Expanding your child's eating repertoire
Having a child who limits their eating can be concerning and stressful for parents. Implementing an eating program will require patience as gradual introduction of foods will be the best approach for ensuring long term success.
It is recommended that you rule out all medical issues before beginning an eating program.
It is crucial to stick to a routine of eating. Have three meals per day at the same time each day. Have two snacks a day at the same time each day.
It is recommended you have three meals a day with two snacks in between.
Require the child to sit at the table for every meal to develop consistency and increase instructional control. Don’t allow your child to graze all day (eat small portions throughout the day). You need your child to be hungry during meal time in order to maximise success.
Try to focus on reinforcement. Reinforce your child for appropriate eating behaviour and ignore all inappropriate behaviour.
Make sure that snacks to not replace meals in size. During the snack times, the child will not be required to have the new food in the beginning as we do not want to make the demand for eating too high and cause further aversions.
Get your child into the routine of eating three meals and two snacks a day of preferred food items before beginning to present new foods.
Begin by analysing the current food repertoire of the child. Determine the tastes/textures/temperatures of the food your child is already eating. Use this information to choose 3 new foods which have similar characteristics
If your child will accept eating Ritz crackers start with introducing a different kind of cracker such as a rice cracker
If you child will accept eating apple sauce start with introducing a yogurt
If your child will accept drinking orange juice begin introducing other flavours of juice
Only present one new food per meal but rotate the three foods systematically so they have expose to each one time a day. Keep data on each food separately. This means one food could be at step one but another food could be at step 3.
Once you have established which foods to introduce, determine which of the following steps you will need to begin at to be successful. Start where your child is successful to give you the opportunity to reinforce and then move to the next step.
When your child is eating a preferred item at meal time have the new food item on their plate. Do not make any reference to the food or tell them they will have to eat it. When they are able to tolerate the food being on their plate for three days in a row move to step 2.
Now that the child is able to tolerate the new food on their plate we want the child to begin touching the new food item. Give them a few pieces of their preferred food item and then tell them to touch/pick up the other food item. As soon as they have done this give them more of the preferred food item and verbal reinforcement. Only have them touch the new food item up to three times per meal. After three days in a row of being able to touch the new food with no inappropriate behaviours move to step 3.
At stage three begin to require the child touch the new food to their lips. Start by giving them a few pieces/bits of the preferred food item and then instruct/prompt them to touch the new food to their lips. Once they have done this give back the preferred food item and provide verbal reinforcement. Have them touch the new food item to their lips 5 times per meal. It may take awhile to work up to the number of trials successfully. After three days of success at step 3, move to step 4.
Now the child must put the new food item in their mouth or touch it with their tongue. Start by giving them a few pieces/bits of the preferred food item and then instruct/prompt them to put the new food in their mouth. Have them put the new food in their mouth 5 times per meal. Again, this may take awhile to work up to this number of trails. After 3 days of success at this level move to step 5.
Make sure the new food is in small pieces and begin to require the child to chew and swallow the food. Start by giving them a few pieces/bits of the preferred food item and then instruct/prompt them to eat the new food item. As soon as they have eaten the new food give them more of the preferred food item and verbal reinforcement. Criteria to move to step 6 will be when the child can put chew and swallow 5 bites of food for three consecutive days in a row.
Once your child is able to chew and swallow 5 small pieces of the new food, begin to slowly increase the size and amount of the item they must eat. Also, begin allowing them to eat the new food and preferred food item on their own rather than making it contingent.
Once your child is able to eat the new food item introduce another item. You may not have to start at step 1 so check to see which level your child is successful with and begin there.
Keep introducing new foods in the same format as soon as the child is able to eat a new food.
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