Helping Picky Eaters: When Feeding Struggles Go Beyond the Dinner Table
Picky eating is common in childhood–we’ve all met kids who hate broccoli or only want to eat blueberries by the handful. However, feeding struggles can go beyond this typical picture of picky eating to the point that they start really impacting your child’s day-to-day life (and your family’s).
If your child is regularly gagging or having serious meltdowns at the dinner table, they may need more support than the typical strategies can offer. That’s where the team at Skills on the Hill Pediatric Therapy can help. Our speech and occupational therapists can work with your child to address the underlying reasons for their feeding struggles, ensuring your child gets the nutrients they need.
Important Updates for 2026
What Families Need to Know
As we head into the new year, we’re rolling out several updates designed to strengthen continuity of care, support your child’s progress, and keep our scheduling running smoothly. Please take a moment to review our updated attendance, illness, coverage, weather, and insurance policies—all outlined in the detailed message available at our front desk and sent separately to current families via email.
Understanding Feeding Struggles
Feeding difficulties can develop for many reasons, and often a combination of factors is at play. Furthermore, the repeated stress of battles at the dinner table can reinforce avoidance, even when everyone is trying their best. Understanding your child’s feeding struggles is the first step in getting them the help they need.
Three Common Signs of Feeding Difficulties (And What They Can Mean)
Strong Reactions To Textures
Does your child ever complain that their food is too much–too crunchy, too mushy, too slimy? These complaints often indicate that they have sensory processing difficulties, which means their brains treat everyday textures, smells, or tastes like a threat. That can trigger a fight-or-flight response around even the most basic of foods.
If these complaints sound familiar, your child might be struggling with sensory processing:
- Refusing mixed textures, such as soup with chunks in it
- Avoiding foods that are sticky, gritty, cold, or slippery
- Covering their nose, gagging, or leaving the room during cooking
- Needing foods prepared the same way every time
It’s important to remember these complaints aren’t your child being defiant. Instead, they’re reacting to very real sensory stimuli and trying their best to stay regulated.
Gagging
Gagging during mealtimes isn’t your child being overdramatic. It’s a protective response and your child’s way of showing that they feel unsafe with a texture, a bite size, or a new taste. Some kids will even gag at the sight or smell alone, which is just their body reacting before the bite even happens.
There are several reasons why kids might gag around food, including:
- High sensory alertness to texture, smell, or temperature
- Oral-motor skill gaps, such as trouble chewing, moving food side-to-side, or managing large pieces
- Anxiety from previous negative experiences, such as a choking scare, vomiting, or pressure at meals
- Medical factors such as acid reflux, constipation, or allergies
Food Refusal
A child refusing certain foods can be a huge source of stress for families, but as with gagging, it’s often a protective response. When your child refuses a specific food, it’s because that food feels unsafe, uncomfortable, or overwhelming for them. Food refusal often occurs for the same reason that gagging does, including sensory sensitivities, skill gaps, and anxiety. Some kids also don’t feel hunger as strongly or get full fast, and so may refuse food for those reasons. And sometimes your child is just too tired to deal with high-effort foods
Managing Feeding Difficulties with Skills on the Hill Pediatric Therapy
When your child is really struggling with feeding, the typical advice for picky eaters is not only ineffective, but it may actually worsen the situation. That’s because the advice isn’t actually addressing the reason your child is struggling.
Fortunately, our team can help. We’ll assess your child’s symptoms and create a personalized, step-by-step care plan to address them directly. This might include:
- Speech-language therapy for feeding and swallowing skills, safe chewing, pacing, and oral coordination
- Occupational therapy for general feeding skills, sensory sensitivities, tolerance of textures, and nervous system regulation
- Parent coaching so strategies work at home, in school lunches, and on the go
Your child’s sessions will be structured, focused, and playful. We progress them in small steps, gradually building the necessary skills and tolerances so they don’t feel overwhelmed.
We’re Here to Help, so Contact Us Today!
We know how frustrating feed struggles can be, but they can improve. The right support can make meals calmer, safer, and more predictable for you, your child, and your whole family. Schedule your initial assessment with us today to get started.
Why Executive Functioning Support Matters and How You Can Build It at Home
At Skills on the Hill, we often talk about “executive functioning,” but what does that really mean, and why does it matter for your child’s success, both now and later?
What is executive functioning?
Executive functioning refers to a set of brain-based skills that help kids plan, focus, remember instructions, manage emotions, and follow through with tasks. These include working memory (holding and using information), inhibitory control (resisting distractions or impulses), cognitive flexibility (shifting between tasks or ideas), planning and organization, and self-monitoring. For many children, especially those with developmental differences or additional needs, these skills can be harder to develop or call on, making daily life, school, and relationships more challenging.
Why does executive functioning matter?
- Academic success. Kids with strong executive functioning are more able to start and complete homework, follow multi-step instructions, organize materials, and manage projects over time.
- Emotional and social well-being. These skills help children regulate emotions, adapt to change, manage frustration, and interact more thoughtfully with peers.
- Life skills and independence. As children grow, executive functioning lays the groundwork for time management, self-care, household responsibilities, and eventually successful navigation of work, relationships, and personal goals.
Because executive functioning develops gradually, early support can make a lasting difference.
How parents and caregivers can help
- Use predictable routines and structure. A regular morning, homework, and bedtime routine gives children a framework that supports focus, organization, and emotional regulation. Consistency helps reduce mental overload by limiting “what to do next” decisions.
- Break big tasks into smaller, manageable steps. For example, instead of saying “clean your room,” try “first pick up clothes, then toys, then put books on shelf.” This helps children learn planning, sequencing, and reduces overwhelm.
- Use visual supports and external tools. Visual schedules, checklists, timers, calendars – these external aids help children “see” what needs to be done, remember steps, and manage time.
- Encourage play, responsibility, and problem-solving. Everyday activities such as chores, games, and imaginative play can build executive skills. Household tasks, turn-taking games, and creative play provide low-pressure, natural practice.
- Model self-regulation and planning. Children learn a lot by watching adults: narrate how you plan, organize tasks, handle mistakes calmly, or manage frustration. Demonstrating these skills helps your child internalize them over time.
The Difference Support Can Make
For a child who struggles with executive functioning, receiving consistent guidance – whether through therapy, home routines, or supportive parenting – can transform not just their school performance, but their confidence, independence, and emotional resilience. At Skills on the Hill, our executive-functioning support program is designed to work hand-in-hand with you. Together, we can help build a foundation that supports your child’s success academically, socially, and emotionally for the long-term.
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Recipe of the Month:
Strawberry Santas
Ingredients:
- 12 large strawberries
- 1 cup whipped cream cheese
- 2 tablespoons powdered sugar
- ¼ teaspoon vanilla
- Decorative red and black icing for the face.
Instructions:
- Prepare the strawberries by carefully washing them. Next, you’ll cut the strawberries into three pieces. Cut the stem off the strawberry so you will have a flat side to sit them down on. Then cut the berries in half with enough room on top for the top of the strawberry to be a Santa hat.
- Next, prepare the filling. In a small mixing bowl, mix together the cream cheese, powdered sugar and vanilla.
- Carefully put the cream cheese mixture into a piping bag.
- To assemble the strawberry Santas, put the bottom of the Santa on a plate. Pipe the cream cheese mixture on top of the strawberry, tall enough that you have room to draw the face.
- Add the Santa hat on top of the body and then use the piping bag to add the white top.
- Carefully use the decorative icing to draw the face.
- Serve immediately or store in the fridge until ready to enjoy.
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