Help! I Have a Picky Eater! - STRATEGIES TO GET YOU STARTED ON THE PATH TO
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Help! I Have a PRACTICAL
STRATE GIE S TO GE T
YO U STARTE D O N
Picky Eater! THE PATH TO
SUCCE SS
Liz Engelsen, MSOT, OTRL
Melissa Czinski, MOT, OTRL
Building Bridges Therapy Center
Objectives 1. Identify who is in the audience and what learning needs are 2. Summarize oral motor, sensory, and miscellaneous factors that affect feeding/eating 3. Provide strategies that include: ◦ Sensory Preparation ◦ Food Chaining ◦ Managing Food Jags ◦ Family Meals and Modeling ◦ Food Play ◦ Food Science
Picky Eaters vs. Problem Feeders
Decreased range but will eat at least 30 different Severely restricted range; usually eat less than 20
foods different foods
Foods lost due to food jags are usually regained Foods lost due to food jags are usually not regained
after 2 week break after a break
Able to tolerate new foods on plate Cry or fall apart when new foods are presented
Eat at least 1 food from most food textures or Refuse entire categories of food textures or
nutrition groups nutrition groups
Frequently eat a different meal than the rest of the Always eat a different meal than the rest of the
family but will still participate in family meals family and usually do not participate in family
meals
Sometimes referred to as a "picky eater" by parents Persistently referred to as a "picky eater" by
at well-visit checkups parents across several well-visit checkups
FACTORS AFFECTING FEEDING
Oral Motor Tongue-moves food around the mouth, holds food on gumline to chew (works with cheeks-both have to be strong enough), ejects food from mouth, moves food to be swallowed Cheeks-hold food on the gumline to chew (works with tongue-both have to be strong enough), help with sucking/drinking, managing liquid in mouth Jaw-Biting, chewing Lips-retrieving food from utensils, drinking from cup/straw, keeping food in mouth (Throat)-swallow
Sensory Processing The 8 Sensory Systems: 1. Visual: sense of sight 2. Auditory: sense of hearing 3. Olfactory: sense of smell 4. Gustatory: sense of taste We make SENSE of the world by 5. Tactile: sense of touch integrating these systems! 6. Vestibular: sense of balance and spatial orientation for the purpose of coordinating motor movement 7. Proprioception: sense of one's body position in space 8. Interoception: sense of what is going on within one's body (ie. hunger/thirst, temperature, pain, emotion, etc.)
Sensory Integration An innate neurobiological process that refers to the way we receive information from our senses, organize it, and use it to participate in daily activities
How does this affect feeding? • ALL of the sensory systems are involved in the feeding and eating process • Eating is one of the only human occupations that involves every sensory system • If our senses are not functioning together properly, we may not be able to tolerate the feeding and eating process • Dysregulation --> trigger fight or flight/stress response --> turns off appetite • We need optimal sensory processing for the feeding and eating process
How does this affect feeding? • ALL of the sensory systems are involved in the feeding and eating process • Eating is one of the only human occupations that involves every sensory system • If our senses are not functioning together properly, we may not be able to tolerate the feeding and eating process • Dysregulation --> trigger fight or flight/stress response --> turns off appetite • We need optimal sensory processing for the feeding and eating process
Photo analysis – What is going on with this boy's sensory systems?
Miscellaneous Factors Postural strength and stability ◦ Seating-90-90-90 Hand-to-mouth coordination with finger foods and utensils Environmental factors: ◦ distractions (SCREENS) ◦ who is eating at the meal ◦ the setup of the room, table, etc. ◦ plates, cups, utensils used Medical Needs Emotional Factors (Stress, Trauma) Nutritional Needs (allergies, sensitivities, etc)
STRATEGIES FOR THE HOME
Goal: achieve total body organization and
regulation prior to meal
Sensory Preparation
PROPRIOCEPTIVE SYSTEM VESTIBULAR SYSTEM TACTILE SYSTEM
• Heavy work (i.e. pushing, pulling, • Slow, linear swinging • Deep pressure (i.e. bear hugs, massage, make
carrying, lifting) - tug of war, catch with a • Slow, rotary swinging a "sandwich" or "burrito" by wrapping
heavy ball/bean bags, exercise) • Rocking in a rocking chair child tightly in pillows/cushions, roll exercise
• Chores (i.e. laundry, dishwasher, clean • Rocking in a hammock or lycra swing ball over front/back of child as they lay, etc.)
up room/toys, carry groceries, shovel • Roll over exercise ball on back or front • Weighted materials (i.e. blankets, lap pads,
snow, etc.) • Invert head for downward dog and vests, or heavy comforters, couch cushions,
• Animal walks, wheelbarrow walks, stomping, other yoga poses etc.)
skipping, or hopping • Peanut rock • Tactile play with play-doh, putty, slime,
• Climbing activities (i.e. monkey bars, sensory bins (beans, rice, sand, etc.), shaving
climbing structures, rock wall) cream, etc. (as long as these are not aversive
• Jumping activities (i.e. trampoline, jump to the child)
rope, leap frog, hopskotch)
• YogaGoal: create "chains" or "links" between foods already eaten and
foods that are slightly different, thus, growing the food
repertoire
Food Chaining
A child-friendly approach to expanding the food repertoire by
introducing new foods that are very similar to preferred foods
in appearance, taste, and/or texture one after the other
Easy to tailor to specific child's needs
Adds foods from start to finish
Especially great for: children who are very visual, children who
are rigid with specific brands or flavors of preferred foods, and
children who have limited play skillsFood Chaining Example From here, we can then try adding a thin layer of butter, toasting the bread more heavily, keeping a very small amount of crust on, etc. We can also gradually progress to thin layers of nut butters, jams/jellies or put two pieces of bread together to work towards a sandwich, etc.
Goal: decrease potential for lost foods; avoid
getting "stuck" on certain flavors, colors, or
textures; improve variability within food
repertoire
Managing Food Jags
How can you prevent
What is a "food jag"? this from happening?
When a child gets "burnt out" on a
food and stops eating it. 1. Decrease the frequency of presenting
a food, even if it is a favorite and highly
requested
How does a food jag 2. Change the way you present the food
(color, shape, amount, prepare
happen? differently)
When a child eats the same food 3. Buy a different variation of the food
very frequently, they get sick of it! (I.e. flavor)
See the "Preventing Food Jags"
handout for more information
and tips to prevent food jagsGoal: connect over foods as a family,
model positive food talk, encourage
learning and exploration of novel
Family Meals and Modeling foods
• Eating together
• When you care about mealtime and spend quality
time here, engagement in food goes up.
• Family style, serving each person (child)
• Learning Plate
• New foods
• Talk about them
• Smell them
• Taste them
• Everyone learns about the food at their comfort
level-there is NO pressure and NO suggesting a
child do "X"A child's main occupation is PLAY Goal: utilize play to decrease
anxiety/fear associated with new
Food play allows for learning foods and replace with fun while
moving up the Steps to Eating
Food Play and creating positive experiences
Interacts With
• Child and adult pass or throw container with food inside
back and forth
• Child uses a food chopper, cookie cutters, or knives to make
novel shapes
Tolerates • Child uses preferred food (ex-veggie straw) to paint pictures
• Peek-a-boo with non-preferred (ex-applesauce or yogurt)
• Make food pieces "rain" into bowl
• Slide food back and forth across table, using sounds and
noises to describe what is happening (i.e. pancake wheels
go "vroom vroom")Food Play
Touch – Hands
• Squishing, smashing, breaking, etc.
• Draw or write in purees with fingertip
• Make silly faces on plate with
different foods for each part
Smell Touch – Body & Face
• Peek-a-boo opening container to let • Hide and seek (i.e. down sleeve, down
smell out shirt, etc.)
• Therapist and child make a fan with • Wear as clothing or jewelry (i.e.
hand and use to fan food smell necklaces, hats, etc.)
towards nose • Make silly faces (i.e. mustaches,
• Lean towards food to smell while beards, eyebrows, etc.)
blowing it across tableFood Play
Touch – Lips & Mouth
• Use food as lipstick or chapstick
• Give kisses
• Use as toothbrush to brush teeth
Taste
• Hide and seek in mouth
• "Animal tongue" taste
• "Paint" tongue
Chew & Swallow
• Chew and spit
• Animal chewing
• Who can crunch faster, slower, etc.?Goal: use the senses to learn about
new foods prior to eating them, thus
decreasing anxiety/fear
Food Science
Attempt to make
Describe characteristics of food connections between
• Look (color, shape, size, what else it foods.
• What else is orange that
looks like, etc) we ate today?
• Feel (wet/dry, soft/hard, cold/hot, • What else was bumpy?
• I'm thinking of a food
smooth/bumpy, rough/sticky) you always eat that's
• Smell (small, medium, large, sweet, also shaped like a
circle...
sour, salty, spicy, bitter, bready)
• Taste (small, medium, large, sweet, sour,
salty, spicy, bitter, bready)
• Sounds (loud, quiet, crunchy, squeaky)Your child is rapidly Limited food selection is
losing foods they used impacting your child's
to eat nutrition/health/weight
When to Talk You are constantly
to Your Doctor Mealtimes are incredibly
worrying about your
About Feeding stressful
Therapy child's food intake
Your child eats less than
None of the strategies
20-30 foods or
you have tried are
no/limited fruits,
helping
vegetables, or proteinsQuestions? Contact: Building Bridges Therapy Center www.bridgestherapy.com 734-454-0866 Office@bridgestherapy.com
References
Beckman, D.A. (1988/2012) Oral motor interventions.
Beckmanoralmotor.com.
Fraker, C. et al (2007). Food chaining: The proven 6-step
plan to stop picky eating, solve feeding problems, and
expand your child's diet. De Capo Press.
Toomey, et. al. (1990/2018). SOS: When children won't
eat, picky eaters vs. problem feeders, assessment and
treatment using the SOS approach to feeding. (utilized
multiple talking points from therapist training and
handouts)INTENSIVE FEEDING PROGRAM
734.454.0866
www.BridgesTherapy.com
WHEN FOOD IS A CONSTANT
WORRY…. Let us help.
If your daily life ONE HOUR SESSIONS
is impacted 4 DAYS/WEEK
because your child:
For 3 WEEKS
Only eats the same five foods
Makes eating together Our occupational
as a family nearly impossible therapists have
Is not gaining weight specific training
to use techniques*
Requires a separate meal designed to help your
child feel safe while
Creates chaotic and stressful exploring food.
meals for the entire family
Our intensive, customized
program is focused,
Building Bridges offers a specialized engaging, and fun!
feeding program to help.
I can honestly say that it far
Our Occupational
surpassed what I thought weTherapists take a
fun, safeMy
would accomplish. approach
son is far to feeding,
more adventurous so with
kidshisenjoy
food. eating.
I truly feel the feeding intensive
jump-started a new adventure in
food for him and for us.
- Robin M.
(Jake’s Mom)
*Therapists use the Toomey SOS & Beckman Oral Motor approach
We participate with most insurance carriers.
Questions/Scheduling: Contact office@bridgestherapy.comFAMILY MEALS
The goal of Family Meals is for your Child to eat a volume of their preferred foods.
However, a secondary goal is for your Child to be learning about other, non-preferred or
new foods as well. Therefore, at EVERY meal AND snack, your Child should be offered at
least one protein, one starch and one fruit/vegetable. At least one of these foods must be
a preferred food. Do NOT restrict access to preferred foods until your therapist indicates
that your Child has enough feeding skills for you to do so.
STEP 1 = give Child a verbal warning, “we will be eating in 5 minutes”.
STEP 2 = if instructed by your therapist, have your Child engage in a Postural
Activation Exercise (see handout) or other Sensory Preparation
exercise
STEP 3 = get your Child and say “it is time to WASH HANDS now” (not “it is
time to eat”)
STEP 4 = bring Child to sink to wash hands (change the soap, washcloth or
sponge and water temperature etc. every other day for Sensory Preparation)
STEP 5 = bring to the Table and have sit into chair (can have one preferred food
already out on the table if needed to entice Child into their seat)
STEP 6 = begin Family Style serving (each person passes each food and takes a
small amount to put on their plate or the “Learning Plate”; Rule of Thumb
re: serving size = 1 tablespoon per year of age)
STEP 7 = everyone eats, allowing your Child to self-feed for at least the first
10 minutes of the meal. Adults are to talk about the food and use
over-exaggerated oral-motor movements to “show and tell” the
Child about how to make the food work in the mouth.
STEP 8 = after at least 10-20 minutes, begin any special feeding programs or
adult feeding of your Child that has been recommended by your
therapist.
STEP 9 = when Child appears to be done eating, offer a drink in a cup (can
offer after the ½ way point in the meal if needs a drink sooner). Can try to
re-offer a food after the drink, if Child appears to not have eaten
enough at the meal. Do this in a playful manner; don’t push.
STEP 10 = when done eating and drinking, begin a “Clean Up” routine =
Child blows or throws 1 piece of each food offered at that meal
into the trash or a scraps bowl, then washes hands and/or table
BEFORE getting down from the table.
If Child tries to get down too early, remind him/her “we haven’t done Clean Up yet. It’s not time to
get down”, and then offer another food. Don’t forget to use your “Key Phrases”
Copyright 2008/2010
Kay A. Toomey, Ph.D.MANAGEMENT OF FOOD JAGS
What are Food Jags? Some children, especially those with feeding difficulties, prefer to eat the
same food prepared the same way every day or at every meal. This is known as a “Food Jag”. The main
problem with food jags is that children will eventually get bored or burned out on these preferred foods.
Once children with feeding difficulties shun the preferred foods they’ve been jagging on, these foods are
typically lost out of that child’s food range - permanently. They may then continue this process of
eliminating foods until they have very few foods left in their food repertoire.
Preventing Food Jags: These are the ways to prevent food jags and the loss of foods:
1. Offer any one particular food ONLY every OTHER day (i.e. NOT every day)
2. If the child does not have a wide enough food range to eat 3 different foods at each of 5 meals
across the course of 2 days, then you must change at least one sensory property within the
preferred food EVERY time you serve that food; shape, color, taste, texture, temperature. Below
are some ideas about how to change the sensory properties (do each type of change for 2 weeks
before moving onto the other type of change – in order as listed below):
Changing Shape: cut the food into different forms than it is usually presented.
Using cookie cutters is an excellent and fun way to do this.
Changing Color: add food coloring to the favorite foods
Changing Taste: add a new flavoring to the food, such as using spices (dill, lemon, garlic, salt,
tarragon) or extra butter, flavored Pam, or parmesan cheese. Add flavored syrups or jellies,
soy sauce, tomato sauce, Jello powders, gravy or dried soup powders
Changing Texture: add a thickening agent such as corn starch, Thick-It; add an extra egg to
cooking; add extra oil to cooking mixtures; cook the food into a different texture (e.g. making an
omelet vs. fried eggs)
An Example: Johnny likes pancakes and wants to eat them every morning (and only them) for
breakfast. If Johnny refuses all other foods and falls apart without his pancakes, his Mother would offer
them BUT she would change something about them each day as follows:
Week 1 - change the shape (have Johnny cut his pancakes with cookie cutters that are different every
day until he will allow the pancake to be presented by Mom already cut into a different shape)
Week 2 - change the color each day (have Johnny help cook the pancakes and add a food
coloring. If he doesn’t understand that food coloring doesn’t change taste, you may
have to have his experiment with changing the color of water with food coloring and
tasting that there is no flavor change)
Week 3 - change the taste and the texture slightly by adding an extra egg one day, and extra
oil the next (alternating days until both are tolerated well)
Week 4 - change the flavor of the pancakes clearly by adding flavored syrups or different jelly
on different days
Week 5 - change the taste and texture by adding real pieces of fruit to the pancakes
The Just Noticeable Difference: At first, a child may be quite resistant to any type of change in
their preferred food. They may notice even very small differences in any of the food properties. The
goal is for you to change the food enough that a Just Noticeable Difference is noted by the child. This
Just Noticeable Difference should NOT be so large that your child has a meltdown and refuses to eat.
The size of the Just Noticeable Difference that can be tolerated is different for every child. You will need
to experiment to find what your child can tolerate by first changing a property of the food in a small way
(in the order listed above). Your child should act like they noticed, BUT ARE OKAY, with the change. If
they fall apart, you made too big of a change and you need to back down and change the food less next.
Copyright, 2002/2010
Kay A. Toomey, Ph.D.Food Science Tracking Sheet
Food / Date Sight Touch Smell Taste Sound Rating
Color: Wet / Dry Small / Med. / Lrg. Small / Med. / Lrg. Loud / Quiet / Score:
_______________ Soft / Hard Sweet / Sour / Salty Sweet / Sour / Salty No sound ______/ 10
Shape: Cold / Hot / Warm / Spicy / Bitter / / Spicy / Bitter /
_______________ / Room Temp Bready Bready Crunchy / Squeaky
Smooth / Bumpy / Smells Like: Tastes Like:
Shiny / Matte Slimy / Sticky _______________ _______________
Color: Wet / Dry Small / Med. / Lrg. Small / Med. / Lrg. Loud / Quiet / Score:
_______________ Soft / Hard Sweet / Sour / Salty Sweet / Sour / Salty No sound ______/ 10
Shape: Cold / Hot / Warm / Spicy / Bitter / / Spicy / Bitter /
_______________ / Room Temp Bready Bready Crunchy / Squeaky
Smooth / Bumpy Smells Like: Tastes Like:
Shiny / Matte Slimy / Sticky _______________ _______________
Color: Wet / Dry Small / Med. / Lrg. Small / Med. / Lrg. Loud / Quiet / Score:
_______________ Soft / Hard Sweet / Sour / Salty Sweet / Sour / Salty No sound ______/ 10
Shape: Cold / Hot / Warm / Spicy / Bitter / / Spicy / Bitter /
_______________ / Room Temp Bready Bready Crunchy / Squeaky
Smooth / Bumpy Smells Like: Tastes Like:
Shiny / Matte Slimy / Sticky _______________ _______________
Color: Wet / Dry Small / Med. / Lrg. Small / Med. / Lrg. Loud / Quiet / Score:
_______________ Soft / Hard Sweet / Sour / Salty Sweet / Sour / Salty No sound ______/ 10
Shape: Cold / Hot / Warm / Spicy / Bitter / / Spicy / Bitter /
_______________ / Room Temp Bready Bready Crunchy / Squeaky
Smooth / Bumpy Smells Like: Tastes Like:
Shiny / Matte Slimy / Sticky _______________ _______________
Color: Wet / Dry Small / Med. / Lrg. Small / Med. / Lrg. Loud / Quiet / Score:
_______________ Soft / Hard Sweet / Sour / Salty Sweet / Sour / Salty No sound ______/ 10
Shape: Cold / Hot / Warm / Spicy / Bitter / / Spicy / Bitter /
_______________ / Room Temp Bready Bready Crunchy / Squeaky
Smooth / Bumpy Smells Like: Tastes Like:
Shiny / Matte Slimy / Sticky _______________ _______________
Color: Wet / Dry Small / Med. / Lrg. Small / Med. / Lrg. Loud / Quiet / Score:
_______________ Soft / Hard Sweet / Sour / Salty Sweet / Sour / Salty No sound ______/ 10
Shape: Cold / Hot / Warm / Spicy / Bitter / / Spicy / Bitter /
_______________ / Room Temp Bready Bready Crunchy / Squeaky
Smooth / Bumpy Smells Like: Tastes Like:
Shiny / Matte Slimy / Sticky _______________ _______________
Adapted from Dr. Kay Toomey’s Sequential Oral Sensory (SOS) Approach to Feeding Food Science Tracking SheetKEY PHRASES FOR CREATING A POSITIVE FEEDING EXPERIENCE
How we talk to our children during meals is very critical. The words we use need to be
teaching words, meant to help our children learn what it is that they need to be doing
specifically at meals. OUR GOAL = to advance a child up the "Steps To Eating"
without using ... Questions, or Negative Instructions, Demands or Commands
“YOU CAN” Replace as many of your questions with “YOU CAN” vs “can you?”
1 - the “you can” phrase implies confidence that our child can do the task being shown
them; it avoids the interruption of asking a question because it is a statement
instead; it avoids the power struggle you set yourself up for by asking a question
2 - if they reply with “no, I can’t”, you can just say “when you are ready, I believe you
can!” And avoid that power struggle all together
3 - talk about others CAN too = “Joey can (describe action)”, “We can. (describe action)”
4 - ask ONLY choice questions (“do you want A or B”) and ONLY when the child is
NOT already eating
5 - REMEMBER - if “no” is not an acceptable answer, don’t ask it as a question!
QUESTIONS: need to be avoided because...
- they interrupt children eating who know they are expected to answer our questions to them,
even if they chose not to respond. We never want to interrupt a child eating !
- they set us up to power struggle with our children. What do you do when they answer with a
“no”? If you let the “no” stand, they don’t eat. If you disregard the “no” and push them,
not only are you going to power struggle, but you are also invalidating the opinion YOU
JUST ASKED FOR with your question.
- “Can You....?” is the most frequent question parents use. This question, in particular, implies a
lack of confidence on our part as to whether our child really can do this eating task. That
lack of confidence is imparted to our child with this question.
_____________________________________________________________________
NEUTRAL OR POSITIVE EDUCATIONAL LANGUAGE: use language that is
focused on teaching your child about the sensory properties of the food
and the mechanics of how the food breaks apart/moves AND how this food
is similar to a known food
1 - give the food a name and describe what it looks like (color, shape, size, texture)
2 - “Teach the Physics of Food” = explore the food with your hands and eyes. Can
you bang it on the table, or is it wiggly? Does it crush into powder, or squish into
mush? Does it feel bumpy, or smooth? Does powder stick to your fingers, or is it
sticky? All of these different types of foods are going to work differently once the
food gets into the mouth. We want your children to understand as much about
the food as possible, and what is going to happen to the food once it gets into the
mouth, BEFORE it gets in your child’s mouth.
Copyright, 2002/2010
Kay A. Toomey, Ph.D.
toomey@starcenter.us3 - If it is too threatening to talk about the child’s food, talk about your own food and
eating. Manipulate your own food with your hands and mouth. Teaching your
child to eat is a SHOW AND TELL exercise. Remember, you are the Professor
and every meal/snack is a classroom/teaching opportunity.
4 - If your child is struggling with a food (sensory or oral-motor wise), show them and tell
them in explicit detail how to alternatively manage that food (e.g. “You look
worried about that food. If it is making you worried, you can move it up here; you
can cover it up”), (e.g. “Take a bite of that licorice from the side here with your
strong back teeth. Hold it down tight in your teeth and then bite and pull”), (e.g.
“See how I can take a bite of my chip and move my tongue sideways to put it on
my big boy molars and now I can chew, chew, chew and then swallow it to my
tummy”).
NEGATIVE DEMANDS OR COMMANDS: need to be avoided because...
- a “do this or else” statement does little to create a postive mealtime atmosphere
- demanding a child do something in a negative fashion or tone of voice, often upsets them
- remember, your child’s negative emotions are connected to the Adrenaline neurotransmitter
system, which in turn directly suppresses appetite.
We never want to do anything at a meal that is going to directly suppress appetite!
- our demands and commands often times set us apart from our children at meals as the
authority figure rather than helping them feel like we are joining them in tackling this
difficult task. They also may give our children a sense that we feel they are stupid or
silly (e.g. ”take a bite already!”), or they may make our children feel as if we have no
understanding of just how difficult a task eating is for them (e.g. “stop playing with your
food and just eat it!”).
_____________________________________________________________________
“DO” LANGUAGE vs. Don’t Language: use language that is rule based and helps
your child understand the exact, correct behavior you expect. “Do
language” tells the child the rule, rather than saying “stop”, “don’t”, “no”.
It also then gives the appropriate behavior in specific terms.
1 - instead of “stop throwing” say, “food stays on the table. If you don’t want it, put it up
here” Or, “push it away”
2 - instead of “sit down!” say, “chairs are for sitting, not standing. We sit on our
bottoms in the chair”.
3 - instead of “stop screaming” say, “we need to use an inside voice here. If something
is upsetting you, you can use your words in an inside voice”
4 - instead of “don’t spill that drink” say, “cups are for drinking. If you are going to spill,
the cup will go over here until you are ready to actually take a drink”
NEGATIVE INSTRUCTIONS: need to be avoided because...
- they interrupt eating, they set you up for power struggles and they do not teach children WHAT
TO DO. Negative instructions typically only teach children what NOT to do, WITHOUT
providing a more appropriate alternative (eg. “stop screaming”; “don’t throw”, “stop that”, “don’t
spill that drink”).
- negative instructions usually deal with a maladaptive behavior after it has occurred and do not
help to “set up” our children to be successful from the start.
Copyright, 2002/2010
Kay A. Toomey, Ph.D.
toomey@starcenter.usEATING
chews and swallows whole bolus independently
chews, swallows whole bolus with drink
chews, swallows some and spits some
bites, chews “x” times & spits out
bites pieces, holds in mouth for “x” seconds & spits out
bites off piece & spits out immediately
full tongue lick
licks lips or teeth
STEPS TO EATING TASTE
tip of tongue, top of tongue
teeth
lips
nose, underneath nose
chin, cheek
top of head
chest, neck
arm, shoulder
whole hand
fingertips, fingerpads
one finger tip
TOUCH
leans down or picks up to smell
odor in child’s forward space
odor at table
odor in room
SMELLS
uses utensils or container to serve self onto own plate/space
uses utensils or a container to stir or pour food/drink outside of own space
uses utensils or a container to stir or pour food/drink for others
assists in preparation/set up with food
INTERACTS WITH
looks at food when directly in child’s space
being at the table with the food just outside of child’s space
being at the table with the food ½ way across the table
being at the table with the food on the other side of the table
being in the same room
TOLERATES
Copyright, 1995/2010 Kay A. Toomey, Ph.D.Copyright, 1995/2010 Kay A. Toomey, Ph.D.
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