The Manners Monster: 5 Tips for Taming the Beast at the Table

Do you ever find yourself wanting to pull out your hair at mealtimes because your children’s manners are atrocious? I do. From my almost-tween putting his feet on other people’s chairs and sitting sideways while he eats, to my second son burping loudly and using his hands to eat, to my preschooler throwing her food at her brothers (among other things). Sigh. It is a daily occurrence, and it requires even the most Zen of parents to dig deep for that calm place. I find myself asking my husband, “Are we raising a brood of Neanderthals?” But, we aren’t (even though I could swear it at times!). We are raising children, and they are not little adults. They don’t have the social awareness to know that their behavior isn’t appropriate, and it is up to us to gently guide them so they won’t end up being shunned from social gatherings. However, even though we know what the end goal is, there are considerations when we are talking about the acquisition of manners. Much of what seems like bad manners may actually be typical development, or may help children with sensory issues learn about their food. Using hands instead of utensils is normal as little ones explore the physical properties of their food and gain skills with utensils. They may switch back and forth for a while, depending on what type of food it is, how hungry they are, and what their experience and comfort is with that particular food. There is also the possibility that your child actually can’t help it. Consider the elementary-aged child who was constantly told to chew with her mouth closed; she finally was able to...

When “It’s Not Working”: 10 Opportunities to Support Children with Extreme Picky Eating

Helping your child with picky eating, extreme or not, is a marathon, not a sprint… When we work with clients, or hear from parents at workshops or parents who’ve read our book, the STEPS “click” right away for some: their children are less anxious, enjoying meals, and tuning in to appetite and curiosity about new foods. But occasionally we hear, “It’s not working!” Sound familiar? Then this post is for you. Much of the time when families struggle or see no progress, they are still working on getting some (or all) of the steps in place. Perhaps there is unaddressed fear and worry, or families are afraid to go “all in.” We’ve compiled a list of the ten most common opportunities that we see. But first, a reminder in broad terms of the STEPS+ we outline in our book (with chapter numbers for reference) Step 1: Decrease stress, anxiety (yours and your child’s), and power struggles (chapter 4) Step 2: Establish a routine (chapter 5) Step 3: Enjoy pleasant family meals (chapter 6) Step 4: Build skills in “what” and “how” to feed (chapter 7) Step 5: Strengthen and support oral motor and sensory skills (chapter 8) Top Ten Opportunities to Get in STEP and Help Your Picky Eater 1: You and your partner aren’t on the same page. Let’s say Dad makes Timmy earn dessert by eating a bite of veggie, or requires milk with meals, while Mom is trying not to pressure. (A 2014 study found that dads tend to pressure more than moms.) Result: There is no consistent approach, which is confusing for Timmy, and this increases his anxiety! (STEP...

Medscape’s ‘War and Peace at the Dinner Table’: Is MAKING Kids Eat the “Only Way”, and Other Points to Ponder

This clip won the America’s Funniest Home Video $10,000 prize. Is it helping her learn to like green beans?   As clinicians, parents, and experts in childhood feeding struggles, we are concerned about the one-sided nature of the online article and video War and Peace at the Dinner Table: Advising Parents of Picky Eaters, presenting advice to physicians on how to help children with extreme picky eating. Below, we present a discussion and resources for parents and professionals who might like to learn more. First off, we agree with the following points in the article: clinicians should take a parent’s concerns about picky eating seriously (Kerzner), and that ARFID (avoidant restrictive food intake disorder) or extreme picky eating (EPE) impacts family life and the social and emotional development of the child. We also agree that without support, a significant proportion of children will not outgrow their eating struggles and that mealtime “hygiene”, like avoiding grazing, supports appetite and curiosity around new foods. However, we feel that several statements are not supported by the evidence, and in the absence of a widely accepted ‘best’ practice, must be examined. 1) This sweeping generalization: These children don’t have sensory sensitivities. Many children who suffer from ARFID or EPE had medical or underlying conditions and challenges, including sensory issues, that contribute to the establishment of a feeding disorder (Arts-Rodas, Chatoor). The DSM-V ARFID diagnostic criteria recognize three subtypes of the disorder sensory (emphasis ours), associated with an aversive experience, or associated with low appetite. Sensory challenges are at least a contributing factor for many children with EPE, particularly for those on the autism...

“Help! My Child Isn’t Eating at School!” 8 Fuel-at-School Tips for Picky Eaters

School has started for some of us, and will start for the rest of the country soon! A big worry for parents of picky eaters, especially those with more extreme picky eating and anxiety, is what happens at school around food. We get emails with a variation on this theme all the time: “My son is six, we’ve struggled to get him to eat enough his whole life. It’s all worse at school where he is already anxious. He has twenty minutes, and lunch staff try to make him eat which makes him upset. They threaten to take away recess time. He comes home with his lunch untouched most days and is understandably crabby when I pick him up.” Government programs address child hunger, often through schools: from breakfast in the classroom to free and reduced lunches, millions of children are getting fuel for their day. But what about the “hidden hungry”? The kids these programs can’t help? There are hundreds of thousands of kids heading to school every day from homes with enough food and resources. But they are too distracted, anxious or scared to eat.   Helping Your Child with Fuel at School Gather information How much time does your child have to eat? Can he open containers on his own? Is temperature an issue? Does he prefer foods hot, warm or very cold? Is lunch right before recess, so he’s eager to get outside to maximize playtime? Is he eating in his snowsuit or carrying gloves, or has a hat that gets in his way? Are adults or other children pressuring him to eat? Ask him to...

Musings on Anxiety, Sensitivities, and Extreme Picky Eating

Earlier this week, a study came out linking moderate and extreme picky eating with anxiety and depression in children. It has caused quite a stir in the media, with headlines like, “Is picky eating causing depression?” That grabs attention! With one in three parents describing their child as “picky” at some point, the reporting on this study has probably caused more anxiety.  Quick answer, no, typical picky eating, which impacts one in three kids at some point, does not lead to depression, anxiety or ADHD, nor was it associated. A small percentage of children have severe or moderate selective eating which were the two groups associated with anxiety and other concerns. Of note, this study, like all studies had some limitations. Among them, it was voluntary (meaning some parents opted not to partake which could alter findings), and the study followed a portion of the children for a few years, not to adulthood, and didn’t take into account how the challenges were addressed among other factors. The study itself doesn’t claim that picky eating causes depression, another example of how the media distorts science. Here is a nice summary of the study, and below are some more thoughts that we (Jenny and Katja) had on the issue to help parents unpack these scary headlines.   IS picky eating causing anxiety and depression? Do you see anxiety in children with more severe picky eating? This study found a correlation, not causation, between moderate to severe picky eating and other conditions like anxiety and ADHD, which has been suggested in other research. It does not mean that picky eating causes depression or anxiety...

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