Picky Eater or Oral Motor Delay?

No doubt as a feeding therapist you will have distraught parents coming through your doors with children who have been labeled “picky eaters.” These children often have a limited repertoire of foods they will accept and eat, often causing the family much heartache as they try to manage getting all the nutrition that their child needs to grow and maintain optimal health while also being limited to the small amount of foods that their child will take. They are looking to YOU the feeding expert to help. 

Picky Eater or Oral Motor Delay

One of the first things you will need to identify is if the “picky eating” is due to a sensory feeding disorder, oral motor deficit, or possibly a combination of both

What is sensory feeding disorder?

A sensory feeding disorder is when a child limits/avoids foods with a certain appearance, texture, smell, and/or taste. It is essentially a sensory processing difficulty in the mouth and makes it difficult for a child to accept and try new foods that are not already in their food repertoire. 

What is oral motor deficit?

An oral motor deficit is where the muscles of the mouth & face needed for chewing, swallowing, and managing food in a safe and efficient manner have limited strength, range of motion, and/or coordination. We also refer to this as oral phase dysphagia.   

As you assess children coming into your clinic labeled “picky eaters,” it is imperative that you assess their oral motor skills. Many times, we see impairment in one or more oral motor areas. As we discussed in last weeks blog post, the jaw is foundational for all feeding skills. 

In many children labeled as “picky eaters,” we often see weakness in the jaw leading to difficulty chewing a variety of foods. Certain textures of foods are harder to chew, so children with an underlying weakness in the jaw/chewing, will avoid these textures (e.g., grilled meat) because they feel unsafe, fatigue quickly, struggle to manage the food once in their mouth and may even be afraid of choking. In these instances, the child has been misdiagnosed as having a sensory feeding disorder when they actually have an oral motor deficit.

Is it sensory or is it oral motor based? It could be a combination of both. When you complete your comprehensive feeding evaluation that we teach in Feed The Peds®, DOCUMENT EVERYTHING (pro tip: video record it) so that you will be able to assess what the root cause is that is leading to the child being a picky eater. We do not want to use a bandaid approach in our therapy sessions. With our comprehensive feeding therapy training in Feed The Peds®, we train you to get to the root of WHY a child presents with a feeding delay or disorder and create a comprehensive treatment plan that meets the child where they are. 

As a Feed The Peds® trained Feeding Therapist, you’ll be able to differentiate whether it is an oral motor deficit, a sensory feeding disorder or both and provide evidence-based feeding therapy tailored to address their needs. We are so thankful for Feeding Therapists like YOU that are continuing your learning journey and equipping yourself with the tools needed to provide feeding therapy services to children in need.