Feeding difficulties and picky eating can range from mild selectivity to serious swallowing disorders (dysphagia). While most children go through typical picky eating phases, some have more significant feeding challenges that require professional support. Understanding the difference between normal picky eating and problematic feeding helps you know when to seek help.
Almost all children become somewhat 'picky' during toddlerhood—this is a normal developmental phase. However, some children have more significant feeding difficulties that go beyond typical selectivity and may indicate a feeding disorder requiring professional intervention.
Understanding the difference helps parents know when to be patient with normal phases versus when to seek evaluation.
The Sequential Oral Sensory (SOS) Approach, developed by Dr. Kay Toomey, is an evidence-based method for expanding food acceptance in picky eaters. It recognizes that eating is a complex sensory experience and helps children move through a hierarchy of food interaction at their own pace.
Oral motor skills are the movements of the muscles in the mouth, face, and throat that are needed for feeding and speech. Some children have weakness, low muscle tone, or coordination difficulties that affect their ability to eat safely and efficiently.
Signs of oral motor difficulties during feeding include: drooling beyond age 2, food falling out of mouth, difficulty chewing thoroughly, pocketing food in cheeks, gagging on textures, difficulty drinking from cups or straws, and messy eating beyond what's expected for age.
Many feeding difficulties have a sensory component. Children may be oversensitive (hypersensitive) to textures, temperatures, flavors, or smells, or they may be undersensitive (hyposensitive) and need more intense sensory input. Occupational therapists specializing in sensory processing often work alongside SLPs on feeding.
Feeding difficulties often require an interdisciplinary team approach. Different professionals address different aspects of feeding.
Follow Ellyn Satter's Division of Responsibility: Parents decide WHAT food is offered, WHEN meals occur, and WHERE eating happens. Children decide WHETHER to eat and HOW MUCH. This reduces pressure and food battles.
Build on foods your child already accepts by making small changes. If they eat chicken nuggets, try a different brand, then try homemade, then try baked chicken strips. Small steps build the food repertoire.
Research shows it can take 10-20+ exposures before a child accepts a new food. Keep offering foods without pressure. Today's rejected food may be tomorrow's favorite—but only if eating isn't a battle.
Children with Down syndrome often have language and communication differences that benefit from early, ongoing support. Speech and language development is influenced by multiple factors including muscle control, health, hearing, vision, and communication experiences. Visual learning strategies and integration of communication into daily activities are particularly effective, and most children make excellent progress with appropriate intervention.
Learn moreArticulation refers to how clearly your child produces speech sounds using their lips, tongue, teeth, and palate. While all children make speech errors as they develop, most naturally acquire all sounds by age 8. Speech sound disorders occur when errors persist beyond the expected age or significantly affect how well a child can be understood. With appropriate therapy and consistent practice, most children can achieve clear speech.
Learn moreBritish Columbia offers several publicly-funded programs supporting children's speech and language development. Understanding what's available—and how to access it—helps families get the support their children need. This page covers provincial funding programs, regional health authority services, and local organizations in BC.
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