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Resources for Feeding, Eating, Drinking, Speech, and Mouth/Airway Function


Hot Topic Blog - Feeding, Eating, & Drinking


By Dianne Lazer, MA, CCC-SLP/COM of Marlton, New Jersey

August 2014


It’s not easy dealing with a picky eater. You know the ones who only eat breads, crackers, and chips or what others refer to as the “white diet” and refuse to eat healthy foods like fruits, vegetables, and meats. Some gag or vomit every time they smell, touch, or see a food they don’t like. Parents report they are making two and three different meals, so their children will eat. Or, parents give in and let them eat pancakes or bagels and juice for dinner, so “at least they are eating something!”

Sensory integration (SI) issues are often thought to be the cause of why children get caught in this never ending cycle. According to A. Jean Ayres, Ph. D. (the person who first researched and coined the phrase) sensory integration is the ability to take in information through our senses (touch, movement, smell, taste, vision, and hearing), to put it together with prior information (memories and knowledge stored in the brain), and to make a meaningful response. When SI issues are notable enough, children are sometimes diagnosed with a sensory processing disorder. The terms sensory processing disorder and sensory integration disorder are often used interchangeably.

Children who present with sensory integration issues may have difficulty taking in and sorting information through their senses especially when eating. Eating involves sorting, receiving, and integrating enormous amounts of sensory data from taste to texture to temperature to color. To keep from being overwhelmed by these many sensations, children with sensory issues are often picky and controlling around food. They might prefer crunchy, salty snacks over mixed textured or hard to chew healthy foods like fruits, vegetables, or meats. Chips and crackers give consistent feedback when put in the mouth and are ultimately easier to eat than mixed texture or hard to chew foods. In other words, children can hear and feel the crunch while eating chips and crackers and their saliva can easily melt down these foods, so the child does not have to chew and manipulate the food very much in order to swallow it.

Crunchy, salty foods also “taste” better to many children because they are highly processed with salt and/or sugar. As previously mentioned, less work managing these foods makes it easier for children to handle them. Chips and crackers can be picked up and manipulated easily with the hands as well. However, these highly processed foods are addicting, and relying on food with poor nutritional value may prevent the sensory system from maturing as explained in the next paragraph.

According to Kelly Dorfman, MS, LND and author of What’s Eating Your Child (2011), highly processed foods are nutrient deficient and may lower zinc and vitamin B levels changing the child’s sense of taste and smell. Children may not look “malnourished” because they are gaining weight, but the calories they are eating aren’t providing the nutrients they need for optimal development. The lack of nutrients in their diets could cause permanent damage to their neurological systems and, therefore, could be a possible cause of the sensory integration and regulation difficulties they present. Ms. Dorfman recommends a two-step nutritional therapy approach that can help alleviate a child’s feeding difficulties:

1. Take away what’s bothering the patient

2. Close the gap of nutritional deficiency

When working with children who have sensory integration difficulties, we must first look at what may be bothering the child’s gastrointestinal track. For very young infants and toddlers, the culprit is often dairy foods, since young children usually eat a lot of these foods. Common symptoms of dairy protein intolerance include ear infections, constipation, eczema, and/or chronic congestion. Taking away what’s irritating them can take pressure off an already overloaded sensory system and improve its functioning.

Closing the gap of nutritional deficiency is the next step. Ms. Dorfman often recommends probiotics, fish oils, and therapeutic multivitamins/minerals. The probiotics help improve digestive functions. Therapeutic multiple vitamins and minerals can help improve appetite and immune function, and fish oil contains fat necessary for operating the nervous system. Since sensory processing difficulties stem from immaturity in neurological development, the right kind of fat is crucial in a child’s diet.

Once a child has good nutritional support in place, a specific feeding program can be designed to improve variety, texture, and volume of solid foods. That’s where the Green Monster book series plays a valuable role. These books are specifically designed to teach parents and children why it’s important to eat a healthy diet in a child-friendly way, complete with pictures to color and magic wands to make the green monsters come alive and tell their story! Soon, the children learn the Green Monsters are really their friends and become willing to start the process of trying new foods and changing the way they think about food in the long term.

For more information about the Green Monster four-book series, contact our office. They can also be purchased online through Amazon.

Contact Information:

Dianne Lazer, MA, CCC-SLP/COM, Speech-language Pathologist/Certified Orofacial Myologist

Better Speech & Feeding Center

901-B Route 73 North

Marlton, NJ 08053

Work Phone: 865-751-1937

Fax: 856-751-1938


Dianne Lazer (the owner of this article) granted permission to Ages and Stages®, LLC to reprint it. It was originally published in the Pediatric Wellness Network newsletter in the Spring of 2012.