Food Selectivity

This month’s issue of Metro Parent highlights an interview with Gateway’s very own BCBA, Jessica Todd. Jessica is a Practicum Manager and Supervising BCBA who has a history working with clients that engage in “food selectivity.” It’s no surprise the article provides families with helpful tips to work with their child at overcoming being selective eaters. The article explains how food selectivity is often overlooked but can eventually lead to type 2 diabetes, chronic constipation, hypertension, anemia, and behavioral issues if left unchecked. Luckily, Jessica provides families with future direction and some guidelines when working on increasing the variety of foods their children eat.

To start Jessica suggests identifying if the child is simply engaging in general food refusal or if eating is a skill deficit. Jessica explains, “with skill deficits related to feeding, the child physically many not know how to chew.” This can become a serious problem if a parent is expecting their child to eat solid foods. She goes on to give an example of “tongue chewing” where a child will use their tongue and saliva to dissolve food before swallowing. Another skill deficit could be that the child is not able to use eating utensils correctly. This child might refuse to eat foods that require these utensils because it takes more effort than eating finger foods. If “food selectivity” is due to a skill deficit, it’s important to teach these necessary skills before expecting your child to increase the variety of foods they eat.

If “food selectivity” is not a result of a skill deficit, BCBAs will often begin with reinforcement interventions to increase the child’s motivation. Jessica provides three different strategies families can use: choices, “first, then” statements, and token boards. When providing choices, the parent will take at least two foods they would like their child to begin eating and allow the child to determine which one they want to start with. To use “first, then” statements Jessica suggests parents “put the non-preferred food on a plate in front of the child and say something to the effect of, ‘first you eat the banana, then you can have M&M’s.” This increases the motivation to eat the non-preferred food and once the child is used to eating the banana you can begin removing the preferred food, in this case the M&M. The last strategy presented is the article is the use of a token board. Each token can represent a specific food, or a specific number of bites. The parent then explains to their child that they need to earn all their tokens before they can have dessert. Token boards provide the child with clear expectations and allows them to see their progress towards a preferred food. Eventually, the token board can be faded out and removed as well.

Jessica understands that these tips can seem easy at first but in a lot of cases children will begin crying and refusing to eat but in her words, “once we get past the initial hump where they learn the new rule, we identify a whole new world of foods they actually enjoy. We’ll start hearing them say things like, ‘I love oranges!’ It’s amazing.”

To read the article in its entirety click on this link: Metro Parent. Also, if you would like further guidance on working through “food selectivity” reach out to your child’s BCBA to collaborate on a program that works for you and your family! Remember to stay up to date with all things new at Gateway by following our social media accounts and blog posts!