Refusing Food and Mealtime Meltdowns
Spending time together around the dinner table can be a wonderful way for families to connect. But when a child refuses most of their food or gets upset when they have to try something new, meals can quickly become stressful.
These challenges aren’t a matter of poor behavior. Rather, they often indicate a problem with your child’s feeding skills, sensory responses, developmental factors, or a combination of influences. Eating is a complex process, and when one part of this process is difficult, eating can become harder for the child and the whole family.
Fortunately, the team at Skills on the Hill Pediatric Therapy is here to help.
A Closer Look at Pediatric Feeding Challenges
Pediatric feeding challenges occur when a child has ongoing difficulty eating or drinking that is appropriate for their age and individual needs. The key to getting the right treatment, however, is understanding the factors that may be contributing to your child’s challenges. You might have two kids who are both refusing to eat vegetables, but for two very different reasons.
For example, some kids struggle with oral-motor skills, which help them use their lips, tongue, cheeks, and jaw to manage food and drink. A child who struggles with these skills might refuse that piece of broccoli because biting or chewing it safely and comfortably feels difficult.
However, some feeding difficulties stem from sensory processing challenges. Sensory processing affects how kids respond to the texture, taste, smell, temperature, or appearance of food. In these cases, your child might refuse broccoli because, to them, it’s too mushy or tastes too bitter (even if it seems fine to you).
Other factors can also impact feeding skills. Postural stability and motor skills are essential for a child’s ability to sit, reach, use utensils, and participate successfully during meals. Feeding is also shaped by routines, past experiences, and interactions between kids and their caregivers.
How Do I Know My Child Isn’t Just Being Picky?
Some amount of pickiness is common among kids. However, what we call “picky eating” often does point to feeding challenges, especially if that pickiness persists to the point that it interferes with growth, nutrition, and the development of age-appropriate eating skills.
If you notice these signs, we recommend bringing your child in for an evaluation:
- Eating a very limited range of foods or food textures
- Refusing foods based on color, smell, texture, or appearance
- Gagging or coughing during meals
- Poor growth or concerns about getting enough nutrition or fluids
- Having trouble biting, chewing, or moving food around the mouth
- Holding food in the cheeks instead of swallowing it
- Regularly taking longer than expected to finish meals
- Becoming upset, anxious, or overwhelmed around food
Addressing Feeding Challenges with Pediatric Therapy
The first thing we’ll do is determine why your child is struggling with feeding skills. That way, we can create a customized care plan that addresses the specific areas affecting your child.
Building Oral Motor and Feeding Skills
We can help your child develop the physical skills involved in eating, such as biting, chewing, or lip closure. We’ll guide them through activities that meet their current abilities and adjust them as they learn new skills.
Making Food Exploration Feel More Manageable
If your child is sensitive to certain aspects of food (like taste or smell), expecting them to take even one bite can create more resistance.
Instead, we use gradual exposure. We might begin by building tolerance to having a food nearby. Then, we’ll encourage your child to interact with it through play, with no expectation of eating it. Only when they’re ready will we encourage them to have a taste.
Supporting Sensory Regulation
Many kids with sensory regulation challenges will struggle to stay emotionally regulated during a meal. We can develop individualized strategies to help your child stay comfortable and engaged as they explore foods and practice mealtime skills.
Helping Families Build Supportive Mealtime Routines
Parents and caregivers are essential members of the feeding team. We’ll work with you and your family to create everyday strategies to support the skills your child is learning in therapy. For some kids, this might mean establishing predictable meal and snack routines. For others, it may be a matter of working to reduce pressure and conflict around eating.
Helping Your Child Build Confidence at the Table
If feeding has become a source of concern in your home, Skills on the Hill Pediatric Therapy is here to help. Our team can help identify factors contributing to your child’s feeding challenges and create a personalized plan to support greater confidence and participation at mealtime. Give us a call to get started.
Helping Your Child Feel More Confident at Mealtime
Schedule an Evaluation
Everything You Need to Know About Feeding Therapy Understanding the Feeding Therapy Process
At Skills on the Hill Pediatric Therapy, we know navigating feeding challenges can be tough. Let’s take a look at some frequently asked questions about the process.
What Happens During a Feeding Evaluation?
A feeding evaluation is essential because it helps us understand why eating is difficult. It involves a therapist observing your child as they eat. We’ll look at:
- How your child sits and positions their body
- Biting, chewing, and tongue movements
- Responses to different tastes and textures
- Drinking and swallowing skills
We’ll also talk with you about your child’s medical history, development, nutrition, and any other concerns you might have.
This information helps guide an individualized plan.
What If My Child Refuses to Participate in Therapy?
A big part of the feeding therapy process is helping kids feel more comfortable interacting with food and participating in mealtime activities. We take a fun, child-led approach and utilize positive reinforcement to gradually build the skills your child needs. Essentially, we start where they’re comfortable, and then work from there.
Feeding therapy is designed to meet children where they are. A gradual, supportive approach can help make participation in mealtime activities feel more manageable.
Does Feeding Therapy Involve Other Healthcare Professionals?
Sometimes. Feeding difficulties can affect several areas of health and development. In some cases, kids have feeding challenges due to an underlying medical issue (such as gastrointestinal concerns or food allergies) that might require the help of a different specialist.
Our team is always happy to work with your child’s other healthcare providers to support coordinated care when appropriate and ensure they get the treatment they need.
Have More Questions About Feeding Therapy?
Every child’s feeding needs are different. The Skills on the Hill Pediatric Therapy team can help you understand what’s contributing to mealtime difficulties and let you know what approach will be best for your child.
To get started, schedule an initial evaluation today.
Schedule an Initial EvaluationWhat Our Families Are Saying
Our son has been going here for a few years now, and he absolutely loves it. It is such a well-run office, and the providers are amazing! We are very grateful that SOTH is part of our care team… highly recommend checking them out!”
Celebrating National Physical Therapy & AAC Awareness Month
This month, we’re celebrating the many ways therapy can help children communicate, move, play, and participate in the world around them.
Pediatric physical therapy helps children build strength, balance, coordination, and confidence so they can move more comfortably and participate in the activities they love. AAC (Augmentative and Alternative Communication) gives children tools and strategies to express their wants, needs, ideas, and feelings, whether through gestures, picture boards, sign language, or speech-generating devices.
Got an Old iPad? Help a Child Find Their Voice.
We’re building a Tech Lending Closet at Skills on the Hill — a collection of gently used tablets that we’ll loan to children waiting for insurance approval on their communication devices. For a child who relies on a tablet to communicate, that approval process can feel impossibly long. A loaner device can bridge the gap and keep their progress moving.
Give Your Old Tablet a Meaningful Second Life
Have an iPad or tablet collecting dust at home? We’d love to give it a second life supporting children who use communication devices to express themselves, connect with others, and continue making developmental progress while they wait for permanent equipment approval.
Before donating, please make sure your device is:
- Wiped / factory reset (all personal data removed)
- Find My iPhone/Device turned OFF
- Unlocked (no passcode or Apple ID lock)
Thank you for helping us help our kids communicate.
Know a School That Could Use Our Support?
Skills on the Hill is partnering with area schools, preschools, and daycares to provide developmental screenings for students and workshops for educators on strategies that help all learners access the curriculum.
Help Us Connect with Local Schools & Educators
We’re looking to grow these partnerships — and warm introductions from families like you are the best way in. If you have a great connection at your child’s school, whether that’s a director, principal, program coordinator, or learning specialist, we’d be grateful for an introduction.
Together, we can support educators with practical strategies and help more students access the tools they need to thrive both academically and socially.
Simply send us an email and we’ll take it from there.
Check Out Our Storefront on Amazon!
At Skills on the Hill, we know that the right tools can make everyday routines more manageable, engaging, and meaningful. That’s why we’ve curated an Amazon storefront filled with therapist-recommended products that can support communication, independence, sensory exploration, learning, movement, and play.
ALSLEA Large Visual Schedule for Kids with Autism — 124 Cards
Visual Schedule • 124 Cards • Home, Classroom & Therapy Use
Help children understand daily routines and activities with this large visual schedule board from ALSLEA. The board includes a variety of activity, title, arrow, blank, and reward cards that can be used to create personalized routines for mornings, evenings, school, chores, play, and more.
Visual schedules can provide children with clear, easy-to-understand visual information about what comes next, helping make daily routines more predictable and supporting independence. The board can be hung on a wall or door or folded to stand upright on a desk or table.
With colorful picture cards and a convenient storage bag, this visual schedule can be a useful tool for creating visual supports at home, in classrooms, or as part of a child’s learning and therapy environment.
Rainbow Fruit Skewers
Bright, colorful, and easy for little hands to help assemble, these rainbow fruit skewers turn fresh fruit into a fun snack. Kids can choose their favorite fruits and help create their own colorful combinations.
Ingredients
- 1 cup strawberries, hulled
- 1 cup pineapple chunks
- 1 cup green grapes
- 1 cup blueberries
- 1 cup mandarin orange segments
Kitchen Gear
- Cutting board
- Small knife (adult needed)
- Wooden skewers or short food-safe sticks
Directions
Wash all of the fruit. An adult should cut any larger fruit into bite-sized pieces.
Arrange the fruit in rainbow order. Try strawberries, mandarin oranges, pineapple, green grapes, and blueberries.
Carefully slide the fruit onto the skewers, alternating colors as you go. Younger children can help choose the fruit and create the color pattern.
Serve immediately and enjoy your colorful, fresh, and fruity snack!
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