Guest post written by Marsha Dunn Klein, OTR/L,MEd, FAOTA
Goals for children who have pediatric feeding disorders in some settings commonly include some variants of these:
Marsha will consume (# of bites) of a particular food.
Marsha will consume (# of bites or quantity) of food, without refusal behaviors…
Marsha will decrease her refusal percentage when presented with new foods…
There are some assumptions here. Let us consider these.
That the adults get to decide what and how much a child eats………. NO!
That the eating is a one-way activity and the child has no say in the matter. ……….. NO!
That when adults present food, the child MUST eat it ……….. NO!
That the child is not allowed to say “no”… FOR ANY REASON ……… NO!
On a recent trip to China, I noted that there were scorpions on sale in the market. Imagine someone is making eating goals for YOU about scorpions such as:
YOU will consume 6 scorpions….
YOU will consume 6 scorpions (fed to you by someone else) with NO refusal behavior…
YOU will decrease your refusal percentage of scorpions when presented by someone else…
To start with, I live in Arizona and scorpions are quite common. We are taught to keep away from them so if I were presented with scorpions, in my opinion, the RIGHT response would be to say “NO”. But, humor aside, let’s look further.
The child who says “NO” to these scorpions in the above paradigm would be labeled as “refusing” or described as exhibiting “food refusal” or having a “behavior problem”. Requiring a child to eat a food that she is saying “NO” to is contrary to some very solid principles of feeding children.
So, Instead of describing the child as REFUSING and then pushing into that worry, could we consider this reaction from the child as her RESPONSE, her communication, rather than a “behavior that does not comply with the adult presentation.”
Can we note the child’s response and try to understand what the child might be communicating to us? Maybe the child is not hungry? Maybe the child feels worried about the scorpion because he is not able to chew it? Maybe she is worried about the smell, or the texture, or the sound of it crunching in her ear. Maybe she tried a scorpion in the past and it made her vomit. Maybe she actually wanted to try it but wanted to go slower and try it at her own pace and mix it with mashed potatoes.