Mealtimes & Nutrition
Many caregivers grapple with concerns about children’s nutrition and eating habits. Picky eating, food preferences, or struggles during mealtimes are common, and it is hard to know how to prevent and address these problems while maintaining a social and supportive mealtime. Caregivers should ensure that there are no physiological barriers (e.g., difficulty chewing or swallowing, allergies) which will require medical or therapeutic intervention prior to embarking on a behavioral strategy.
What can caregivers do about picky eating?
Picky eating can be a frustrating issue to manage during mealtimes. Caregivers want to ensure that children consume a varied and balanced diet. Children with picky eating habits are highly selective about what foods they accept, and they may only consume foods with certain textures, smells, tastes, or names. Fortunately, there are several different strategies that caregivers can implement to help manage this concern.
Strategies put in place prior to mealtime can be thought of as antecedent strategies because they occur before the child’s eating (or refusal) occurs. Antecedent strategies such as offering choices can help children be more motivated to try different foods. Another antecedent strategy consists of offering dips such as yogurt or hummus or blending preferred foods (e.g., applesauce) into less-preferred foods.
Using a “first…then” strategy can also be helpful. For example, before the child sits down for a meal, the caregiver can say, “First, you have to eat your asparagus. Then, you can have French fries.” The important piece here is to make sure to set up the “first…then” contingency before the child has a chance to refuse the vegetables. If you only make a preferred food available after the child has refused a different food, you have just taught the child that the way to be offered their preferred food is to refuse a nonpreferred food. Also for that reason, it is important to honor reasonable choices that children make using calm words in the absence of refusal or other behavioral challenges. This “first...then” strategy relies on the Premack Principle, which states that behaviors that are more likely (e.g., eating French fries) will reinforce behaviors that are less likely (e.g., eating asparagus).
Reliance on the Premack Principle brings us to the second category of strategies: consequences. From a behavioral perspective, any event that follows a behavior may be considered a consequence to that behavior. The term “consequence” is neutral in that it doesn’t convey a negative or abative function nor a positive or appetitive function. It simply refers to an event that follows a behavior. A consequence-based approach to addressing picky eating might include selecting a special treat to follow consumption of a nonpreferred food. For example, a mini chocolate chip could follow a bite of a novel creamed chicken dish. If chocolate chips are a reinforcer for the child who doesn’t want to eat the creamed chicken, the behavior of trying the creamed chicken will be reinforced by the chocolate chip, provided that it is given to the child immediately and contingently following their consumption of a bite of chicken. Again, it will be important to describe this contingency to the child before presenting the chicken to avoid reinforcing a chain in which the child refuses to eat the nonpreferred food and is then offered a highly preferred food. Note that the reinforcer does not have to be a type of food. Perhaps the child can watch 30 seconds of their favorite music video after they take a bite; the Premack Principle should hold either way! Over time, once the child is successful, caregivers can increase the requirement to access the reinforcer (e.g., first take 3 bites, then you can have 30 sec of your video). If a child spontaneously, without instruction or prompting, tries a nonpreferred food, an adult should deliver praise (and maybe a chocolate chip) in that instance, too!
How can caregivers broaden their child’s food preferences?
One strategy that may be used to broaden preferences is exposure. Placing a new food on a child’s plate without any instruction or requirement to try it will help children get used to the presence of different foods. If the child does try the new food, caregivers should reinforce that behavior of trying new foods as described above (perhaps with praise and/or a special treat). If the child does not try the food independently, caregivers can apply an approach called shaping where the child is prompted to take steps toward trying the food. For example a child may be asked to simply touch the food with their fork, to later spear the food with their fork, to gradually bring the food to their mouth, over time begin to lick the food, and eventually to place it in their mouth. Each time the child engages in a step that is closer to that goal of consuming the new food, the caregiver should provide reinforcement.
Preferences can also be broadened through a technique called fading. For example, if a child doesn’t like to drink milk, and there is no medical reason for them to avoid it (e.g., no allergy or sensitivity), milk can be blended with chocolate, strawberry, or another flavoring. This is similar to the antecedent strategy of blending described above. Let’s use chocolate for this example. When the child drinks chocolate milk, they can access a reinforcer (e.g., a preferred treat or activity). Once they drink chocolate milk reliably, the caregiver can begin gradually mixing less and less chocolate into the milk (i.e., “fading” the presence of the chocolate) over a period of several weeks. Throughout this time, the child should still access reinforcement after they consume the milk. Eventually, they will be drinking milk with very little to no chocolate flavoring. They may even come to like and prefer unflavored milk!
Caregivers should know that all of these processes take time and require their attention. However, they should be able to see small increments of progress throughout if they are holding consistent and reasonable expectations.
How can caregivers reduce behavioral struggles during mealtime?
Behavioral struggles during mealtimes can be addressed similarly to behavioral struggles at other times. Being aware of the effects of antecedents and consequences on behavior is critical. Maintaining consistent, reasonable expectations is helpful. As noted above, making sure to describe any rules or contingencies, including the reinforcers available for engaging in a desired behavior (e.g., eating new foods, finishing within a certain time period, waiting in between bites, staying seated, or whatever the desired mealtime behavior is) BEFORE the struggle occurs at a given meal will help ensure that caregivers are taking a proactive, skill-building approach rather than a reactive and punishing approach to changing mealtime behavior.
A Board-Certified Behavior Analyst (BCBA)® can help caregivers identify and correct any concerns. To find a BCBA near you, consult your pediatrician or local school district. You can also go to www.bacb.com to search for providers. Additionally, you may email abaforkids.org@gmail.com for individualized help with your search.
Have a Question?
Please feel free to reach out if you have any questions or want to learn more about Applied Behavior Analysis (ABA).