Archive

Archive for November, 2010

Another Bad Tip for Feeding the Hypersensitive, Orally Defensive or Sensory Processing Disordered Child

November 30, 2010 1 comment

HYPERSENSITIVE or Orally Defensive children are not your typical picky eaters. — photo by Anna Migeon

In my last post, we looked at Amy, one of those children generally considered to be on the autism spectrum, with neurological and physiological causes for being a picky eater.   Amy was diagnosed as “hypersensitive to oral input” or “orally defensive.”

Such children should be under the supervision of a doctor to make sure that their nutritional needs are met. But as with all children who resist eating, the family dynamics and relationship around eating can either aggravate the problems, or ease them.

Amy’s parents do their best to get her to eat. Most recommendations they’ve been given for getting their hypersensitive child to eat involve various forms of pressure and urging. The more desperate they are to get her to eat, the more she digs in her heels, saying her throat “feels swollen up.”

If pressuring your child to eat doesn’t work very well, as it doesn’t with Amy, doing more of the same probably won’t work any better. It may be time to try something completely different.

Bad Tip #4: “Praise her for trying or eating things.”

What could be wrong with affirming and approving your child, who has such a troubled relationship with food, when she does manage to eat?

Amy is a child in ongoing distress. She’s hungry yet can hardly get food down her throat. She needs to feel unconditionally accepted as well as to feel capable and in charge of herself and her own eating. We want to increase her level of comfort with the food itself, not take advantage of her desire for acceptance to control her and to increase the pressure on her. Being watched, fussed over, urged, and evaluated only turns eating into an even less pleasant experience.

“I’m so proud of you for trying the beets!” sounds like positive reinforcement— hardly qualifying as “pressure”— but  it actually underlines the idea in the child’s mind that eating beets is an act of self-denial, the disagreeable thing you do to make your mom happy.

Praise or  any other such tactics to control her and pressure her to eat just causes Amy to retreat further. Even more than most of us, she naturally resists a push. She needs, even more than the typical child, to take the lead in her own eating.

Instead of Praise for Eating:

  • Switch the environment of pressure to eat to one of letting her come after food as she is able.  Allow her to pursue food for herself instead of feeling she must defend herself against its onslaught or eat something that disgusts her to gain her parents’ approval. Assume she is hungry and wants to eat if she can. Don’t use the power as the parent to get the child to do what you want, even it is “for her own good.” Make only good choices available, then support and reassure rather than pressure her. Let her be in control of her own eating. Your child shouldn’t be eating to please you or for any other reason than to enjoy it and to feel satisfied by it, in the friendly company of her family or friends. Give her the dignity of as much self-control as possible. Avoid giving her any cause to refuse to eat out of rebellion. Back off and let her take the initiative to touch, sniff, taste.
  • Remain as neutral, casual and calm as possible about her eating.  Denying her feelings and difficulties or expressing anger, as frustrating as it all is, will only make matters worse. It’s not fun for her, either. Your hypersensitive child doesn’t start out refusing to eat to make you crazy or to be bratty, though as with any child, that element tends to develop under pressure.

Getting excited when she does manage to eat something different may increase the pressure on her and detract from her own positive feelings about the eating itself. The flip side of the praise coin is criticism. If we praise, what will stop us from criticizing when it doesn’t go as we want it to? If we act like eating is a behavior, good or bad, and judge her for it, how is she going to feel accepted when she can’t help being an extremely picky eater?

Try to accept her problems as the way things are and move forward with as much cheer and nonchalance as you can muster.

  • Let her take the lead about whether she wants to talk about her eating and how she feels about it. Don’t use your own feelings to pressure her to eat. Accept and acknowledge her negative feelings. Instead of praising, reflect and name her own feelings of satisfaction about eating.

***

Coming soon:

How to support and encourage a child who has difficulty eating

More Bad Tips for Feeding Hypersensitive, Orally Defensive or Sensory Processing Disordered Children

Related Post:

Three Bad Tips for Feeding Hypersensitive, Orally Defensive or Sensory Processing Disordered Children

Three Bad Tips for Feeding Hypersensitive, Orally Defensive or Sensory Processing Disordered Children

November 23, 2010 4 comments

ORALLY HYPERSENSITIVE children are not your typical picky eaters. — photo by Anna Migeon

Amy, age 8, will only eat a few things: little beyond a certain brand of macaroni and cheese, bean and cheese tacos, very smooth mashed potatoes and apple sauce put through the blender again.

As a baby Amy had trouble sucking. She grew slowly. She finds most foods too salty, spicy, lumpy or gritty, or even too hot or cold. She abhors all toothpaste. Once she threw up when she licked a sticker. She screams at the dentist. If she tries something she can’t swallow, it triggers a higher level of resistance, even to what she would normally eat.

Diagnosed as “hypersensitive to oral input,”  or “orally defensive,” Amy isn’t your run-of the-mill picky eater. It’s not her parents’ fault. It’s not all in her head, but rather in neurological differences in her brain. She is physically, clinically, more sensitive to what goes in her mouth than the average child. Also known as “supertasters,” children like Amy sense and respond more intensely than the typical child.

Amy’s parents dread visits to the doctor, where they hear that she needs to eat more and get more fruits and vegetables, and how she’s deficient in various nutrients.

They’ve pushed her to eat since she was born. Pushing has never worked, so their strategy, based on expert advice, was to do more of it.

Let’s look at some of the tips Amy’s parents were given, and how doing just the opposite is likely to get better results.

1.   “Make an incentive chart to get her to eat.”

Imagine how you’d feel if you gagged easily over food, and someone is there, always urging, pressuring you to put certain things in your mouth. Even for children of easy-going temperament, pressure to do  what is physically repulsive to you probably just makes you want to do it even less. But for a child who is oversensitive, wouldn’t it just makes a tough situation worse?

My friend Cynthia, a normal adult, told me how she once went out to eat with a guy who, instead of letting her choose her own meal, ordered for her. When the crab came, she told him, “Oh, I’m allergic to crab.” But, she told me, “I love crab.” Like children do, she was asserting her own ability to choose for herself.

When Amy, unlike Cynthia, starts out actually not wanting to eat the food in question, think how much more resistance arm-twisting can create. Children don’t like to be over-controlled any more than adults. We all like our freedom. A reward for eating might get Amy to eat something different — this time — but only decreases her desire to eat it in the future. She may want the reward, but turn out resenting what she has to do to get it all the more.

Eating is not behavior, good or bad. Even oversensitive children come equipped with their own motivation to eat: hunger. That’s what we need to leverage. Pressure doesn’t increase the drive to eat; it kills it, especially for the child with difficulties in eating.

The pressure and manipulation of an incentive chart also reinforces the idea that eating is an unpleasant task and makes the eating environment even less positive. It makes for added tension and resistance.

2.   “Put fruit and vegetables on her plate consistently.”

Again, pushing only aggravates the problem. Instead, just put the food on the table. Children can and should be required to join the family at the table and behave, but never pushed eat. Let them take the initiative and decide what goes on their own plates and in their mouths. No pressure. Let hunger, and nothing else, lead the way.

Children who are urged to eat risk becoming like Cynthia with the crab, or like the wild mice who were brought into the lab and trained to turn on their own light and running wheel. If a human turned on their light or wheel, the mice would exercise “foolish freedom” and turn them off, even to their own detriment.

Even more than the average child, the hypersensitive child needs to feel free and unpressured at the table. Let her ask for what she wants. Once a child feels safe from urging, that is the best hope of her being open to trying something new.

3.    “Focus on making her just try things.”

The best chance of Amy eating is her coming to the table hungry, seeing and smelling the food from a safe distance, and feeling her own prompting to put it in her mouth. Let the food sell itself. Messages of “you should” and “you have to” alert her and put her on the defensive. Parents of a hypersensitive child have enough natural resistance to contend with; the last thing they need is extra resistance that arises directly due to their own pushing.

Any child, even an orally defensive child, will naturally come to food on her own because she is hungry. Studies show that children are more likely to eat something at first and again later if they are allowed to approach the food of their own free will.

It is better to pull food away, let her see that she needs to pursue the food if she is hungry, rather than defend herself against it. Orally defensive children especially need to be in control what’s coming toward their mouths. They will be hungry and they will figure out something they can manage to eat on their own.  Restrict access to food you don’t want her to eat, provide only good choices, and allow her desire for good food to build. That’s all the pressure she needs, from within.

###

Related posts:

Three More Bad Tips for Feeding the Hypersensitive Child

How to Use “Negative Reverse Selling” at the Dinner Table

Foolish Freedom: Why Some Kids Refuse to Eat Even to the Point of Harming Themselves


Six Lessons from English School Lunches

November 14, 2010 1 comment

WHY DO KIDS TEND TO BE LESS PICKY about food when they eat school lunches than they are at home? photo by Anna Migeon

In England, it was recently discovered that picky kids were less picky when they ate school lunches than they were at home. The benefits carried over to home, with many kids coming home and asking for the same foods they were getting at school. It happens that in England, home-packed lunches were found to be generally higher in sugar, fat and salt than the school lunches there. So encouraging parents to let kids eat school food instead of mom’s home-packed lunches seems to be getting them to eat more healthy at school as well as at home.

There are several probable reasons for this reduction in pickiness at school.

But today’s question is:  how can we recreate the conditions of an English school lunch, at home? How can we make home more like school in ways that will increase kids’ eating of good food?

1.  Leave kids to eat, or not, in peace. No hovering. No pressure in any form, including praise, rewards, charts, or dessert bargains. Let hunger motivate them to eat what is available: only healthy choices.

2.  Create a pleasant, friendly environment at the table. No negative talk about food or urging them to eat. Talk about more interesting subjects.

3.  Continually introduce plenty of healthy new meals, designed to tempt.

4.   No snacking outside meals, so they’ll be hungry for your food choices.

5. Don’t give in and follow a child’s lead on food.  Determine the best options for your child and stick to them. Don’t provide bad choices just to get him to eat. Let him adapt to you, and he will.

6.  Don’t take fussiness seriously.  It’s not written in stone. Just as we don’t assume kids will stay in diapers their whole lives because they wear them now, or assume they’ll still be sucking on a pacifier till adulthood, we don’t go along with their temporary aversion to taking baths, for example. We don’t assume our son will never like girls because they have cooties when he’s eight.  We don’t encourage them to be entrenched in childish ways or deal with them out of the expectation of the label “picky.” No, we give them a chance to change their mind and grow up, every day. We encourage them to be open to good things, and we have faith in them.

***

Why some kids in England ate at school but not at home

November 12, 2010 1 comment

CAN MEALS AT HOME go as well as school lunches? -- photo by Anna Migeon

An English mom, Donna Lovett of Norwich, recently started her “fussy” son, Connor, on school lunches, sure that he wouldn’t eat a thing. She was surprised to see that he loved the school food. He even got into fish and vegetables, she noted. It’s opened the way to serving foods at home she didn’t think were “possible” before.

recent report from The Food Trust in England has revealed that four out of five kids who ate school lunches there started trying new foods at school that they would never have eaten at home. Half of those children also asked their parents to make some of the dishes that they’d tried at school.

This study came out to encourage parents to have their kids eat at the school cafeteria, following an earlier study that revealed that many parents were packing unhealthy lunches for their children, “because they worry that they are too fussy to eat anything else.”  Lunches from home proved to have considerably more sugar, fat and salt in them than a school lunch. Not surprising if kids are dictating the menu.

Unfortunately, there’s a major difference between American school lunches and their English counterparts. In England, schools are required to meet (maybe they do) reasonably nutritious standards (maybe they are).  In any case, school lunches are apparently healthier than the lunches a lot of parents were sending in with their picky kids. “Naked Chef” Jamie Oliver succeed in bringing better lunches to English schools, as he tried valiantly to do here, so school lunches probably are considerably better than the average American school lunch.

Maybe I’m wrong, but I don’t believe parents can do much worse than what most American schools are feeding kids.

Since we in America don’t generally have reasonably nutritious school lunches to leverage in getting our fussy eaters to eat more healthful foods and broaden their minds about eating, what can we American parents do? Can we learn something from the success of the English?

Let’s start by looking at some possible explanations for why Connor is willing to eat all kinds of food at school that he wouldn’t eat at home.

Why did Connor eat better at school than at home?

1.  When Connor found himself at lunch time at school without his narrow range of junky foods that his parents thought was all he liked, and since he was in school all morning and probably hadn’t eaten a thing since breakfast, he was hungry. Mom wasn’t there to provide any alternatives to the school food. Crying would get him nowhere, besides being embarrassing. He decided to eat what was available, and discovered that quite a bit of it tasted pretty good. Especially after eating the same junky stuff all the time.

2.  The group dynamic: the other kids were probably eating it, and seemed happy enough, without much discussion.

3. There were more interesting things to talk about at lunch at school with his friends than what he was or wasn’t eating, so he was distracted from his fussiness. His friends weren’t concerned about whether he liked the food or ate it or not or stayed hungry. It was his problem alone, and suddenly not a terribly interesting problem.

4.  Absence of adult pressure and hovering to extinguish their desire to eat. The teachers didn’t care either about what or whether he ate, or how many bites he took. Even if they did care, which is doubtful, they didn’t have enough time to scrutinize and hound all those kids at once. So he figured he might as well eat what he felt like eating, all on his own. There was no one to fight about it with, so what good would it do to be picky? All he’d get out of food refusal would be immediate hunger, and probably the bored looks, or worse, of his classmates.

So how can we recreate the conditions of an English school lunch, at home? How can we make home more like school in ways that will increase kids’ eating of good food?

Related  posts:

Six lessons from the English School Lunch

“Stealth health” or “psychological nudges”? Getting kids eating better

The Codependent Mom: feeding your child’s food addiction

Interview with Paul Gratkowski: Picky eater grows up to go from obesity to fitness, learning to like veggies along the way

November 4, 2010 Leave a comment

Paul Gratkowski, right, has biked about 40,000 miles in the last four years. He learned some secrets about enjoying vegetables on his way from bad health to exceptional fitness.

This year will be the third year in a row that Paul Gratkowski, 44, will bike over 10,000 miles.  Today, he’s obviously in great shape. He also now loves eating healthy. But Paul grew up as a picky eater, and ten years ago, he was “on the road to an early grave,” as his doctor told him.

He started out young, biking a lot, and made some epic bike trips in his 20s, including going from Los Angles to Boston in 42 days, averaging 82 miles a day. But he couldn’t keep it up once he hit his 30s.

“I had to come to terms with the fact that my body would not allow me to continue to smoke and drink and to eat poorly, and to exercise at that level,” he said. “The booze, bad food, and cigarettes took over and I ballooned up to just under 300 pounds.”

I asked Paul, almost 100 pounds lighter today, about picky eating and his journey to health and healthy eating today.

SA: So you were a picky eater as a child? What’s the difference today?

Paul: Since I am such a health nut now I eat food for what it does for my body instead of what it tastes like.

SA: That’s kind of sad. It’s great if you can have both.

Paul: I do like veggies now.

SA: How did you learn to like veggies?

Paul: I prepare them in a way that I can enjoy them more, in Chinese food, for example. I like it fresh and crispy. I rediscovered asparagus. I now sauté it with garlic and it is one of my favorites that way. Sauteed asparagus is like a totally different animal than the way it was served when I was a child. It is crisp, not mushy. I use a low-fat spray with chopped garlic… so simple.

SA: OK, I like that approach. Preparing healthy food so it tastes good. Isn’t that what everybody should be doing?

Paul: I am down 85 pounds in seven years, so people are always asking me about what I eat. Believe it or not I am the food authority around here!

SA: How did you come to make that change?

Paul: The doctor gave me a “come-to-Jesus” talk. I would probably be dead by now if I hadn’t changed. He said I wouldn’t live past 50. Nearly every lab test was bad. I had high blood pressure, and was on the verge of developing diabetes. I decided to make some major changes in my life. I totally gave up alcohol and cigarettes. I started the long road back to fitness. Most of it came off with an insane amount of exercise. I also owe some credit to Weight Watchers. I have been a member for five plus years and am currently a lifetime member. I’m also a recovering alcoholic, still in Alcoholics Anonymous. I am now in the best shape of my life at 44. All of my lab tests are now good, my blood pressure is normal, and I have an extremely low resting pulse rate: in the high 40’s to low 50’s on most days. I helped a friend move recently and I did the work of the three 20-somethings who were also there helping. I would keep moving while they took a smoking break. I feel as if I have regained my youth!

SA: That is awesome that you eat smart and lost all the weight, got in shape and enjoy eating well. That’s a great success story.

Paul: Ah, geez.

****

Posts about picky eaters:

How to get kids to eat at the table: The Push-Pull Principle

Picky kids and the codependent mom: three tips to break the cycle