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*The information on this blog and website is for informational purposes only. It is not meant to replace careful evaluation and treatment. If you have concerns about your or your  child’s eating, nutrition or growth, consult a doctor.

Giving Your Teen a Self-help Book About Picky/Selective Eating

Giving Your Teen a Self-help Book About Picky/Selective Eating

Maybe you’ve given up hope. Maybe you decided fighting over every bite wasn’t worth it so your teen fixes a bowl of cereal or you pick up a plain burger and fries on the way home from work most nights. Maybe you are still trying the bribes, rewards, nagging, punishment tactics you’ve been doing for years.Maybe you eat dinner alone and your teen eats and texts in their room.Now there’s a new book, Conquer Picky Eating for Teens and Adults. We want your teen to have this book, that’s why we wrote it after all. We’ve heard from parents who are planning to buy this book for their teen. We’re glad… but we advise caution. For those of you who have read our first book (Helping Your Child with Extreme Picky Eating,  geared towards parents of younger children) you’ll know we review that for most selective eaters, pressure to eat, even rewards and praise, doesn’t work.So, how can you approach this topic of picky eating without your teen feeling it as pressure?  “It is normal for teens to seek independence from parents and this may include rejecting parental suggestions.”Erin VandenLangenberg PhD Ideally, we want teens to come to this work with their own motivations, to feel ready to take control of the process; to explore their past around eating, why they might have had picky eating that persisted beyond what is common for half of their peers. Turns out, temperament can play a big part. We’ve worked with countless families who shared how wonderfully independent and strong-willed their children could be (okay, they didn’t always say “wonderfully”) but you get the... read more
A Journey to Healing and Growth: One Mother’s Telling

A Journey to Healing and Growth: One Mother’s Telling

Bethany’s Journal: Amari’s Journey of Healing   Amari, age two, was adopted at age 14 months from Ethiopia and initially had some hoarding behaviors. After being home for about a year, her eating changed dramatically, with no identifiable cause. While underlying medical causes were being evaluated, Bethany needed help. The following are excerpts from Bethany’s notes and emails on the first few months during the transition from an anxious/pressured feeding relationship to one focused on routine, avoiding pressure, and healing anxiety. This post is largely excerpted from Katja’s first book Love Me, Feed Me,  focused on adoptive and fostering families. Bethany used responsive, trust-based philosophies expanded upon in the STEPS+ approach in our book, Helping Your Child with Extreme Picky Eating. This post is for informational purposes, and not meant to replace care of the individual child.   February 10, day one: A few months ago, she started to get pickier and ate less and less, eventually eating about five bites at each meal and down to two cups of milk a day and gaining nothing. She would pocket and take an hour to finish those bites. In one year home, she grew four inches and gained only nine ounces . . . We saw a nutritionist who told us how to sneak calories into her food. We saw a speech pathologist who determined that the issue was “psych” and barely glanced at her. In the last week, Amari has gotten SO much worse. She hardly drinks 1 and a half cups of milk/day, drinks nothing else, and takes about three bites at meals. I can force feed her more, but she gags constantly and... read more
What is “Responsive” Feeding Therapy?

What is “Responsive” Feeding Therapy?

Responsive feeding therapy is facilitating (re)discovery of internal cues, curiosity and strengths, while building skills (mastery).   “You don’t teach development, development is discovery.” Serena Wieder PhD (video on DIR Floortime)   Responsive therapies respond to each child, meeting the child where he or she is, not following a strict protocol without deviation.         By necessity, this occurs within a relationship. The primary is between the parent and the child, otherwise known as the “feeding relationship.” (Satter, Chatoor…)     Responsive feeding and feeding therapies also happen in relationship between the child and any adult feeding or providing food and meals to the child, and with any therapists involved in more formal therapies.     “Happiness is the most important factor at mealtimes and in therapy programs to help children develop feeding skills.” Suzanne Evans Morris SLP PhD Therapist and author, Pre-Feeding Skills     What do you think? What do responsive feeding therapies mean to you? Share this... read more
Feeding Therapy Approaches Differ When Children Struggle to Eat: Find the Right Help for Your Family

Feeding Therapy Approaches Differ When Children Struggle to Eat: Find the Right Help for Your Family

The article, When Your Baby Won’t Eat chronicles the heartbreak and triumph of one family’s journey with pediatric feeding struggles. The author and mother shares some of the confusion around finding the right help for her family. Virginia Sole-Smith writes, “Do you try to correct the behavior- training a child to eat well –Pavlov Style- or do you try to rediscover that primal urge and trust her to take it from there? It’s a divisive question among the doctors and therapists who work with children like Violet, as well as a debate unfolding consciously or not, around most kitchen tables in the country.” Feeding therapy programs differ; from the ABA, or applied behavioral approach on one end of the spectrum (the Pavlovian approach) where adults may hold a child’s hands down, may use “gentle mandibular guidance” and “escape extinction,” to a more responsive approach where the child’s reactions and behaviors are not viewed as behaviors to eliminate, but as vital communication and clues to guide treatment. Confusing for parents is that many treatment programs, even with opposing approaches, sound the same online, using words like “child-led” and “family-centered” to the point that parents might have no idea what is actually happening in therapy. Parents, we know it is beyond confusing; experts in the field of feeding kids often express opposite viewpoints, with OTs, SLPs, MDs, RDs, PhDs disagreeing on the best ways to treat pediatric feeding challenges. Consider the following sentiments, from folks in positions of authority. Which is “correct”? Never force your child to eat. You’re the parent, it’s the same as with seat-belts, just make them eat it! If your child gags the puree, scoop... read more
Is STEPs+ Approach “Enough” for Children with Complex Developmental or Medical Challenges?

Is STEPs+ Approach “Enough” for Children with Complex Developmental or Medical Challenges?

The following is Jenny’s (SLP, co-author) response to a comment that the STEPs+ approach described in our book, Helping Your Child with Extreme Picky Eating may not be “enough” for children with complex medical or developmental problems. The comment implied that the approach was solely about placing food on the child’s tray day after day; the response follows: “While I understand your concerns about progress with a medically complex child, we feel strongly that our approach can and does work for these children. Using the strategies at home while an experienced therapist guides you and your child in making specific skill gains is the best-case scenario. Putting food in front of a child on the tray doesn’t paint the whole picture. As the director of a feeding clinic, I have worked with hundreds of children who are NOT neurotypical, have multiple complex medical challenges, and who are severe enough in their feeding issues to require feeding tubes, using this approach. Most of my patients and my co-author’s clients have already had other therapies, from behavioral to SOS and sensory play therapies, and haven’t made progress. When the STEPS+ approach is applied, which can often take weeks or months for some families to get the hang of, with attention to gaining skills and addressing issues such as you describe your son having, these children make significant gains over time. Many have their feeding tubes removed. However, it doesn’t happen overnight, and it may not be what every parent feels is right for their child, and that’s okay. What is learned over a long period of time (months or years) cannot be undone and... read more
Facilitating (Not Forcing) Your Child’s Eating (Extreme Picky Eating Edition)

Facilitating (Not Forcing) Your Child’s Eating (Extreme Picky Eating Edition)

“I’m not forcing, I’m just aggressively facilitating…” I was watching a show on Netflix* when I caught this line, “I’m not forcing, I’m just aggressively facilitating.” My ears perked at the words facilitation and force, and of course made me think of children with extreme picky eating, of feeding, and the “aggressive facilitation” that can sometimes happen, even in feeding therapies. There is much research that suggests that when children are pressured or coerced to eat, overall intake, and intake of fruits and veggies decreases.  Here are a few examples… “…approximately half of all mothers and a greater proportion of fathers… ignore the child’s hunger signals and may use force, punishment, or inappropriate rewards to coerce the child to eat. These practices initially appear effective, but become counterproductive, resulting in poor adjustment of energy intake, consumption of fewer fruits and vegetables, and a greater risk of under- or overweight.” (Kerzner 2015) “…stringent parental controls can… limit children’s acceptance of a variety of foods and disrupt children’s regulation of energy intake by altering children’s responsiveness to internal cues of hunger and satiety.” (Brown & Ogden, 2004) Pressure to eat likely disrupts child’s ability to respond to internal cues of hunger and satiety (Carper et al., 2000) Pressure to eat … “exacerbate feeding problems and make mealtimes more negative for both parent and child.” (Harris 1992; Skuse 1993) Pressuring strategies could be implicated in the development and persistence of these problems (Farrow & Blissett, 2008) Pressure to eat predicted food avoidance behaviors: slow eating, emotional undereating, satiety responsiveness (Powell 2011) Parent prompts assoc w/ food avoidant behaviors, correcting for child emotionality and maternal... read more
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