When Picky Eaters Become Problem Feeders











Image by Masuba from Pixabay

Let’s face it, parenting is not easy! When raising kids, parents are faced with a number of challenges, including lack of sleep, constant demands and mess absolutely everywhere! As children develop, they become more independent in their choices and behaviors. And the food is a big one. Even though it is normal for children to love pumpkin one day, and hate it the next one, fussy eating might become a real struggle for parents. Feeding therapy can help when mealtimes become a daunting part of the daily routine, a battleground or just really stressful. You are not alone. 

Here at BodyMatters, psychologists, Sarah and Amy deliver two types of feeding therapy treatments to help parents and their children who require support to overcome their struggles with eating a more diverse diet. 

  • SOS (Sequential Oral Sensory) approach. 

This approach to feeding program was developed 25 years ago by Dr. Kay Toomey, a pediatric psychologist who has worked with children who won’t eat for almost 30 years. The SOS approach is a transdisciplinary program designed to assess and address the reasons why a child is struggling to eat (Toomey & Ross, 2011). This approach uses a whole child perspective, considering all areas of human function involved in the process of learning to eat: organs, muscles, sensory, learning, development, nutrition, and environment. SOS feeding therapy uses play-based interventions to increase the child’s level of comfort around food. The program allows the child to explore, and learn about the different properties of food in a non-stressful way. 

This therapy usually has six major steps that help children to:

  1. Tolerate the physical presence or sight of food
  2. Interact with food without necessarily using skin contact
  3. Manage the smell of food
  4. Touch food using skin contact
  5. Taste food
  6. Chew and swallow food


Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder (CBT-AR)

CBT is an evidence-based treatment that explores the links between thoughts, emotions, and behavior. This model works under the premise that people’s emotions and behaviours are influenced by their perceptions of events. What this means is that what determines what someone feels is not due to a situation in and of itself, but by the way they make meaning of the situation. 

CBT-AR is a new approach to treat Avoidant/Restrictive food intake disorder (ARFID). ARFID is characterized by a restrictive/avoidant eating behaviour that is based on factors such as food appearance, food group, texture, smell or past experiences, rather than a desire to lose weight. CBT-AR aims to change the relationship with certain foods that trigger the restriction or avoidance. Usually, when working with children, CBT-AR is delivered as a family supported therapy. This therapy is structured in four stages. 

  1. Learn about ARFID and make early changes: during this stage, the aim is to increase education on ARFID to figure out what maintains the avoidant/restrictive symptoms (for example is there a sensory sensitivity? Did the child have a fearful experience in the past with a particular food?)
  2. Continue early changes and set big goals: throughout these weeks the therapist helps the parents and children to set goals to face the child’s fears while continuing to work on increasing volume/variety of food.
  3. Face fears: this stage is the heart of the treatment. Here, the goal is to support the child to gain exposure with new or feared food by tasting small amounts at first and then incorporating larger amounts.
  4. Relapse prevention: in this final stage the goal is to complete the treatment by developing a skills plan to keep practicing at home. 

BodyMatters will be hosting a ‘Food Explorers Workshop’ to help your child  build their sense of ​adventure​ for food by​ exploring​ and ​interacting​ with a range of foods in a supportive environment. Led by Psychologist Amy Newsom, each week your child will be introduced to and taught ​skills​ to tolerate new foods, and you will be guided as to how to support​ them at home. The aim of this group is to expand the ​variety​ of foods eaten by your child.

This group will suit you & your child if:

  • Your child struggles to try new foods
  • Your child avoids certain colours, textures or smells in food
  • You are tired of cooking separate meals each night for your child
  • Mealtimes in your household can feel like a battlegroundDetails:Who​: An adult is required to attend each session with the child.
    What​: Each week you will be given suggestions for foods to bring along

    When​: Fridays 3.30 – 5pm for 10 weeks during Term 2, 2020. Beginning Friday 1s​ t​ May 2020.
    Where​: Mosman Art GalleryHow Much​: $500 per child for 10 weeks. Private health rebates may be available depending on level of cover.Contact BodyMatters on 02 9908 3833 or ​info@bodymatters.com.au​ for further information. Register online via our website ​https://bodymatters.com.au/events-calendar/



Thomas, J.J., & Eddy, K.Y. (2018). Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder: Children, Adolescents, & Adults. U.K, Cambridge: Cambridge University Press.










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