceptualization problem is present. In severe cases, the child may be unable to recognize a food item if it is served by a different person, in a different place, on a different plate, etc.
   
7. Anxiety problem (the child is uncomfortable and therefore unable to eat).
   
8. Behavioural problem (opposition).
   
9. Psycho-emotional problem (post-traumatic shock following surgery, choking episode).

As we attempt to understand the child's challenge, it is also important that we consider how the child's environment plays a role in his selectivity. For example, if a child eats well at home, but is selective at daycare, we must consider the presence of anxiety-provoking elements within his daycare setting.

We must also analyze the types of food the child rejects. Does he always refuse the same texture (for example crunchy foods) or taste (acidic foods such as fruit)? Does he only refuse foods that are mixed together? Does the child refuse to eat mixed textures but accept the same foods when they are served separately?

In terms of motor development, we can expect different types of foods to be associated with different challenges. For example, managing liquids does not require the same movements required for eating solids.

When textures are combined, it is more difficult for the child to recognize foods and their distinctive taste. Mixed textures also involve an additional challenge on an oral-motor level. For example, the child can be required to chew a small food item as he retains liquid in his mouth. Certain children choose to simply eliminate these foods from their repertoire.

Finally, it is essential that you question the child's general development. Is food selectivity this child's only challenge? Food selectivity can be a symptom of a bigger developmental challenge.

When serious challenges involving food are present, particularly when they are affecting a child's health, a medical consultation is necessary.

An occupational therapist represents one type of professional who can address the problem, contribute to helping you understand the problem and suggest possible interventions and coping methods. Very often, a nutritionist and doctor are also involved in this process.

Thank you for your question.

Josiane Caron Santha
Occupational therapist