Picky Eaters & Problem Feeders

While many children go through phases of selective eating, some exhibit food refusal and dietary restriction that goes far beyond typical picky eating. Problem feeders, also known as children with Avoidant/Restrictive Food Intake Disorder (ARFID), accept fewer than 20 foods, may lose previously accepted foods without acquiring new ones, and may refuse entire food groups or textures. This level of restriction can compromise nutritional intake, growth, and family quality of life.

The causes of problem feeding are often multifactorial and may include sensory processing differences, oral motor skill deficits, negative mealtime experiences (such as choking or vomiting), gastrointestinal discomfort, anxiety, and learned behavioral patterns. Understanding the underlying cause of food refusal is essential for developing an effective treatment approach.

Speech-language pathologists working in pediatric feeding use a combination of sensory-based, behavioral, and oral motor strategies to systematically expand a child's food repertoire. Treatment emphasizes creating positive mealtime experiences, reducing anxiety around new foods, building oral motor skills for new textures, and empowering families with strategies to support progress at home.