How Feeding Therapy Helps and Why Picky Eating Isn’t Always Just a Phase
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Feeding Therapy: A Personal Journey
My parents describe me as an extreme picky eater when I was a kid. For years, my diet was basically a bowl of plain rice and a banana—and that was it. Even now, while I eat a much wider variety of foods, I still struggle with mushy textures or anything with a strong sea smell.
So when my son, Luca, turned one, I was determined to do things differently. I wanted to introduce him to a wide range of cuisines—Italian, French, Thai, Japanese, Korean, American. But I quickly noticed he couldn’t tolerate multiple textures in a single bite. A sandwich, for example, was too overwhelming. Instead, I had to break things down and give him the ingredients separately: just the bread, or just the carrots. Because of my own history, I could recognize how overwhelming that experience might feel for him.
For me, it was never just about not liking the taste—it was almost a physical reaction. When I bit into certain foods, especially mushy ones, it felt itchy inside my mouth, like my throat and tongue wanted to push the food back out. On the outside it probably didn’t look dramatic, but on the inside it was very real, and it made me want to avoid those foods altogether.
For a long time, I assumed that was just what picky eating was. I didn’t realize that feeding therapy even existed, and I thought occupational therapy was simply about slowly getting kids used to new textures.
Over time, though, I learned there’s a difference between typical “picky eating” and true feeding challenges. For many autistic children, eating isn’t just about flavor—it’s about texture, smell, color, routine, even the way food feels in their mouth. Those challenges can make mealtimes stressful for both kids and parents. And that’s where feeding therapy comes in.
What Is Feeding Therapy?
Feeding therapy is a specialized type of therapy that helps children who struggle with eating. The therapist—often an occupational therapist (OT) or speech-language pathologist (SLP) with training in feeding—works on:
- Expanding the variety of foods a child will eat
- Supporting safe chewing and swallowing
- Helping kids tolerate new textures, smells, and tastes
- Reducing stress and anxiety around mealtimes
- Building positive associations with food
Feeding therapy isn’t about forcing a child to eat. It’s about gently and gradually building comfort, skills, and confidence around food.
✔️ You can see how this process plays out in Before and After Occupational Therapy: The First Bite of Sandwich.
Signs Your Child Might Need Feeding Therapy
So how do you know if your child’s eating is “just picky” or something more? Every child is different, but here are some signs that feeding therapy might help:
- Eats fewer than 15–20 different foods total
- Refuses entire food groups (like no fruits or no proteins at all)
- Only accepts food in one form (for example, only chicken nuggets from a certain brand)
- Gags, chokes, or vomits often when trying new foods
- Struggles with chewing or moving food around in their mouth
- Refuses foods based on texture, smell, or appearance
- Extreme anxiety or meltdowns around mealtime
- Poor weight gain or nutrition concerns raised by the doctor
According to the American Speech-Language-Hearing Association, feeding disorders not only impact nutrition but can also affect a child’s social and emotional development.
In our case, I realized it wasn’t just “picky eating” when my child literally gagged at the sight of a new food on the plate. It wasn’t stubbornness—it was genuine discomfort.
What Happens in Feeding Therapy?
Every child’s plan is unique, but here are some common approaches you might see:
- Play-Based Exploration
Feeding therapy often starts with play. Instead of expecting a child to eat a new food right away, the therapist might encourage touching it, smelling it, or even just having it on the plate. For example, stacking cucumber slices like building blocks might come before actually tasting one. - Food Chaining
Therapists use small steps to build from a “safe food” to something new. If your child eats French fries, they might try potato wedges next, then mashed potatoes, slowly bridging toward other vegetables. - Oral-Motor Skills
If chewing or swallowing is difficult, therapy might include exercises that strengthen the mouth, tongue, and jaw. This can involve tools, games, or specific food textures. - Sensory Strategies
For kids who are sensitive to textures or smells, therapists might use sensory play (like finger painting with pudding) to build tolerance in a low-pressure way. - Parent Coaching
Feeding therapy usually includes parents, because what happens at home matters most. Therapists may guide you on how to present foods, respond to refusals, and keep mealtimes positive.
Common Approaches in Feeding Therapy
Different therapists use different models, and you may hear terms like these:
- SOS Approach (Sequential Oral Sensory): Focuses on gradual, step-by-step exposure to foods, starting with looking, touching, smelling, and eventually tasting.
- Food Chaining: Uses familiar foods as bridges to new ones, based on similar flavors or textures.
- Responsive Feeding: Emphasizes reducing pressure and following the child’s lead, creating a positive mealtime environment.
There’s no one-size-fits-all method. What matters most is finding an approach that respects your child’s comfort and moves at their pace.
When to Seek Help
If you’ve tried the usual “kid-friendly tricks” and mealtimes are still stressful or limited, it may be time to consider feeding therapy. Talk to your pediatrician or your child’s therapy team (OT, SLP, or Regional Center coordinator in California) and ask for an evaluation.
The earlier you start, the easier it is to expand food acceptance. But it’s never too late—older kids and even teens can benefit too.
Practical Tips I Learned Along the Way
Here are some strategies from feeding therapy that made a big difference in our home:
- Tiny Steps Count – Even licking a new food is progress. Don’t expect big leaps right away.
- Neutral Language – Instead of “you have to try this,” say, “this is a new food we’re exploring.”
- Separate but Present – Put a small amount of the new food on the plate alongside safe foods, so it becomes familiar without pressure.
- Family Style Meals – Let your child serve themselves (even if they skip the new food at first). It gives them control.
- Routine Helps – Regular meal and snack times reduce battles and give predictability.
Final Encouragement
If you’re in the thick of mealtime struggles, please know you’re not alone. Feeding challenges are common for autistic kids, and they’re not a reflection of your parenting.
Feeding therapy isn’t about forcing your child to eat—it’s about helping them build comfort, skills, and trust at their own pace. With the right support, progress does happen, and mealtimes can become less stressful and more joyful again.
So take a deep breath. Celebrate the small steps. And know that each bite forward is a step toward a happier, healthier future.
