Many parents are well familiar with children’s picky eating. Sometimes a child may only want to eat one type of food or only certain textures. Children become picky eaters for a variety of reasons such as being sensitive to certain smells or tastes or even seeing others refuse food. However, as parents, we have an obligation to make sure our kids are getting a well balanced diet. To this end, I would like to present to you a few food acceptance strategies that keep the dinner table a place where your family can come together for quality time rather than it becoming a battleground.
For this strategy, it’s important to identify a preferred food for your child. At meal time, break the non-preferred food into small, bite-sized pieces. Tell your child that he or she must eat one piece of the non-preferred food before getting a piece of the preferred food. Over time, you can gradually increase the number of bites of the non-preferred food while keeping the one bite of the preferred food. Eventually the child will be able to eat an entire meal without having to have a preferred bite until the end.
Another strategy developed by Meier, Fryling, and Wallace (2012) uses a high-probability sequence. This is appropriate for kids who consume some foods but not others. Break the non-preferred and preferred foods into small bites. At the table, give your child three bites of the preferred food, one bite at a time, 15 seconds apart. So that’s preferred food, 15s, preferred food, 15s, preferred food, 15s. After the third 15s set, place the non-preferred food in front of the child. If he or she eats it, then wait 15s and present the preferred food again starting the sequence over. Over time, you can gradually reduce number of preferred food bites one at a time until the child is just eating the non-preferred food. If, after the first non-preferred food presentation, the child refuses (pushes it away, says no, etc.) remove the non-preferred food, wait 15s and then start over.
If the above food presentation does not work over multiple sessions, then another procedure might be more appropriate. This one, created by Piazza, Patel, Gulotta, Sevin, and Layer (2003) is a procedure for total food refusal or for those that the above treatment was ineffective. In this protocol you identify a preferred toy or other activity. You present the food with the instruction, “Take a bite.” If your child accepts the food within 5s, give lots of praise and access to the preferred activity or item for 15s. Remove the toy and wait 15s more, then present another bite of food. If the child spits out the bite, he or she cannot have the toy or activity for this bite. Simply pick up the food and represent the bite by holding the food up to the child’s lips. Be sure not to provide any attention for spitting out the food (i.e., don’t say something like, “That’s not what we do with food” or “don’t do that,” etc.). Simply hold the food to the child’s lips for the duration of the session or he or she eats it, whichever happens first. If the child does not eat the food at all during the initial 5s, put the food up to his or her lips and tell him or her to “Take a bite” once every thirty seconds. This should continue until the session ends or the child takes a bite, whichever comes first.
While this is not an all inclusive list of procedures to try when a child refuses food, this is a good place to start. If none of these procedures seem to help the situation, be sure to ask your behavior assistant and Behavior Analyst for help. Hopefully these procedures will make the table a place for family get-togethers rather than a battle over eating!
References
Piazza, C. C., Patel, M. R., Gulotta, C. S., Sevin, B. M., & Layer, S. A. (2003). On the relative contributions of positive reinforcement and escape extinction in the treatment of food refusal. The Journal of Applied Behavior Analysis, 36, 309–324.
Reed, G. K., Piazza, C. C., Patel, M. R., Layer, S. A., Bachmeyer, M. H., Bethke, S. D., & Gutshall, K. A. (2004). On the relative contributions of noncontingent reinforcement and escape extinction in the treatment of food refusal. The Journal of Applied Behavior Analysis, 37, 27–42.
Meier, A. E., Fryling, M. J., & Wallace, M. D. (2012). Using high-probability foods to increase the acceptance of low-probability foods. The Journal of Applied Behavior Analysis, 45, 149–153.