Building Skills for Positive Eating & The SOS Approach to Feeding

Does your child struggle to tolerate a wide range of foods, despite trying every trick in the book?
Or are you starting a little one on solids and want to know how to help them build strong skills to be confident with food?

When it comes to helping a child on the road to eating, as Occupational Therapists we look to normal development. And in order to understand that, it’s helpful to put ourselves in our child’s shoes:

Imagine you’re in a foreign country, being served foods you’ve never seen before, you look closely and decide with your eyes what you feel brave enough to try. Then you tentatively pick it up, probably with as little skin contact as possible, followed by smelling it. If it passes the smell test, you take a tiny first bite starts with your teeth touching the food until you’ve learned enough about this food to feel it’s safe to put in your mouth and actually eat it.

This can be what it’s like for your child when they try a new food. However, as adults, we know how to cope with this experimentation and foods we try, but don’t like. So, in order to help your child’s eating, it’s important we equip them with the skills to do so:

Eating starts by looking
As humans, we begin eating with our eyes. But if your child can’t tolerate looking at a particular food yet, then this is the first step to address towards building their skill.

Tip: Start by exposing your child to a range of foods visually from a young age (which, if they do not appeal for now, may not actually involve eating initially). Once they feel comfortable with a food visually, they may want to explore it more by touch, smell or having a quick taste.

Variety is Key
In addition to visual variety, providing your child with a range of tastes and textures is key to building their sensory and oral motor skills. Aim to have at least three different tastes in each meal — this can help prevent your child getting tired of a food, which could lead to them refusing it altogether later down the track. A variety of flavours and textures are especially important for toddlers who are moving to solids, so they develop their palate and chewing skills.

Tip: The way food is presented can make it seem like something completely different to your child. For example, a cut-up apple is very different to a whole apple in how it looks, feels and tastes. So, you can use one food in a variety of ways once they visually tolerate it.

Self-Help Skills

Food can come back out of our mouth.
Imagine you take a bit of a new, unfamiliar food, and it tastes disgusting! That’s okay, because you can politely take your napkin and spit it out without anybody noticing. If taste is a challenging experience for your child, teaching them self-help skills will show them how to manage these sensory experiences and reduce avoidance behaviours around trying new foods.

Tip: If your child tries something and you can see the flavour was too much and the meltdown is about to start, try to interrupt this before the negative emotions overwhelm them. Try using neutral (rather than negative or reactionary) language and calmly show them how they can help themselves:
“Wow, that was a BIG flavour, we can use our wash cloth and wipe it off”
“We can take a big drink to wash it away”
“We can spit it out”

Food stays on the table — we can cover it
If your child doesn’t like a food— whether from visual repulsion or they’ve tried it and don’t like it — they may throw it on the floor or try to leave the table. This can be their way of communicating that, at present, they can’t stand looking at or being near the food. However, keeping food on the table is important in establishing normal eating behaviours and will make it easier to re-introduce the food to them in the future.

Tip: If your child is throwing a food on the floor you can say, “That’s okay, we can cover the food; food stays on the table”. You can cover the food with a napkin, paper plate or something else that is normal on the table.

If your child throws a food on the floor and you ask them to pick it up, they may associate this with a reward (being able to leave the table). In order to prevent this, pick up the food and put it back on the table while saying “Food stays on the table”.

Learn to Spit it Out!
When your child is trying new foods, it’s important to equip them with skills so they feel safe while experimenting. Although it may sound counter-intuitive, showing them how to get food out of their mouth is important to help them manage, reduce or prevent gagging themselves. This will help them be more likely to try a new food in the first place.

Tip: You can start by helping them practice putting food in their mouth and taking it out using their fingers. Then, work towards them doing this without your help.

Building Oral Motor (Tongue and Jaw Movement) Skills

Some foods are more challenging for a child to chew than others (like a piece of meat or a raw carrot), so it’s important to teach them how to use their tongue to aid their chewing, and their subsequent experience of eating that food.
Managing where food is in your mouth and moving it around comes from having good tactile sensory awareness of your mouth and the ability to move your tongue – such as taking the tip of your tongue over to your cheek and to your back molar.
If your child is putting their fingers in their mouth, it’s likely because they need help moving food in their mouth, which indicates they need to strengthen their oral motor skills.

Tips: Use a long, hard food that can be kept in the hand while eating (e.g. a raw carrot). When they place it in their mouth, it helps their tongue practice movement side to side. (Always supervise your child when they are learning to eat with these foods.)

 Create a game to practice their oral motor skills. For example, you can show your child how to play tennis in their mouth using a round, melt-able food (e.g. a cheese puffball or tiny meringue) and moving it from one cheek over to the other.

Over-stuffing the mouth
If your child is over-stuffing their mouth they may have difficulty processing the tactile information that tells them where the food is, so the more food they put in the easier it is to keep track of in the mouth. Teach your child the right size of bite – show them what is “too big” by demonstrating, put it in your mouth and take it out again say “too big”, again same with “too small” and then show them “just right”.

Final tips
Helping your child develop their eating skills can be a long process. Things to keep in mind:

 Be patient

 Be the teacher — role model how to touch, explore and taste foods

 Discuss the food — try to think like your child: “Wow! Look we can line up all these carrot sticks to make a train track.”

 Your child’s actions are their way of communicating with you

 Don’t give up!

And if your child needs help with their eating skills, an SOS-trained* Occupational Therapist
can assist them in developing normal eating behaviours. Leona Brennan and Lisa Hughes are
trained in the SOS feeding program. For an appointment please call 9913 3823.

*The SOS Approach to Feeding program was developed by Dr. Kay Toomey.
For more information on the SOS Approach to Feeding Program please visit http://sosapproach-
conferences.com

Author: Leona Brennan