The Picky Eater, Part 2
by Kelly Dorfman, M.S., Co-founder DDR
The ﬁrst article on picky eating addressed biomedical and sensory reason for eating problems. Ruling out or treating these oral motor and digestive issues is always the top priority when trying to improve the diet. The next step is devising a workable plan that encourages better eating and downplays resistance.
Accidental Negative Reinforcement
Parenting a child who refuses to eat is distressing. Hours can be wasted on creative dishes that are spit out. Frustration with the child’s rigidity leads to fruitless negotiations and bribes. When inducements fail, yelling is next. Yet this inordinate amount of focused attention "accidentally" reinforces the very conduct that needs changing. Children need attention and they will accept it whether it is positive or negative.
Eating behavior is tricky to address because even a child with severe developmental delays can refuse food. People like to have power over their environment. Children with sensory issues have a stronger need to control their surroundings in order to lessen their anxiety. In the hopes of avoiding angry scenes, sympathetic parents give up. Giving in also reinforces the stuck behavior by enabling poor eating.
Don’t Force, Don’t Give in
To encourage children to eat better, stick to your goals without forcing. Positive change happens when parents take charge of their own behavior. Because the child is closely linked to the parent, he must shift in response. Psychotherapists insist that you cannot change another person but you can affect the dynamics of the relationship by changing yourself.
Encouraging the Picky Eater
- Step 1- Work on one food at a time. A new food everyday is overwhelming. Pick one item that would improve the diet. If a child already eats ice cream and milk, pudding is not qualitatively better. Consider fruits, vegetables or protein foods (like small pieces of chicken). These foods are often missing in the diets of fussy eaters. Choose a version of the food close in texture to other foods the child eats. Kids preferring soft creamy foods might handle applesauce or pureed chicken soup. For those drawn to crunch try peeled cucumbers or thinly sliced apple. Also consider foods the child liked in the past but no longer eats.
- Step 2- Give your child a small "job". Learning to eat well is a job. The child should be told ahead of time that their job is to learn to eat healthy foods like Elmo, Thomas the Tank Engine or some other figure they like. Their "job" is a doable task, such as taking one bite or in extreme cases, picking up the food. Encourage them to help you select the food by giving them several choices.
- Step 3- Acknowledged only positive behavior. Most fussy eaters will say, "no", when asked whether they want pears or baby carrots. If this happens say, "I see you need help choosing, so I will pick this time. You can choose next time." The child can then see that lack of cooperation changes nothing. Food appearing at dinner (a better time than the morning) is another opportunity for the child to see if resistance works. Keep discussion about the "job" to a minimum. If the task is accomplished, stay warm and connected. Act like you knew he could do it all along. If the child refuses or throws a ﬁt, brieﬂy make sure he is safe and walk away. Say you will return when he calms down. If the job is unﬁnished, become unavailable for anything else the child wants until it is. Sadly, the TV and computer cannot be turned on. You would love to go to the park, as soon as job is done. Do not threaten, "If only you would eat…..". Instead utilize "when; then." When you are ﬁnished eating, then we can read a story. If the child wanders around all evening without eating the food, simply comment that tomorrow you will be working on the job again.
- Step 4- If you are losing your temper; take a time out. We want to teach children that cooperating works. This means staying calm, when they are frustrated and misbehaving. After a long day, this can be challenging. When you reach your limit, give yourself a time out. Forcing the child into time-out rewards bad conduct with increased interaction. Your child needs you to stay calm, so he can get calm.
By focusing on positive attempts at eating, youngsters learn to get attention by cooperating. With consistent application of this principle, even the most ﬁnicky eater can expand his palate.[Initially published in New Developments: Volume 8, Number 1 - Fall, 2002]