Ansbach, Germany – March 19, 2024 – We’ve all known (or been) a child who just won’t touch anything green, or who insists that pasta can only come “plain.” But how do you know if this is typical picky eating or if something deeper might be going on? Our interdisciplinary Feeding and Eating Disorders (FED) Team recently presented a workshop at the Ansbach Health Clinic to help families navigate this question.
Hungry for answers? Start with our quiz below.
Speech-language pathologists (SLPs) can support feeding challenges through a combination of strategies, focusing on both food expansion and oral motor function:
Food Expansion and Sensory Strategies
SLPs help children expand their food preferences by gradually introducing new tastes, textures, and smells in a structured and low-pressure manner.
Oral Motor Function and Safe Swallowing
SLPs specialize in strengthening the muscles needed for chewing, tongue movement, and coordination, which are crucial for safe swallowing. They focus on preventing choking, managing texture transitions (e.g., from liquids to solids), and improving swallowing efficiency in both children and adults. This support is essential for individuals who experience difficulty swallowing, gagging, or choking during meals.
Did you know? SLPs work with both children and adults, especially in cases where swallowing difficulties arise from medical events like strokes. They may coordinate with other healthcare providers for comprehensive care, such as conducting swallow studies.
Occupational therapists (OTs) view feeding as a complex activity that involves the entire body—sensory, motor, and behavioral systems. They provide support by:
Mealtime Support and Environmental Modifications
OTs help develop strategies such as creating structured mealtime routines, modifying the eating environment, and introducing adaptive feeding tools.
Improving Posture and Motor Skills
OTs work to improve postural control, motor coordination, and fine motor skills, which are key to self-feeding, using utensils, and appropriate body alignment during meals.
Resolving sensory food challenges
OTs assess and treat sensory sensitivities and other sensory challenges with sensory play, gradual exposure, food chaining, and texture modification.
You might seek an OT’s help when:
Applied behavior analysis (ABA) uses a data-driven approach to address feeding challenges by focusing on deficits in learning, motivation, and skill acquisition. Common intervention components include:
Reinforcement
Providing praise or rewards when a child engages in desired feeding behaviors, such as trying a new food or participating in mealtime activities.
Systematic Desensitization and Shaping
Gradually introduce new foods through small, manageable steps—such as smelling, touching, and tasting—while reinforcing each successive approximation toward the goal of eating, to build comfort and reduce anxiety around new foods.
Prompting & Fading
Providing enough support for success at each stage, then gradually reducing that support to encourage independence.
Note on funding: While ABA therapy has a robust research base across ages and other demographics, US and German funders often only pay for it in cases of autism. Nonetheless, our ABA therapists are available to consult by private arrangement or, for complex cases, pro bono as members of our FED Team.
Feeding and eating are multifaceted, involving more than just taste preferences. Sometimes, it’s a simple case of picky eating that will resolve over time with patience and gentle encouragement. Other times, a combination of therapeutic interventions can help your child (or even an adult) build a healthier relationship with food.
If mealtimes are stressful at your house or you see any red flags in your child’s feeding, talk with your pediatrician or primary care provider. They can guide you to the right specialist—whether that’s an SLP, an OT, a behavior analyst, or a coordinated team of all three. With the right support, you and your loved ones can find new ways to enjoy the variety and nourishment that food has to offer.
We would like to thank the following contributors (left to right):
Kate Ness, M.Ed., BCBA [presenter]
Justyna Przeperska, M.Ed., BCBA, FED Team Coordinator
Samantha Wagner, M.S., CF-SLP [presenter]
A special thanks to Sparkle George, Exceptional Family Member Program (EFMP) Manager, Army Community Service, USAG Ansbach, for organizing and inviting us to share at this meaningful event.
Simone van der Walt, B.OT., HPCSA Reg. OT [presenter]
Not shown: Elizabeth Kuegeler-Wolters, M.A., CCC-SLP and Daphne Le, M.A., CCC-SLP
