As a pediatric feeding therapist, it’s not unusual for me to get a call from a mother who says “My kid’s 14 years old and still eats only six foods. He’s so picky! I thought he would grow out of it.” True, with patience and consistent strategies, some kids do indeed grow out of the picky-eater stage, typically at its peak aro
und age three. But if the child had underlying motor, physiological or sensory challenges that stalled the developmental process of learning to eat a variety of foods, it’s not unusual that selective eating behaviors will prevail into the teenage years. I approach treatment with teens in a similar manner as my younger clients while respecting one important fact: They are teenagers!
Here are my top five tips for interacting with teens while building trust and confidence, plus making feeding therapy successful (and fun!) for both of you:
#5 Use Cool Games: I always incorporate games into feeding practice. Learning to try new foods is HARD, at any age. Including games in the process of biting, chewing and tasting keeps anxiety levels low and still allows learning to take place. Using games as a means of distraction, such as eating while playing independently on an iPad, does not allow for conscious learning. Instead, try using games that are reciprocal in nature and where each player’s turn lasts no more than ten seconds. If your client is working on learning to drink a smoothie, perhaps he might take a drink, get a turn, etc. Try Blockus, UNO Blast or Connect-4 Launchers, all interactive and exciting games. Plus, they are easy to clean, which is important in feeding treatment.
#4 Create Your Own Games: To quote a bit of teenage lingo, find out what the teenager “is obsessed with” and create games around that obsession. Does she love three-toed sloths? Pull up the best sloth videos on YouTube and create a Jeopardy game around them, hiding each video under categories like “Kristen Bell for One Hundred Please.” I once had a client who knew every Movie Production Logo in Hollywood. His mother sent me pictures of ten favorite logos and I laminated two copies of each. During feeding therapy in his home, we would spread out the laminated pictures all over the kitchen floor and after each bite, try to toss a penny onto a picture. Get a match, and you get a point. Another client of mine was obsessed with paintball, but I wasn’t about to do feeding therapy in a paintball bunker. Instead, I brought my Discovery Toys Marbleworks® and with each bite we added one piece, eventually building intricate contraptions and using the paintballs as marbles.
#3 Ask WHY: Once I get to know a teen, I always ask this question: “Is there a special reason you want to learn to try new foods?” One teen told me that he wanted to ask his girlfriend to Prom, but was afraid that he couldn’t take her to a fancy restaurant for dinner. “I don’t think they serve pizza there, and that’s all I know how to eat.” That was eye-opening for me! Now I know his motivation and we have a timeline for success. When there is no motivation, that’s a problem. It’s common for a teen to reply: “I don’t want to learn to eat anything new – my Mom is making me.” This is the time to help a teen FIND motivation. “How’s wrestling going? Did you know you need protein to build more lean muscle? What types of protein would you like to learn to eat: nuts, hamburger or vegetable protein?” One of my clients had been consisting on four strawberry Pediasures mixed with whole milk every day for over three years before starting therapy. He used to eat some solid foods, but over time began to limit his intake until he was food jagging on Pediasure. He didn’t see a problem, because he liked the way he could gulp down a Pediasure and rush outside during break time to play basketball with his friends. That worked for him because it enabled him to avoid social eating in the cafeteria, which made him very anxious. I suspected that the high dairy content was making him constipated, thus decreasing appetite. Let’s face it: A teen is not likely to tell ME about his constipation. But, I called his pediatrician and requested that they have the constipation talk during the upcoming sports physical. Once his doctor explained that he would no longer have to struggle with bathroom issues, which was a huge source of embarrassment for him, the teen was open to tasting some new foods. Feeding therapy, especially with teens, goes best when we focus on the whole child and learning what’s important in his unique world.
#2 Teach positive self-talk: So many older kids engage in negative talk about food because it stops parents from serving it. Over time, those negative comments become a habit that for lack of better term, is a form of self-brainwashing. While it’s important to acknowledge a teen’s feelings if he says “I can’t – I’m scared I’ll gag,” it’s just as important to help him talk positively about eating. I explain it this way:
I want you to talk to your own brain the way you would talk to your best friend. If your best friend had practiced with his soccer coach to take a goal kick in soccer but was feeling anxious when it came time to attempt it, he might turn and whisper to you, “I can’t – I’m scared that I’ll miss.” You’d probably tell him “You’ve practiced with coach and you have the skills to do it! It’s OK to be nervous – you can still make that goal!” He needs to hear that from you. Well, your brain needs to hear the same positive talk from you when you talk about food. It’s OK to be nervous and it’s OK not to like the taste of it. We’re just beginning to learn how to how to eat this new food and we are practicing it.”
And this SLP’s #1 Tip? Give Them the Script: Teens may not always have the most descriptive vocabulary, except to narrow taste and texture down to “gross.” Give them the language and discuss what terms like savory, buttery, creamy truly mean. A reference list of 345 terms to describe food can be found here. Plus, it helpful to use comparison phrases such as “It’s similar to tiny dots of corn, but it’s called polenta” in order to build familiarity with a food they’ve experienced in some manner, such as corn. If the most interaction they’ve had with corn is just staring at it, that’s OK! Stare at the polenta. Make it a kitchen science experiment and discuss all the properties of polenta if you need to. Give them the words that build visual familiarity with polenta: “yellow cornmeal”, “hulled”, etc. Talk about how it can be baked, fried, grilled or stirred into a porridge. Interact with it – get to know it. Now you’ve got a teen whose introducing his brain to polenta by saying: “Polenta is cornmeal, which is made from something I’m familiar with: corn. I think it looks best when it’s fried, because I like fried foods.” He’s OPEN to the concept of Polenta because he has the terminology to describe it and understand the properties. As you progress from visual interaction to tactile exploration, provide terms that describe the feel of polenta such as “gritty” and “course.” Eventually, you’ll be discussing the same feel in the mouth. As all SLPs know, language is empowering.
What other strategies do you have when helping teens interact with new foods? Please list them in the comments section, thank you!
Melanie Potock, MA, CCC-SLP, treats children birth to teens who have difficulty eating. She is the author of Happy Mealtimes with Happy Kids and the producer of the award-winning kids’ CD Dancing in the Kitchen: Songs that Celebrate the Joy of Food! Melanie’s two-day course on pediatric feeding is offered for ASHA CEUs and includes both her book and CD for each attendee. She can be reached at Melanie@mymunchbug.com.