Picky Eating :Diagnosis and Treatment of Food Selectivity
Updated: Sep 25
What is a #“Picky Eater”?A child’s insistence on eating a narrow range of foods on a consistent basis (Williams & Fox, 2008) This is often associated with:◦ An unwillingness to try new foods◦ Insufficient intake and variety to maintain a healthy nutritional status◦ Dependence upon nutritional supplements The Diagnosis of “Feeding Disorder of Infancy and EarlyChildhood” became “Avoidant/RestrictiveFood Intake Disorder” (ARFID)The Criteria for diagnosis (1 or more of thefollowing)◦ Substantial weight loss or absence of expectedweight gain◦ Nutritional deficiency◦ Dependence on a feeding tube or dietarysupplement◦ Significant psychosocial interference.The prevalence of food selectivity or “picky eating” in typically developing children ranges from 10%-35% (Reau, Senturia, Lebailly, & Christoffel, 1996;Wright, Parkinson, Shiptom, & Drewett, 2007).Between 46% and 89% of children with AutismSpectrum Disorders (ASD) are reported to have some form of food selectivity (Ledford & Gast, Some “selective eaters” may eat starches, meats, and dairy products but only a few fruits and vegetables. Some may eat fewer than five foods, from only one or two food groups. Given this continuum, there is currently no classification system for selective eaters based upon the number of foods eaten or the nutritional adequacy of a child’s diet throughout various phases of development it is common for children to have some selective eating. If a child does not outgrow the selective phase, it may persist and becomeproblematic for the child’s health and development. Consuming a limited diet variety can impact a child’s nutritional status. Mealtime problems can limit social interactions and social opportunities for the child and their family. Selective eating can result in stigmatization. Gastrointestinal Disorders that can be associated with this problem are:◦ Reflux◦ Slow Motility/Delayed Emptying◦ Constipation Food Allergies Dysphagia Respiratory Impairments◦ Need for respiratory support◦ Increased respiratory effort during meals Treatment strategies can improve overall behavior in various environments by reducing the child’s aversion to novel experiences and in Selective eating and/or other feeding problems can include medical, oral motor and/or behavioral components (Piazza, 2018)increasing compliance.If your child appears to be having difficulty in this area you should consult a Speech-Language Pathologist (SLP) who will:◦ Assesses the patient’s oral motor skills andfeeding safety◦ Provides recommendations regarding oralmotor exercises, food and liquid textures foreach patient. The SLP will then construct a Feeding goal Hierarchy which will address the feeding issue with the guidance of the family. The family/caregivers are an important part of the team approach to this disorder..