Pediatric Occupational Therapy

Picky Eating - More than meets the eye.

St clair occupational therapy

As a child, I was an extremely picky eater. The list of foods I refused to eat was far longer than the list of what I would eat. In a rural town in the early ’90s, my Mom’s support network all had the same misinformed opinion that my picky eating was just bad behavior and that my mom simply was being too soft on me.

The understanding of developmental and sensory disorders has skyrocketed in the thirty years since then. Plus, with the internet, any parent frustrated with their picky eater has thousands of resources and a wealth of information on why children experience feeding difficulties.

I was lucky. The foods I liked were enough to keep me adequately fed, and were relatively healthy options. My favorite foods were raw vegetables, plain cheeseburgers, chicken alfredo, and Chinese takeout. Many children who are picky eaters are in a much more difficult situation. It’s common for a child with feeding difficulties to refuse to eat any proteins or vegetables. In more severe cases a child may only have one or two foods they will eat at all. At those times intervention is necessary to keep the child from becoming malnourished as nearly all essential vitamins and nutrients are gained from food.

Feeding difficulties come in many forms such as picky eaters, problem feeders, past trauma, anxiety, swallowing difficulties, inadequate chewing, poor suck-swallow-breathe, and more. Most feeding difficulties we can treat here at Flourishing Lives, and today I would like to highlight another one, Sensory Aversion.

This happens to be the one that, in hindsight, I realize was the cause of most of my picky eating. I still won’t eat peanuts or hot dogs, YUCK! I hate the taste. But everything else I have come to at least tolerate if I need to be polite. I can even pinpoint some of the reasons why I disliked certain textures. I played outside a lot as a kid. I hated foods that were slimy and soft, like cooked onions or bell pepper, and I have a vague memory of cooked green peppers reminding me of slugs (Which unlike in Michigan, are extremely abundant where I grew up.) If you’re not easily grossed out, google ‘banana slug’ and I’m sure you’ll see how I made that connection. I don’t think I ever ate a slug, and my Mom can’t recall any incidents, but sometimes the thought alone is enough to make a solid negative connection.

When we provide treatment for a child with feeding issues we prefer to start treatment outside the kitchen, and we have two major reasons for this.

The first reason is to build a positive relationship with the child. If they come for play-based therapy for a round of thirty visits before we start feeding, they typically have a positive view of coming here. We use our play-based treatment model because we know that more progress can be made if you’re having a good time than if you want nothing more than to leave. It’s backed by roughly 60 years of research, and every day we see it continue to make progress in the children who walk through our doors.

The second reason is to treat the cause, not the symptom. ‘Picky eating’ is often a symptom of a larger problem. Sometimes it is something that might seem unrelated like coordination, strength, or even posture. Try swallowing while your chin is tucked towards your chest, it’s significantly harder! If we treat these things before starting feeding therapy, it will go much more smoothly. As a child becomes better at tolerating tactile sensations they may even start eating more foods independently. Sensory Aversion is something we treat in many of our patients regardless of their feeding ability, and we have a wealth of methods to approach it.

If your child is showing signs of picky eating, Flourishing Lives may be able to help. Call us at 586-293-1234 or email us at to see if your family is a good fit for Occupational Therapy!

Pediatric Occupational Therapy
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