By Barbara A. Samfield, MA-CCC/SLP

My child is such a picky eater! Nearly every parent can relate because many youngsters go through “picky” phases. A favorite food one week is rejected the next, or foods suddenly cannot “touch” on the plate without meltdowns. This common behavior is more about the child’s stage of development than food. With patience, it usually resolves itself.

What if this “picky” phase lasts well into preschool or elementary ages? What if a child “self-limits” to just a few foods that become the “new normal”? In some cases, only specific food brands are tolerated.

This behavior can make Exasperated parents try supplemental nutrition drinks; however, when children with such severely restricted food tolerances self-limit foods even more, then these nutrition drinks could become the only tolerated food. Simply waiting it out has stopped working, and this level of pickiness has become much more complex.

Some children with medical diagnoses, such as autism spectrum disorders, may experience sensory issues related to foods or textures. Children with poor food tolerances may have underlying oral-motor issues within the mouth that result in difficulty managing varied food textures or tastes. Early near-choking or gagging episodes can also linger in the child’s memory, resulting in sensory aversions and other learned responses to foods and eating; however,

When To Be Concerned

1.) First, consult with your child’s physician to rule out allergies or other health

2.) Then, ask for a referral to a pediatric speech-language pathologist with

pediatric feeding expertise and consider an evaluation for children age two or

older who present with any of the following over several months:

  • Tolerating less than 10 different foods
  • Reducing number of foods previously tolerated
  • Limited tolerance of textures
  • Spitting out, gagging, coughing, or over-stuffing during most meals
  • Extreme reactions to foods or foods touching
  • Increase in occurrence or intensity of child’s reactions
  • Weight loss not due to illness

If you are concerned about your child’s pickiness with foods, then consider an evaluation by a qualified speech- language pathologist with expertise in pediatric feeding. It could be more than pickiness.

Barbara Samfield is owner of the Speech and Language Center at Stone Oak, a private practice of speech-language pathologists serving the greater San Antonio community for 18 years. The Center offers individual speech therapy, pediatric feeding therapy, reading services, and social communication groups year round. For more information about the Speech and Language Center at Stone Oak, call 210.495.9944.

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