All You Can Eat

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How does a Psychologist work with children & eating?

Psychologists work with many different people to help them reach their full potential.

We know that eating can be complex, and there can be different reasons for why problems develop. For this reason, we are sometimes just one part of the team who will work with your child. The other people involved may include a paediatrician, dietitian, and speech language therapist.

Many research studies have shown that a behavioural approach is most successful for children with feeding problems, so we’ll focus on that here. At the bottom of this page there is also a video summary of behavioural interventions in homes.

How we develop our strategies (Assessment)

Our first step is to obtain a lot of information about your child and their eating over the years. We’ll get into some details about the foods or drinks your child eats/has eaten, and when they eat them (like, your meal routine). At this point we can also get more information from your child’s health professionals, and they may recommend the types of foods or drinks that we should use with your child.

We then get more information by closely observing your child during some mealtimes and recording some information. We may try different foods or drinks, such as foods your child likes, versus those they don’t like. During some meals, we may change some things that we think might be relevant to your child’s eating and behaviour. Our technical term for this is a Functional Analysis. For example, we might respond differently to your child’s behaviour, or present foods differently.

Strategies we use with your child

We use assessment information, and research evidence to develop treatment options for your child - and you’ll have input. We’ll also decide some feeding goals that we would like your child to achieve.

While our strategies are specific to your individual child, they may include:

  • Setting meal routines - Teaching your child to sit for meals at specific times, for a specific amount of time

  • Providing consistent instructions and expectations to your child

  • Increasing positive interactions during the meal (like conversation or songs)

  • Working on individual foods by presenting them bite-by-bite

  • Reducing the initial effort of eating, like presenting small bites or reduced textures, but then gradually working towards your child’s goal

  • Increasing positive attention (like praise or tickles) when your child eats, and not providing attention when your child engages in refusal or other challenging behaviours

  • Providing more opportunity for your child to choose between foods

  • Providing your child with a preferred activity after eating (reinforcement)

Generally, we’ll first use strategies with your child, while you watch. When your child is making progress, we’ll then teach you to use the strategies. Usually, we’ll support you for a period of time, and continue to collect information that tells us how your child is progressing. If your child is not making progress across multiple meals, then we will look at further strategies and continue to monitor. We’ll also make sure your child is transferring progress to other relevant settings (like school, in the community), and other people.

So, there’s a brief summary, that covers a little of what we do. Below is a recent video summary as well as links to further info.

Links to further information

Improving food selectivity: https://asatonline.org/research-treatment/clinical-corner/improving-food-selectivity/

Improving mealtimes: https://bsci21.org/behavioral-skills-training-at-dinner-time/?fbclid=IwAR25NUl9knfZ_SttHWo-5j-_jbXIpdBmAEMKyvp5OuUDiKOzXTOH4JgZLQ0

Toddlers & mealtimes: https://bsci21.org/toddlers-mealtimes-hope-for-parents-everywhere/

Assessment and treatment of feeding disorders (Dr. Cathleen Piazza): https://www.youtube.com/watch?v=42Uk3SCQ1Ac

Ministry of Health guidelines: https://www.health.govt.nz/your-health/pregnancy-and-kids/under-fives/helpful-advice-years-1-5/feeding-your-child-1-year-and-over