May 31, 2025 • 36 mins
Feeding challenges aren’t just for toddlers—many parents find themselves facing a new kind of mealtime stress when their kids become tweens and teens. In this episode of the Where Parents Talk podcast, host Lianne Castelino is joined by Dena Kelly, a licensed counsellor, board-certified behaviour analyst, and paediatric feeding therapist, who specializes in helping families navigate the emotional and physical toll of picky eating in older children.
Kelly shares evidence-based strategies for tackling picky eating, while unpacking how adolescence, hormonal shifts, social pressures, and parental communication all play a role in shaping a child’s relationship with food.
From creating structured yet flexible mealtime routines to empowering kids with independence in the kitchen, this episode offers practical tools to reduce food-related anxiety and foster healthier eating habits—for both parents and kids.
What You’ll Learn:
How picky eating affects emotional well-being and social development in older children
Why adolescence and hormonal changes can trigger or intensify feeding issues
The role of social media and peer influence in shaping food preferences
Strategies to promote independence and reduce conflict during meals
When and why to seek professional help—even if your child seems to be coping
How to turn mealtimes into a source of connection rather than conflict
Links referenced in this episode:
Companies mentioned in this episode:
- Focused Approach
This podcast is for parents, guardians, teachers and caregivers to learn proven strategies and trusted tips on raising kids, teens and young adults based on science, evidenced and lived experience.
You’ll learn the latest on topics like managing bullying, consent, fostering healthy relationships, and the interconnectedness of mental, emotional and physical health.
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Transcript
Episode Transcript
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(00:00):
Foreign.
Welcome to the Where ParentsTalk podcast. We help grow better
parents through science,evidence and the lived experience
of other parents. Learn how tobetter navigate the mental and physical
health of your tween teen oryoung adult through proven expert
(00:21):
advice. Here's your host,Lianne Castelino.
What effective research basedstrategies can help parents tackle
picky eating and at the sametime support their child's nutrition?
Welcome to Where Parents Talk.My name is Lianne Castelino. Our
guest today is a feedingtherapy professional. Dena Kelly
(00:43):
is also a licensedprofessional counselor and board
certified behavior analystwith more than a dozen years of experience
in feeding therapy. Shedesigns in depth feeding programs
and equips professionals andcaregivers with the skills needed
to apply evidence basedstrategies to improve the eating
(01:04):
habits of children. Dina isalso a mother of two and she joins
us today from Phoenixville,Pennsylvania. Thank you so much for
making the time.
Thank you. Thank you so muchfor having me.
Really interesting topicbecause many parents have gone through
it and it seems like you'llnever ever get past it if, you know,
depending on where you are,you have spent over 20 years working
(01:27):
with families and what led youto focus specifically on feeding
behaviors?
Yeah, so I fell into it byaccident, actually. I was in my graduate
program of study and waslooking for an internship placement
and ended up at an autismclinic, which is an area that I knew
(01:48):
I wanted to work in,pediatrics, autism. And they had
within that autism clinic anoutpatient intensive feeding therapy
program. So I was put in therefor one of my semester and never
looked back from that pointon. So once I got in there and was
really able to see how lifechanging it is for the child and
(02:11):
the family when eating is lessstressful, was so rewarding for me
that I knew that this wasdefinitely the path that I wanted
to go. And so over the lastalmost 15 years now have really focused
primarily on feedinginterventions for families. Families.
(02:34):
So give us a deeper glimpseinto that, Dina, if you could, in
terms of, you know, whatimpacted you when you had that interaction
with those children.
Yeah. So you know, when, whena family's struggling with feeding
challenges or a significantfood restriction, you know, high
level picky eating, is that itimpacts the whole life of that child
(02:55):
and the family. So it limitstheir ability to have calm family
dinners, to go out to arestaurant, to travel. You know,
most parents will report thatthey spent all day dreading dinner
time because it would end upbeing such an exhausting experience
for them. And so once we workon, you know, an appropriate intervention
(03:17):
for that child. And for thatfamily, it reduces a lot of that
stress and anxiety and allowsthe child to access social experiences
that they didn't get tobefore. It usually allows the family
unit as a whole to get alongbetter because that stress has been
reduced. And so it's justsignificant impacts across the board
(03:38):
for children, especially withautism that are in a lot of other
therapy programs as well, isthat once they are actually eating
well throughout the day, is itallows them more stamina to get through
the day. They're less cranky,they're more focused because their
(03:59):
bodies are actually feelingbetter. So it gives them the opportunity
to excel in those othertherapies when they're. When their
oral intake, their feedingintake is improved.
I guess most of us wouldreally associate picky eaters with
younger children typically.But I wonder what current trends
you're seeing as it relates toolder kids, tweens, teens and adolescents.
(04:21):
Yeah, so that's most of mycaseload right now, as crazy as it
is, is actually the olderkiddos. And that actually started
around the time Covid hit. Sowhen Covid hit for us, when there
was a major influx in familiesof older kids calling in, because
prior to that, you know, whenyou think about the school age dish,
(04:43):
you know, elementary, middleschool children, there's a lot of
hustle and bustle, right?They're gone all day at school. They
come home, it's like, quick,let's do some homework and a snack
and maybe we're off to asporting game. And they're grabbing
food from the drive through.They're just grabbing snacks. They're
kind of on the go. And whathappened during COVID is that everybody
was home and then they werehome for every single meal. And then
(05:06):
we were getting these panickedcalls going, oh my gosh, all he wants
is McDonald's every day. Orhe's not eating anything other than
chips. I never really noticedbecause we hadn't sat down for family
meals because things were sobusy. And now that we were forced
into not being busy, we'renoticing that. So we have that. You
know, though, I definitely sawa big trend coming up in that respect.
(05:29):
But the other big component isthat for a lot of kids and, and this
I can't yet explain withfeeding challenges, don't always
have the growth concernsmatched with it. So there are kids
that could be solely eatingone specific food, and they can continue
(05:50):
to grow in height and weight.And so what happens is throughout
the years, they'll go to theiryearly checkups at the pediatrician's
office, and they'll reportthat that child is picky and they're
struggling to get in a varietyof foods, but often from a medical
side, if they're growing inheightened weight, they're continuing
to be told, just wait and see.It's a phase. They're going to grow
(06:12):
out of it, don't worry. Andthose years continue on. And the
longer that children go withcontinued avoidance of eating, the
more difficult it gets to beable to expand that variety. And
so if you get into those yearsof 9, 10, 11, 12, you know, into
(06:32):
those teenage years,oftentimes it's actually snowballing
and becoming a bigger andbigger and bigger issue. And so then
I have the families reachingout and their child's 13, 14, 15
going, I've known this hasbeen a problem since they were two,
three or four, but becausethey were growing, because there
wasn't really any nutritionconcern that they were initially
(06:54):
looking at, we didn't doanything. And now this child is not
going to birthday parties.They don't want to hang out with
their friends at the mall.They, you know, aren't eating during
the school day because there'snothing for them to eat. And so now
this child is strugglingsocially. It's leading to more anxiety,
(07:15):
it's leading to stress in thefamily, all of those sorts of things.
And so it's that wait and seecategory that they usually end up
getting to that point. It's.It's much more uncommon to see a
child that was eating reallywell and then in that tween or teenage
started to develop the foodchallenges. It's usually something
(07:37):
that if in hindsight you lookback, most families will say they've
seen it all along.
So then along those lines,Dina, is it possible to pinpoint
root causes here? Right. Likeyou talked about COVID as an example.
But like picky eating amongchildren seems to be so prevalent.
(07:59):
Is it something that parentsare doing as well or what's contributing
to this?
It's a combination of a fewdifferent things. Right. You know,
developmentally,appropriately, children are going
to go through that no phase,right. Or that time where they want
to just assort assert theirauthority and they are in charge
(08:22):
and they are going to be inthe one giving the instructions and
that sort of a thing. And sothat's appropriate and should be
happening. But what happenswhen you have a child that has potentially
some predisposition for thisfeeding challenge, then paired in
an environment where when theydo say no or they do engage in some
(08:47):
refusal behaviors at mealtime,get removed from that meal time,
get provided with a much morepreferred food item, get a whole
lot of attention andengagement when they're engaging
in those sorts of refusalbehaviors at mealtime. Sometimes
paired the biological partwith the environmental part ends
(09:11):
up being this recipe that endsup putting that child in more of
a restrictive eating pattern.So the other thing to look at is,
is how restrictive they'reactually getting with their food.
So you know, we, we hear thatterm picky eating and it should be
a phase often, but usuallywith picky eaters, even though their
(09:35):
variety of food may not be asexciting, expanded as you know, an
adult would be, or even anolder child might be, is that they
have foods usually in eachfood group that they're eating, even
if it's only a select few. Andusually they can generalize those
foods to a variety ofdifferent environments. So even if
(09:56):
the child only wants to eatchicken nuggets, they'll eat chicken
nuggets. Whether you order itoff of the kids menu at a restaurant,
whether mom makes them athome, whether you get them while
you're on vacation, whateveryou're doing. Chicken nuggets, that's
going to be a win food, right?With the more restrictive eaters
or kids that are strugglingmore internally what they're eating,
(10:19):
they're going to want thespecific chicken nugget from the
specific place that the brandor restaurant and that's it. They
can expand past that. And sousually there's more of that internal
struggle with sensorysensitivities. Sometimes, you know,
kids have higher gag reflexesor certain senses are heightened.
(10:44):
You know, we have kids thathave bigger challenge being around
certain smells or certainfeelings of that texture. That consistency
can really throw them for aloop as far as what they're actually
exposed to eating. But, butmost kids, most people are internally
(11:05):
motivated to eat and enjoyeating. And so usually, you know,
if they're in a typical pickeater stage, they're going to continue
to expand out of that. They'regoing to be willing to try some new
stuff because it's interestingand they like eating. When we're
seeing that significantavoidance and lack of actual interest
in food is where you're havingmore of the concern. And that's often
(11:31):
where parents have more of theinconsistency as to how they handle
that, which can lead to thenagain more of that snowball as far
as how they're going to moveforward in that situation. So sometimes
they get frustrated and sothey get heightened and respond in
an angry way. Maybe sometimesthey actually Just shut down and
(11:52):
get frustrated in that way.And they say, forget it, do whatever
you want. I'm not even goingto, you know, require that you do
anything today. Sometimes theymight negotiate with them and they
go back and forth on, if youjust take this bite of food, I'll
give you this. If you do this,I'll give you this. And get into
all of that. So. So it'sdefinitely a combination of both
(12:15):
the physiological and theenvironmental factors.
Now one of the reallyinteresting pieces of your story
is that you transition from ahands on sort of intervention based
support to program developmentand training caregivers and parents
on the very things that you'vejust outlined there. So what motivated
(12:36):
you to make that pivot, tomake that shift and how has your
perspective evolved as a result?
Yeah, so the pivot startedagain back during that Covid time,
right when everything shutdown and everybody went virtual.
So did in person, persontherapy programs. And so we really
(12:57):
had to do this shift of, youknow, I used to be very hands on
in this program. The parentswould watch from the side as I was
working through a meal timewith the child and starting to learn
the interventions that theyneeded to do. And now we were stuck
in this situation where thatwasn't actually possible and so had
to quickly get creative on howwe would move forward with that.
(13:19):
And what we were able to seeis that there's even better, bigger
benefit to doing it as aparent training approach and being
able to empower the parents toget the, the confidence and control
back in their kitchen andaround meal time to be able to give
their kids the confidence tobe able to actually do better with
(13:41):
their eating. And so now whenI do programming for families, it
is in their home. The parentis taking the lead, the child is
in their own kitchen wherethey're expected to eat most of their
meals. They're eating foodsthat the parents are cooking. And
so it's all part of theprocess of ultimately what we want
(14:03):
them to be doing. Expandedfrom that is that now a big part
of what I do is actuallytraining professionals because what
I was seeing was that there'sthis whole population of kids that
need intervention that can'tnecessarily access it from a private
provider like me. But alsothese professionals that are already
(14:28):
working with these kiddos butdon't necessarily have the skills
to do feeding intervention.And so by actually training the professionals
that are so interested inlearning to expand their knowledge
for feeding, now they'regaining professional development
and those families are able toaccess some of that care that they
(14:49):
wouldn't necessarily have beenable to access privately.
Part of your approach involvesapplied behavior analysis. Can you
take us through what that isand why is this considered an effective
tactic for feeding therapy?
Yeah. So ABA providesstructured individualized approach
(15:10):
to each family. You're lookingat how you can understand and, and
improve the behavior of thatchild. And, and that's really across
the board, but obviously inour case specific to feeding. And
so what we're looking at isboth what's reinforcing that food
refusal, meaning what'skeeping it going, and, and what can
(15:34):
we actually use to reinforceactual eating consumption. So when
kids are really strugglingwith a feeding disorder, they're
not internally driven by toeat, they're not motivated to do
it. Right. I, for me, I loveto eat. I could smell food cooking
in the kitchen and I'm alreadyhungry. I could be full. And if somebody
(15:54):
brings out a treat that looksreally good, I'm still going to eat
it. Right. But our kids thatare struggling with food selectivity
are not necessarily motivatedto eat in the same way. So I equate
it a lot to thinking aboutother just mundane or non preferred
tasks that a kid might have todo. You tell a child to clean up
their toys or brush theirteeth or put on their pajamas, some
(16:18):
of those things that theydon't necessarily have an interest
in doing. But if you can pairthose things with things that are
motivating to them, it givesthem more of a drive to do it. So
you tell the child to clean uptheir toys, they say no, but you
say if we clean up our toys,we can get to the park. Right. Is
that then they may be morelikely if they really want to go
(16:40):
to the park to put their toysaway, even though that wasn't super
interesting to them in thebeginning. And so with food, while
obviously there's some morecomplexities than just putting toys
into a toy box, we have tothink a lot about the different textures
and, you know, smells andcolors and all of the sensory components
that come into food. Andthinking about that when we introduce
(17:02):
those to our kids is that wedo have to look at if this, if the
act of eating is notmotivating to you is what can we
do to be able to help providesome of that motivation and push
to be able to get you moreinterested in trying those foods.
And so a lot of Abi is reallylooking at the environment as a whole
(17:26):
and that child as anindividual and being able to say
what can we do within thischild's environment to be able to
help provide them, you know,that. That extra ohm for that motivation
to be able to make thisbehavior change.
(17:47):
So really interesting examplethat you provided there with the
younger child and the park.What would that look like with a
tween or a teen, for example,when, you know, things become ever
more interesting andchallenging. Could you give us an
example of what that couldlook like in a household?
Yeah. So a lot of what we'relooking at when we're looking at
(18:08):
a intervention program isfirst and foremost is looking at
how we structure mealtime. Alot of times there's just so much
inconsistency, again, betweenschedules, between expectations,
between what the family'seating versus what the child's eating.
And so there's a lot of workthat comes into play before you even
(18:29):
get to that table with thatchild. So it's looking at structuring
actual planned meal time. Soit's not just throwing some food
down and saying, I'm going togo do some other things and you need
to be able to eat, is thatyou're purposefully planning a time
in which you're sitting downwith your child and you're going
to, you know, present that.That food for them. You're also looking
(18:51):
at what is their eatingbehavior outside of that mealtime.
So a lot of kids that. Thathave food refusal or struggle with
eating often graze throughoutthe day. So they're found snacking
on a lot of foods, some chipsand crackers or candy or those sorts
of things. And so if they'redoing that from the time they get
home from school until momsays it's time for dinner, they're
(19:14):
usually not very hungry. Andso one of the other things when it
comes to structuring thosemeal times is looking at can we have
some actual gaps between thelast eating and the next eating.
So it allows our body theactual opportunity to have some digestion
and start to develop that needfor hunger. Right. And that body's
(19:37):
need for food, even if thechild isn't super motivated and wanting
to do it, but it's giving thebody the opportunity to digest those
foods and be more interestedin what is going to be provided.
And then the third part,especially with the older kids, is
they have to be involved inthe process. So a lot of this food
(19:58):
anxiety comes from lack ofcontrol and the unknown. Right. So
a lot of times families arejust making dinner, they're throwing
some stuff down for the kids.The kids have no say. They've never
seen this before. It doesn'tsmell Good. They don't want it. And
so with all of my older kids,they are involved. They are in the
driver's seat of this program.So we sit and sit, and I will say,
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okay, here is, you know, allof the foods on mom's dream list
for you to eat. Let's see howwe can look through some of these
foods and find ones that youcan look at and say, I might try
that. Or that doesn't sound sobad. Right? And being able to allow
them to pick and choose someof those foods along the way. And
(20:43):
what happens with the olderkids is that after a few foods that
seem easier to them, theystart to actually gain some confidence
and they start to realize, Ican do this, and this isn't as scary
as I thought it was. And sowith each new food presentation,
it gives them more and moreconfidence to be able to move further
(21:07):
along and try harder andharder foods. But even with the older
kids, we have to put somemotivators into place. So my older
kids usually have a biggerthing that they're working towards.
I've had children that want anew doll or want a new Lego set or
want something that maybe momand dad have said no to, they didn't
(21:29):
really want to buy, or it'snot really something that they would
get on a regular basis, butit's something that if they meet
their feeding goals, they canactually work towards. And so, you
know, if they're not motivatedby actually eating the food, but
we know it's something thatthey have to do, is that if they
can, you know, work to do,that is that they can earn this thing
(21:50):
that they potentially want.And usually by the time they get
to the point of earning thething, they have actually expanded
their variety. And you'restarting to see that they're. They're
more comfortable eating thosefoods without necessarily needing
more things, is that they'venow built up the confidence to be
(22:11):
able to realize that foodsaren't as scary as they thought that
they were.
So much of what you'redescribing really is placing the
onus on the parent payingattention, as you alluded to, in
terms of what their child isdoing with a food item around foods
in general. So then how can aparent distinguish when picky eating
(22:34):
becomes a true feedingdisorder versus just a phase that
they're going through atwhatever age they're at.
So a couple things. The. Thetypical picky eating phase that falls
in the developmentalappropriate category. Right. Is between
that age about 2 to 3. Right.And so if a child's experiencing
this older I would usuallyargue that they're out of what we
(22:58):
would would categorize asdevelopmentally appropriate picky
eating. But two is it's reallygoing to be what is the impact of
that child's eating on theirlife. So even if they're younger,
you know, children's foodintake impacts everything. So it
(23:19):
will impact their sleep, itwill impact their toileting, it will
impact their behavior, right?When we think about the idea of us
as adults feeling hangry,right when we go too long without
eating and we might be shortertempered, right? Or feeling just
(23:39):
exhausted and lethargic nearthe end of the day, wanting to let
the same thing happens to ourkids. They're quicker to tantrum,
they're quicker to be morefrustrated or non agreeable to listening
to a parent. They'restruggling to fall asleep sleep at
night. You know, they usuallyare struggling with constipation
(24:00):
because they're not getting inall of those good nutrients and it's
impacting their ability to sitat the table and eat something, to
go to a restaurant, to go doall of those sorts of things. So
if you're seeing that yourchild eating behavior is impacting
their whole day, that's whereyou're going to be to be looking
(24:22):
at. You know, we've gotsomething that we want to be able
to work on, on someintervention for. But I will say,
you know, across the board Iit is, it is much better to receive
intervention and help even ifpotentially that child would have
grown out of it than it wouldbe to not and continue to wait. So
(24:46):
because none of us have thatcrystal ball to be able to say this
two year old's going to befine when they're versus this two
year old is still going to bestruggling when he's four. I would
recommend if the parents havethe resources to be able to get that
child at 2 into some feedingprogram, you know, from the get go.
(25:08):
Because most families like yousaid are thankful for really understanding
how to look at mealtimedifferently. We all come into mealtime
with so much, much emotion andso much want and drive for our kids
to love the food as much as wedo. And the reality is most don't
(25:34):
early on even, even kids thatdon't have feeding struggles don't
necessarily love all of thefoods that they're eating even when
they're younger. But we asparents don't. You love that? Isn't
that so good? Or why don't youwant to eat that? It's so good and
so you Know, we, I really workto teach families to be able to say
(25:54):
we want meal time to be, youknow, an enjoyable experience, but
we don't need to focus onwhether or not the child is loving
the food that they're eating.We just need to make sure that they're
ultimately getting in thosefoods so that they can get in their
good nutrients. It allows themto be, you know, engaged in social
activities. It's not impactingtheir daily behavior and sleep patterns
(26:17):
at night.
You know, it's so interesting,as I hear you describe it, what's
really striking is, you know,how much influence a parent's relationship
with food can have on thiswhole equation before anything else
happens. So if you, you know,let's say don't like to cook or grew
up with unstructured mealtimes or have food aversions yourself,
(26:41):
etc. Etc. And now on somelevel, maybe imparting that, you
know, bias on your children,that's going to be like a tall mountain
to climb at one point.
Yeah, I mean, yes, it, itcertainly can be. And so, you know,
I think that's where parentsoften find, you know, my approach
(27:04):
and programming very eyeopening for them to be able to realize
how much of, of theirs, youknow, whether it's eating struggles
or eating infatuation, right.They put on to their child. You know,
I've had families that willcome to me and the mom will say,
you know, I actually struggledwith an eating disorder when I was
(27:26):
a teenager. And so I'm really,really scared to put any boundaries
into place with meal timebecause I don't want my child to
struggle in the same way. Andso while that's super valid, right.
And understanding as to whythey want to allow their child to
have free access to any foodwhenever they want it and whatever
(27:47):
they want to do is that theresearch actually shows that when
done effectively, a feedingintervention program does not lead
to any sort of eating disorderin the future. It's a very different
dynamic. And eating disorderis much more focused on body dysmorphia
and not specifically to thefoods or lack thereof that they're,
(28:11):
that they're eating. And sowhile I understand the concerns that
parents have for that, itusually, you know, can be worked
through as the parents startto realize that their child is struggling
with a different feedingchallenge and not specifically in
a body dysmorphic eating disorder.
(28:33):
When we talk about challengesfor a minute, you know, what are
some of the more commonreasons children would want to avoid,
avoid a certain food, be, youknow, against a certain Food. And
how can parents manage thatsituation without creating an environment
or shame or blame or any of that?
Yeah, so the majority of thetime, I will say, usually involves
(28:54):
a sensory characteristic ofthat food. Once in a while, it could
be a specific incident thatoccurred. So I've had some kids that
might have had a chokingincident or perhaps got the stomach
bug right after eatingsomething. And so then they associate
food, or specifically thosefoods, with bad, and they don't want
(29:17):
to eat that anymore. But mostof it comes from sensory characteristics
of the food. So the way itfeels, the way they're chewing it
in their mouth, the way itsmells, the way it looks, the color,
any of those sorts of things.And so with that, what we look at
is, is meeting the child wherethey're at and helping to shape it
(29:37):
to some of the other foodsthat they can eat. So a child that's
only eating crackers,goldfish, you're not going to give
a piece of salmon to, you'renot going to give broccoli to right
away because they're onlyeating goldfish. And that is a very,
you know, differentconsistency and texture and flavor
and all of those things. Butif we can, could teach the child
(30:00):
that the goldfish is actuallyvery similar to a cheez it, which
now, you know, is a differentshape, but is going to have a similar
crunch and a similar flavor.Right. And then we can work from
maybe that Cheez it to like apiece of toast with some melted cheese
on it. So now you still havethe crunch and you still have the
(30:22):
cheese flavor, but now you'reon a real piece of bread with some
real cheese. And you work yourway up to ultimately getting that
child to a grilled cheese or acheese sandwich of some kind. Now
you've been able to transitionfrom goldfish to sandwich, more real
food. Right. In a way that metthem where they're at and worked
(30:42):
them through their sensorycharacteristics of that food, and
they could build that trust upalong the way. Sometimes with the
kids, it's just some slightvarieties. So taking, you know, they're
already eating strawberryyogurt. Let's look at doing a new
flavor of that yogurt orkeeping it strawberry yogurt, but
(31:02):
change the brand of thatyogurt. So really, some small little
steps towards changes based onwherever that child is with the foods
that they're already eating sothat they can gain that trust along
the way.
So then at what point should aparent be looking at potential red
flags that would indicate theneed for professional intervention?
(31:26):
What does that look like.
So as soon as the child'seating is impacting their day, and
perhaps they might try some ofthese things that, you know, we were
talking about here at home.Oftentimes, even if it's just, you
know, some of these basicinterventions that we're talking
about today, it's helpful whenyou have the support of a feeding
(31:50):
specialist or professional tobe able to help, be that sounding
board for you and help youwork through that. You know, I, I
have even professionals thatwill say, after they've worked with
me for a while and they'vedone some other kids and they, they
could be pretty independent ontheir own, is that they'll say, but
you're still just a phone callaway. Right? They like to be able
(32:11):
to know that they have thatopportunity to have that support
in place. So, you know, evenfamilies that. That think that they
can say, you know, okay, I'mgoing to go in and I'm going to put
in this structure and I'mgoing to lower my expectations so
that we can meet this childwhere they're at and get them started
on the right foot. Havingsomebody to be able to help guide
(32:33):
them, even through thatprocess, if it's a big change for
what their family is typicallyused to doing, can be really helpful.
So my recommendation isalways, if meal time and the child's
eating is impacting thatchild's whole life and the surrounding
family, reach out and get somehelp, even at a consultative level,
(32:54):
to be able to get the supportto help make those changes in your
household so that you can havea more improved meal time.
Speaking of households, youare a mom of two tweens. Curious,
with all of your experienceand expertise, what does mealtime
look like in your home? Haveyou ever had to deploy any of these
strategies? Strategies?
(33:15):
Yeah. You know, I. I laughthat I was doing this before either
one of my children were born.So. So, you know, just like, you
know, different medicalprofessionals will avoid certain
activities for their kids offof fears of things that they have
seen. For me, you know, withfeeding, I, right off the bat, started
my children off of breast milkonto regular textured food because.
(33:40):
Because my own internal angstwas that there would be a struggle
transitioning from puree toregular texture, but also setting
those boundaries in place asto what mealtime looks like, what
they're expected to eat, whatthey're going to see on their plate.
And so I really strive to makesure that there's a fruit or a vegetable
in all of their meals. Andcertainly while some meals are easier
(34:05):
than others. You know, we havethe expectations that are in place,
so we're not having thetantrums at meal time. We're not
having, you know, the childsaying I don't want to eat and running
away. We're not strugglingwith those because we've set the
groundwork from the beginningof what's expected at mealtime.
(34:29):
We're almost out of time,Dina. But I did want to ask you to
tell us a bit about FocusedApproach and what makes the programming
that you deliver and your work unique.
Yeah, well, I really work tocombine both my behavior analytic
background with my clinicalpsych background to come together
(34:49):
and create an individualizedprogram for families and for professionals
to be able to teach whateverit is that they need in their specific
situation. So really beingable to work through a family's emotional
state when it comes to thisfood refusal with their child, but
(35:09):
also being able to recognizewhat that child is feeling and how,
you know, we can help themwork through that themselves. But
I really strive to make surein my programs that they are customized
to each individual family sothat they can get the best success
possible for them.
One quick piece of advice fora parent or a family in the middle
(35:33):
of what we're describing interms of that stress at the table
with a picky eater.
Yeah. So, you know, advice ishard. Right? We talked about a lot
of these things. But I, but Iwill say you're not alone. I think,
you know, is always thebiggest thing I want to strive to
families, I feel like theyoften feel like they're out on their
own island and struggling withthis and nobody else is struggling
(35:54):
with it because they see allthese other kids eating really well
and it's only their childthat's struggling. But the reality
is this is a huge issue for alot of families and with a lot of
children. And so you'redefinitely not alone. And there are
supports out there to be ableto help improve the struggles that
you might currently be having.
(36:16):
Lots of really excellent tipsand advice. Dina Allen, licensed
professional counselor fromFocused Approach and food therapist.
Thank you so much for yourtime and and sharing your insight
with us today.
Thank you so much. To learnmore about today's podcast, guest
and topic, as well as otherparenting themes, visit whereparentstalk.com.
Foreign.
Welcome to the Where ParentsTalk podcast. We help grow better
parents through science,evidence and the lived experience
of other parents. Learn how tobetter navigate the mental and physical
health of your tween teen oryoung adult through proven expert
(00:21):
advice. Here's your host,Lianne Castelino.
What effective research basedstrategies can help parents tackle
picky eating and at the sametime support their child's nutrition?
Welcome to Where Parents Talk.My name is Lianne Castelino. Our
guest today is a feedingtherapy professional. Dena Kelly
(00:43):
is also a licensedprofessional counselor and board
certified behavior analystwith more than a dozen years of experience
in feeding therapy. Shedesigns in depth feeding programs
and equips professionals andcaregivers with the skills needed
to apply evidence basedstrategies to improve the eating
(01:04):
habits of children. Dina isalso a mother of two and she joins
us today from Phoenixville,Pennsylvania. Thank you so much for
making the time.
Thank you. Thank you so muchfor having me.
Really interesting topicbecause many parents have gone through
it and it seems like you'llnever ever get past it if, you know,
depending on where you are,you have spent over 20 years working
(01:27):
with families and what led youto focus specifically on feeding
behaviors?
Yeah, so I fell into it byaccident, actually. I was in my graduate
program of study and waslooking for an internship placement
and ended up at an autismclinic, which is an area that I knew
(01:48):
I wanted to work in,pediatrics, autism. And they had
within that autism clinic anoutpatient intensive feeding therapy
program. So I was put in therefor one of my semester and never
looked back from that pointon. So once I got in there and was
really able to see how lifechanging it is for the child and
(02:11):
the family when eating is lessstressful, was so rewarding for me
that I knew that this wasdefinitely the path that I wanted
to go. And so over the lastalmost 15 years now have really focused
primarily on feedinginterventions for families. Families.
(02:34):
So give us a deeper glimpseinto that, Dina, if you could, in
terms of, you know, whatimpacted you when you had that interaction
with those children.
Yeah. So you know, when, whena family's struggling with feeding
challenges or a significantfood restriction, you know, high
level picky eating, is that itimpacts the whole life of that child
(02:55):
and the family. So it limitstheir ability to have calm family
dinners, to go out to arestaurant, to travel. You know,
most parents will report thatthey spent all day dreading dinner
time because it would end upbeing such an exhausting experience
for them. And so once we workon, you know, an appropriate intervention
(03:17):
for that child. And for thatfamily, it reduces a lot of that
stress and anxiety and allowsthe child to access social experiences
that they didn't get tobefore. It usually allows the family
unit as a whole to get alongbetter because that stress has been
reduced. And so it's justsignificant impacts across the board
(03:38):
for children, especially withautism that are in a lot of other
therapy programs as well, isthat once they are actually eating
well throughout the day, is itallows them more stamina to get through
the day. They're less cranky,they're more focused because their
(03:59):
bodies are actually feelingbetter. So it gives them the opportunity
to excel in those othertherapies when they're. When their
oral intake, their feedingintake is improved.
I guess most of us wouldreally associate picky eaters with
younger children typically.But I wonder what current trends
you're seeing as it relates toolder kids, tweens, teens and adolescents.
(04:21):
Yeah, so that's most of mycaseload right now, as crazy as it
is, is actually the olderkiddos. And that actually started
around the time Covid hit. Sowhen Covid hit for us, when there
was a major influx in familiesof older kids calling in, because
prior to that, you know, whenyou think about the school age dish,
(04:43):
you know, elementary, middleschool children, there's a lot of
hustle and bustle, right?They're gone all day at school. They
come home, it's like, quick,let's do some homework and a snack
and maybe we're off to asporting game. And they're grabbing
food from the drive through.They're just grabbing snacks. They're
kind of on the go. And whathappened during COVID is that everybody
was home and then they werehome for every single meal. And then
(05:06):
we were getting these panickedcalls going, oh my gosh, all he wants
is McDonald's every day. Orhe's not eating anything other than
chips. I never really noticedbecause we hadn't sat down for family
meals because things were sobusy. And now that we were forced
into not being busy, we'renoticing that. So we have that. You
know, though, I definitely sawa big trend coming up in that respect.
(05:29):
But the other big component isthat for a lot of kids and, and this
I can't yet explain withfeeding challenges, don't always
have the growth concernsmatched with it. So there are kids
that could be solely eatingone specific food, and they can continue
(05:50):
to grow in height and weight.And so what happens is throughout
the years, they'll go to theiryearly checkups at the pediatrician's
office, and they'll reportthat that child is picky and they're
struggling to get in a varietyof foods, but often from a medical
side, if they're growing inheightened weight, they're continuing
to be told, just wait and see.It's a phase. They're going to grow
(06:12):
out of it, don't worry. Andthose years continue on. And the
longer that children go withcontinued avoidance of eating, the
more difficult it gets to beable to expand that variety. And
so if you get into those yearsof 9, 10, 11, 12, you know, into
(06:32):
those teenage years,oftentimes it's actually snowballing
and becoming a bigger andbigger and bigger issue. And so then
I have the families reachingout and their child's 13, 14, 15
going, I've known this hasbeen a problem since they were two,
three or four, but becausethey were growing, because there
wasn't really any nutritionconcern that they were initially
(06:54):
looking at, we didn't doanything. And now this child is not
going to birthday parties.They don't want to hang out with
their friends at the mall.They, you know, aren't eating during
the school day because there'snothing for them to eat. And so now
this child is strugglingsocially. It's leading to more anxiety,
(07:15):
it's leading to stress in thefamily, all of those sorts of things.
And so it's that wait and seecategory that they usually end up
getting to that point. It's.It's much more uncommon to see a
child that was eating reallywell and then in that tween or teenage
started to develop the foodchallenges. It's usually something
(07:37):
that if in hindsight you lookback, most families will say they've
seen it all along.
So then along those lines,Dina, is it possible to pinpoint
root causes here? Right. Likeyou talked about COVID as an example.
But like picky eating amongchildren seems to be so prevalent.
(07:59):
Is it something that parentsare doing as well or what's contributing
to this?
It's a combination of a fewdifferent things. Right. You know,
developmentally,appropriately, children are going
to go through that no phase,right. Or that time where they want
to just assort assert theirauthority and they are in charge
(08:22):
and they are going to be inthe one giving the instructions and
that sort of a thing. And sothat's appropriate and should be
happening. But what happenswhen you have a child that has potentially
some predisposition for thisfeeding challenge, then paired in
an environment where when theydo say no or they do engage in some
(08:47):
refusal behaviors at mealtime,get removed from that meal time,
get provided with a much morepreferred food item, get a whole
lot of attention andengagement when they're engaging
in those sorts of refusalbehaviors at mealtime. Sometimes
paired the biological partwith the environmental part ends
(09:11):
up being this recipe that endsup putting that child in more of
a restrictive eating pattern.So the other thing to look at is,
is how restrictive they'reactually getting with their food.
So you know, we, we hear thatterm picky eating and it should be
a phase often, but usuallywith picky eaters, even though their
(09:35):
variety of food may not be asexciting, expanded as you know, an
adult would be, or even anolder child might be, is that they
have foods usually in eachfood group that they're eating, even
if it's only a select few. Andusually they can generalize those
foods to a variety ofdifferent environments. So even if
(09:56):
the child only wants to eatchicken nuggets, they'll eat chicken
nuggets. Whether you order itoff of the kids menu at a restaurant,
whether mom makes them athome, whether you get them while
you're on vacation, whateveryou're doing. Chicken nuggets, that's
going to be a win food, right?With the more restrictive eaters
or kids that are strugglingmore internally what they're eating,
(10:19):
they're going to want thespecific chicken nugget from the
specific place that the brandor restaurant and that's it. They
can expand past that. And sousually there's more of that internal
struggle with sensorysensitivities. Sometimes, you know,
kids have higher gag reflexesor certain senses are heightened.
(10:44):
You know, we have kids thathave bigger challenge being around
certain smells or certainfeelings of that texture. That consistency
can really throw them for aloop as far as what they're actually
exposed to eating. But, butmost kids, most people are internally
(11:05):
motivated to eat and enjoyeating. And so usually, you know,
if they're in a typical pickeater stage, they're going to continue
to expand out of that. They'regoing to be willing to try some new
stuff because it's interestingand they like eating. When we're
seeing that significantavoidance and lack of actual interest
in food is where you're havingmore of the concern. And that's often
(11:31):
where parents have more of theinconsistency as to how they handle
that, which can lead to thenagain more of that snowball as far
as how they're going to moveforward in that situation. So sometimes
they get frustrated and sothey get heightened and respond in
an angry way. Maybe sometimesthey actually Just shut down and
(11:52):
get frustrated in that way.And they say, forget it, do whatever
you want. I'm not even goingto, you know, require that you do
anything today. Sometimes theymight negotiate with them and they
go back and forth on, if youjust take this bite of food, I'll
give you this. If you do this,I'll give you this. And get into
all of that. So. So it'sdefinitely a combination of both
(12:15):
the physiological and theenvironmental factors.
Now one of the reallyinteresting pieces of your story
is that you transition from ahands on sort of intervention based
support to program developmentand training caregivers and parents
on the very things that you'vejust outlined there. So what motivated
(12:36):
you to make that pivot, tomake that shift and how has your
perspective evolved as a result?
Yeah, so the pivot startedagain back during that Covid time,
right when everything shutdown and everybody went virtual.
So did in person, persontherapy programs. And so we really
(12:57):
had to do this shift of, youknow, I used to be very hands on
in this program. The parentswould watch from the side as I was
working through a meal timewith the child and starting to learn
the interventions that theyneeded to do. And now we were stuck
in this situation where thatwasn't actually possible and so had
to quickly get creative on howwe would move forward with that.
(13:19):
And what we were able to seeis that there's even better, bigger
benefit to doing it as aparent training approach and being
able to empower the parents toget the, the confidence and control
back in their kitchen andaround meal time to be able to give
their kids the confidence tobe able to actually do better with
(13:41):
their eating. And so now whenI do programming for families, it
is in their home. The parentis taking the lead, the child is
in their own kitchen wherethey're expected to eat most of their
meals. They're eating foodsthat the parents are cooking. And
so it's all part of theprocess of ultimately what we want
(14:03):
them to be doing. Expandedfrom that is that now a big part
of what I do is actuallytraining professionals because what
I was seeing was that there'sthis whole population of kids that
need intervention that can'tnecessarily access it from a private
provider like me. But alsothese professionals that are already
(14:28):
working with these kiddos butdon't necessarily have the skills
to do feeding intervention.And so by actually training the professionals
that are so interested inlearning to expand their knowledge
for feeding, now they'regaining professional development
and those families are able toaccess some of that care that they
(14:49):
wouldn't necessarily have beenable to access privately.
Part of your approach involvesapplied behavior analysis. Can you
take us through what that isand why is this considered an effective
tactic for feeding therapy?
Yeah. So ABA providesstructured individualized approach
(15:10):
to each family. You're lookingat how you can understand and, and
improve the behavior of thatchild. And, and that's really across
the board, but obviously inour case specific to feeding. And
so what we're looking at isboth what's reinforcing that food
refusal, meaning what'skeeping it going, and, and what can
(15:34):
we actually use to reinforceactual eating consumption. So when
kids are really strugglingwith a feeding disorder, they're
not internally driven by toeat, they're not motivated to do
it. Right. I, for me, I loveto eat. I could smell food cooking
in the kitchen and I'm alreadyhungry. I could be full. And if somebody
(15:54):
brings out a treat that looksreally good, I'm still going to eat
it. Right. But our kids thatare struggling with food selectivity
are not necessarily motivatedto eat in the same way. So I equate
it a lot to thinking aboutother just mundane or non preferred
tasks that a kid might have todo. You tell a child to clean up
their toys or brush theirteeth or put on their pajamas, some
(16:18):
of those things that theydon't necessarily have an interest
in doing. But if you can pairthose things with things that are
motivating to them, it givesthem more of a drive to do it. So
you tell the child to clean uptheir toys, they say no, but you
say if we clean up our toys,we can get to the park. Right. Is
that then they may be morelikely if they really want to go
(16:40):
to the park to put their toysaway, even though that wasn't super
interesting to them in thebeginning. And so with food, while
obviously there's some morecomplexities than just putting toys
into a toy box, we have tothink a lot about the different textures
and, you know, smells andcolors and all of the sensory components
that come into food. Andthinking about that when we introduce
(17:02):
those to our kids is that wedo have to look at if this, if the
act of eating is notmotivating to you is what can we
do to be able to help providesome of that motivation and push
to be able to get you moreinterested in trying those foods.
And so a lot of Abi is reallylooking at the environment as a whole
(17:26):
and that child as anindividual and being able to say
what can we do within thischild's environment to be able to
help provide them, you know,that. That extra ohm for that motivation
to be able to make thisbehavior change.
(17:47):
So really interesting examplethat you provided there with the
younger child and the park.What would that look like with a
tween or a teen, for example,when, you know, things become ever
more interesting andchallenging. Could you give us an
example of what that couldlook like in a household?
Yeah. So a lot of what we'relooking at when we're looking at
(18:08):
a intervention program isfirst and foremost is looking at
how we structure mealtime. Alot of times there's just so much
inconsistency, again, betweenschedules, between expectations,
between what the family'seating versus what the child's eating.
And so there's a lot of workthat comes into play before you even
(18:29):
get to that table with thatchild. So it's looking at structuring
actual planned meal time. Soit's not just throwing some food
down and saying, I'm going togo do some other things and you need
to be able to eat, is thatyou're purposefully planning a time
in which you're sitting downwith your child and you're going
to, you know, present that.That food for them. You're also looking
(18:51):
at what is their eatingbehavior outside of that mealtime.
So a lot of kids that. Thathave food refusal or struggle with
eating often graze throughoutthe day. So they're found snacking
on a lot of foods, some chipsand crackers or candy or those sorts
of things. And so if they'redoing that from the time they get
home from school until momsays it's time for dinner, they're
(19:14):
usually not very hungry. Andso one of the other things when it
comes to structuring thosemeal times is looking at can we have
some actual gaps between thelast eating and the next eating.
So it allows our body theactual opportunity to have some digestion
and start to develop that needfor hunger. Right. And that body's
(19:37):
need for food, even if thechild isn't super motivated and wanting
to do it, but it's giving thebody the opportunity to digest those
foods and be more interestedin what is going to be provided.
And then the third part,especially with the older kids, is
they have to be involved inthe process. So a lot of this food
(19:58):
anxiety comes from lack ofcontrol and the unknown. Right. So
a lot of times families arejust making dinner, they're throwing
some stuff down for the kids.The kids have no say. They've never
seen this before. It doesn'tsmell Good. They don't want it. And
so with all of my older kids,they are involved. They are in the
driver's seat of this program.So we sit and sit, and I will say,
(20:19):
okay, here is, you know, allof the foods on mom's dream list
for you to eat. Let's see howwe can look through some of these
foods and find ones that youcan look at and say, I might try
that. Or that doesn't sound sobad. Right? And being able to allow
them to pick and choose someof those foods along the way. And
(20:43):
what happens with the olderkids is that after a few foods that
seem easier to them, theystart to actually gain some confidence
and they start to realize, Ican do this, and this isn't as scary
as I thought it was. And sowith each new food presentation,
it gives them more and moreconfidence to be able to move further
(21:07):
along and try harder andharder foods. But even with the older
kids, we have to put somemotivators into place. So my older
kids usually have a biggerthing that they're working towards.
I've had children that want anew doll or want a new Lego set or
want something that maybe momand dad have said no to, they didn't
(21:29):
really want to buy, or it'snot really something that they would
get on a regular basis, butit's something that if they meet
their feeding goals, they canactually work towards. And so, you
know, if they're not motivatedby actually eating the food, but
we know it's something thatthey have to do, is that if they
can, you know, work to do,that is that they can earn this thing
(21:50):
that they potentially want.And usually by the time they get
to the point of earning thething, they have actually expanded
their variety. And you'restarting to see that they're. They're
more comfortable eating thosefoods without necessarily needing
more things, is that they'venow built up the confidence to be
(22:11):
able to realize that foodsaren't as scary as they thought that
they were.
So much of what you'redescribing really is placing the
onus on the parent payingattention, as you alluded to, in
terms of what their child isdoing with a food item around foods
in general. So then how can aparent distinguish when picky eating
(22:34):
becomes a true feedingdisorder versus just a phase that
they're going through atwhatever age they're at.
So a couple things. The. Thetypical picky eating phase that falls
in the developmentalappropriate category. Right. Is between
that age about 2 to 3. Right.And so if a child's experiencing
this older I would usuallyargue that they're out of what we
(22:58):
would would categorize asdevelopmentally appropriate picky
eating. But two is it's reallygoing to be what is the impact of
that child's eating on theirlife. So even if they're younger,
you know, children's foodintake impacts everything. So it
(23:19):
will impact their sleep, itwill impact their toileting, it will
impact their behavior, right?When we think about the idea of us
as adults feeling hangry,right when we go too long without
eating and we might be shortertempered, right? Or feeling just
(23:39):
exhausted and lethargic nearthe end of the day, wanting to let
the same thing happens to ourkids. They're quicker to tantrum,
they're quicker to be morefrustrated or non agreeable to listening
to a parent. They'restruggling to fall asleep sleep at
night. You know, they usuallyare struggling with constipation
(24:00):
because they're not getting inall of those good nutrients and it's
impacting their ability to sitat the table and eat something, to
go to a restaurant, to go doall of those sorts of things. So
if you're seeing that yourchild eating behavior is impacting
their whole day, that's whereyou're going to be to be looking
(24:22):
at. You know, we've gotsomething that we want to be able
to work on, on someintervention for. But I will say,
you know, across the board Iit is, it is much better to receive
intervention and help even ifpotentially that child would have
grown out of it than it wouldbe to not and continue to wait. So
(24:46):
because none of us have thatcrystal ball to be able to say this
two year old's going to befine when they're versus this two
year old is still going to bestruggling when he's four. I would
recommend if the parents havethe resources to be able to get that
child at 2 into some feedingprogram, you know, from the get go.
(25:08):
Because most families like yousaid are thankful for really understanding
how to look at mealtimedifferently. We all come into mealtime
with so much, much emotion andso much want and drive for our kids
to love the food as much as wedo. And the reality is most don't
(25:34):
early on even, even kids thatdon't have feeding struggles don't
necessarily love all of thefoods that they're eating even when
they're younger. But we asparents don't. You love that? Isn't
that so good? Or why don't youwant to eat that? It's so good and
so you Know, we, I really workto teach families to be able to say
(25:54):
we want meal time to be, youknow, an enjoyable experience, but
we don't need to focus onwhether or not the child is loving
the food that they're eating.We just need to make sure that they're
ultimately getting in thosefoods so that they can get in their
good nutrients. It allows themto be, you know, engaged in social
activities. It's not impactingtheir daily behavior and sleep patterns
(26:17):
at night.
You know, it's so interesting,as I hear you describe it, what's
really striking is, you know,how much influence a parent's relationship
with food can have on thiswhole equation before anything else
happens. So if you, you know,let's say don't like to cook or grew
up with unstructured mealtimes or have food aversions yourself,
(26:41):
etc. Etc. And now on somelevel, maybe imparting that, you
know, bias on your children,that's going to be like a tall mountain
to climb at one point.
Yeah, I mean, yes, it, itcertainly can be. And so, you know,
I think that's where parentsoften find, you know, my approach
(27:04):
and programming very eyeopening for them to be able to realize
how much of, of theirs, youknow, whether it's eating struggles
or eating infatuation, right.They put on to their child. You know,
I've had families that willcome to me and the mom will say,
you know, I actually struggledwith an eating disorder when I was
(27:26):
a teenager. And so I'm really,really scared to put any boundaries
into place with meal timebecause I don't want my child to
struggle in the same way. Andso while that's super valid, right.
And understanding as to whythey want to allow their child to
have free access to any foodwhenever they want it and whatever
(27:47):
they want to do is that theresearch actually shows that when
done effectively, a feedingintervention program does not lead
to any sort of eating disorderin the future. It's a very different
dynamic. And eating disorderis much more focused on body dysmorphia
and not specifically to thefoods or lack thereof that they're,
(28:11):
that they're eating. And sowhile I understand the concerns that
parents have for that, itusually, you know, can be worked
through as the parents startto realize that their child is struggling
with a different feedingchallenge and not specifically in
a body dysmorphic eating disorder.
(28:33):
When we talk about challengesfor a minute, you know, what are
some of the more commonreasons children would want to avoid,
avoid a certain food, be, youknow, against a certain Food. And
how can parents manage thatsituation without creating an environment
or shame or blame or any of that?
Yeah, so the majority of thetime, I will say, usually involves
(28:54):
a sensory characteristic ofthat food. Once in a while, it could
be a specific incident thatoccurred. So I've had some kids that
might have had a chokingincident or perhaps got the stomach
bug right after eatingsomething. And so then they associate
food, or specifically thosefoods, with bad, and they don't want
(29:17):
to eat that anymore. But mostof it comes from sensory characteristics
of the food. So the way itfeels, the way they're chewing it
in their mouth, the way itsmells, the way it looks, the color,
any of those sorts of things.And so with that, what we look at
is, is meeting the child wherethey're at and helping to shape it
(29:37):
to some of the other foodsthat they can eat. So a child that's
only eating crackers,goldfish, you're not going to give
a piece of salmon to, you'renot going to give broccoli to right
away because they're onlyeating goldfish. And that is a very,
you know, differentconsistency and texture and flavor
and all of those things. Butif we can, could teach the child
(30:00):
that the goldfish is actuallyvery similar to a cheez it, which
now, you know, is a differentshape, but is going to have a similar
crunch and a similar flavor.Right. And then we can work from
maybe that Cheez it to like apiece of toast with some melted cheese
on it. So now you still havethe crunch and you still have the
(30:22):
cheese flavor, but now you'reon a real piece of bread with some
real cheese. And you work yourway up to ultimately getting that
child to a grilled cheese or acheese sandwich of some kind. Now
you've been able to transitionfrom goldfish to sandwich, more real
food. Right. In a way that metthem where they're at and worked
(30:42):
them through their sensorycharacteristics of that food, and
they could build that trust upalong the way. Sometimes with the
kids, it's just some slightvarieties. So taking, you know, they're
already eating strawberryyogurt. Let's look at doing a new
flavor of that yogurt orkeeping it strawberry yogurt, but
(31:02):
change the brand of thatyogurt. So really, some small little
steps towards changes based onwherever that child is with the foods
that they're already eating sothat they can gain that trust along
the way.
So then at what point should aparent be looking at potential red
flags that would indicate theneed for professional intervention?
(31:26):
What does that look like.
So as soon as the child'seating is impacting their day, and
perhaps they might try some ofthese things that, you know, we were
talking about here at home.Oftentimes, even if it's just, you
know, some of these basicinterventions that we're talking
about today, it's helpful whenyou have the support of a feeding
(31:50):
specialist or professional tobe able to help, be that sounding
board for you and help youwork through that. You know, I, I
have even professionals thatwill say, after they've worked with
me for a while and they'vedone some other kids and they, they
could be pretty independent ontheir own, is that they'll say, but
you're still just a phone callaway. Right? They like to be able
(32:11):
to know that they have thatopportunity to have that support
in place. So, you know, evenfamilies that. That think that they
can say, you know, okay, I'mgoing to go in and I'm going to put
in this structure and I'mgoing to lower my expectations so
that we can meet this childwhere they're at and get them started
on the right foot. Havingsomebody to be able to help guide
(32:33):
them, even through thatprocess, if it's a big change for
what their family is typicallyused to doing, can be really helpful.
So my recommendation isalways, if meal time and the child's
eating is impacting thatchild's whole life and the surrounding
family, reach out and get somehelp, even at a consultative level,
(32:54):
to be able to get the supportto help make those changes in your
household so that you can havea more improved meal time.
Speaking of households, youare a mom of two tweens. Curious,
with all of your experienceand expertise, what does mealtime
look like in your home? Haveyou ever had to deploy any of these
strategies? Strategies?
(33:15):
Yeah. You know, I. I laughthat I was doing this before either
one of my children were born.So. So, you know, just like, you
know, different medicalprofessionals will avoid certain
activities for their kids offof fears of things that they have
seen. For me, you know, withfeeding, I, right off the bat, started
my children off of breast milkonto regular textured food because.
(33:40):
Because my own internal angstwas that there would be a struggle
transitioning from puree toregular texture, but also setting
those boundaries in place asto what mealtime looks like, what
they're expected to eat, whatthey're going to see on their plate.
And so I really strive to makesure that there's a fruit or a vegetable
in all of their meals. Andcertainly while some meals are easier
(34:05):
than others. You know, we havethe expectations that are in place,
so we're not having thetantrums at meal time. We're not
having, you know, the childsaying I don't want to eat and running
away. We're not strugglingwith those because we've set the
groundwork from the beginningof what's expected at mealtime.
(34:29):
We're almost out of time,Dina. But I did want to ask you to
tell us a bit about FocusedApproach and what makes the programming
that you deliver and your work unique.
Yeah, well, I really work tocombine both my behavior analytic
background with my clinicalpsych background to come together
(34:49):
and create an individualizedprogram for families and for professionals
to be able to teach whateverit is that they need in their specific
situation. So really beingable to work through a family's emotional
state when it comes to thisfood refusal with their child, but
(35:09):
also being able to recognizewhat that child is feeling and how,
you know, we can help themwork through that themselves. But
I really strive to make surein my programs that they are customized
to each individual family sothat they can get the best success
possible for them.
One quick piece of advice fora parent or a family in the middle
(35:33):
of what we're describing interms of that stress at the table
with a picky eater.
Yeah. So, you know, advice ishard. Right? We talked about a lot
of these things. But I, but Iwill say you're not alone. I think,
you know, is always thebiggest thing I want to strive to
families, I feel like theyoften feel like they're out on their
own island and struggling withthis and nobody else is struggling
(35:54):
with it because they see allthese other kids eating really well
and it's only their childthat's struggling. But the reality
is this is a huge issue for alot of families and with a lot of
children. And so you'redefinitely not alone. And there are
supports out there to be ableto help improve the struggles that
you might currently be having.
(36:16):
Lots of really excellent tipsand advice. Dina Allen, licensed
professional counselor fromFocused Approach and food therapist.
Thank you so much for yourtime and and sharing your insight
with us today.
Thank you so much. To learnmore about today's podcast, guest
and topic, as well as otherparenting themes, visit whereparentstalk.com.
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