133: Helping Picky Eaters with Sarah Appleman, MS, OTR/L

Picture of hosted by Penny Williams

hosted by Penny Williams

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Neurodivergent kids can often be picky eaters. And parents of picky eaters worry about their child’s health and wellness when their list of approved foods is very narrow and limited. However, there are things you can do to help picky eaters broaden their food horizon that don’t include bartering and threats (which don’t work anyway).

In this episode, I’m talking with the author of Play with Your Food, Sarah Appleman. Sarah uses a sensory lens to understand food aversions and help kids become less tactilely defensive in small, incremental steps. Learn how to do that with your child as well as how to make sure you’re setting your kid up for success when it comes to food. Get ready to play with your food!

Resources

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Play with Your Food by Sarah Appleman

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My Guest

Sarah Appleman MS,OTR/L

Sarah Appleman is a published Author, Speaker, and Pediatric Occupational Therapist. Sarah holds a master’s degree from Touro College in Occupational Therapy. She specializes in Early Intervention in children diagnosed with Sensory Processing Dysfunction. Sarah has worked as a senior therapist, supervisor, and mentor to new graduates. She was also a supervisor for School Districts, worked in-home care as well as outpatient facilities.

In her newly released book, “Play With Your Food”, Sarah combines her passion of working with the Special Needs population and baking. Through fun therapeutic interventions, activities and tips, she guides caretakers and children to enjoy participation in the food preparation with fun games while improving the food tolerance of picky eaters.

 

Transcript

Sarah Appleman 0:05

Okay, if a child hates getting their hands messy, it's not just that they don't want to get messy. They're physiologically from their skin to their brain. It's translated as, like noxious to them. Okay? So you have to explain to parents and I say, Listen, you know, we have to start small and it'll seem like little steps. But within weeks to a month, you'll start seeing improvements not just in eating, but their attitude and their behaviors, they start feeling more confident.

Penny Williams 0:37

Welcome to the parenting ADHD Podcast, where I share insights and strategies on raising kids with ADHD straight from the trenches. I'm your host, Penny Williams. I'm a parenting coach other ADHD a Holic and mindset Mama, honored to guide you on the journey of raising your a typical kid. Let's get started.

Welcome back to the parenting ADHD Podcast. I am excited today to be talking to Sarah Appleman, who is the author of the book play with your food. And we are going to talk about insights and strategies around food sensitivities, picky eating that sort of thing. Thanks so much for being here, Sarah. Hi, thank you so much for having me. Yeah, will you start by introducing yourself? Let everybody know who you are and what you do? Sure.

Sarah Appleman 1:36

My name is Sarah Pullman. I'm a pediatric occupational therapist. I've worked with children with a diversity of special needs for the past 21 years. And I just love to cook and bake. And I have my own kids. So I had to combine some of the stuff that I do at work and at home.

Penny Williams 1:55

Yeah. And it's so different when it's your own kid right now. I have so many therapists who either get coaching calls with me or interact in other ways and ask questions and they say, you know, I'm trained in this, but it's so different when it's your own kid. And you really need that outside perspective, some to help with it as well, when you're so personally and emotionally invested, I think, do you want to start by telling us what sort of things tend to contribute to what looks like a picky eater? I know, it's not always that they're just picky. I think that's really a misnomer of a label. But we see that they're maybe refusing certain foods, what are we really seeing under the surface of that? What are the possible causes,

Sarah Appleman 2:43

Right, and this is the toughest place because when I evaluate a child, the first time I'm meeting them, I love to get a full outline perspective of why that child is here. So if I get a child whose parents are like, Oh, he doesn't like to eat, and I have to, you know, go through everything. Well, let's see why. And that's the real, that's the real cause, I would have to find out what is that underlying reasoning? My child is a picky eater. So one of the reasons that I wrote this book specifically was to help children who have sensory processing difficulties, or they have a tendency to avoid not only with food, but with clothing. Smells, yeah. movement. So I said, You know what, let me do that, because I feel that you could have 100 different authors writing 100 different books about picky eaters, but this is the specialty that really has been around for, you know, a really long time, people are still learning about sensory processing. Yeah, so that's really the area where a child I'll look at and I'll say, do they tolerate bathtime? tooth brushing? Are they able to wear different clothes? When you go to the beach? How do they react to sand outside on grass? And if I get a lot of that feedback, oh, my kid hates it. Oh, no, they only eat noodles. Like I always get that same thing. It's Dinosaur chicken nuggets. Yeah, noodles, you know, limited fruits, limited vegetables. Like, okay, that's this type of child. And that's the one that I really, really focused on. Parents, like you said, like, parents will just say, Oh, my kids is a picky eater, or, you know, you get Oh, your kids being a little brat. And I'm like, No, don't say that. There's a reason why they're reacting that way. So that's really the area I specialized and focused on.

Penny Williams 4:30

Yeah, and there's always a reason why is always a reason for behavior. And I love that you're focusing on that sensory aspect of it, because I think that has a lot to do with it, especially in neuro diverse kids like kids with ADHD and maybe autism. So what can parents do? You know, I think this is the biggest issue that parents have is what they try doesn't usually work because we kind of have this idea that if we make get, you know, a commandment or demand, you will eat this, if you want to do that, or, you know, you can't get up from the table until you've eaten enough for me to be satisfied or until you've eaten your vegetables or, you know, if you want sweets, you have to clean your plate, all of those things that I think come naturally don't really help, right?

Sarah Appleman 5:21

Absolutely. That's exactly right, as an adult, and we call ourselves you know, typically functioning adults, right. But all of us have our own idiosyncrasies or things we avoid, or we love that just being a human being. So if there's like, a certain smell, or certain thing that you don't personally eat as an adult, and someone's like, well, if you eat this, I will go take you to go buy, you know, piece of jewelry, you know, you're like, right, I really, really hate it. Like, you know, you can't bribe someone to do something that they are physically and emotionally, you know, distraught at that situation. So I come at it and I say, Okay, if a child hates getting their hands messy, it's not just that they don't want to get messy. They're physiologically from their skin to their brain. It's translated as like noxious to that. Right? Okay. So you have to explain to parents and I say, Listen, you know, we have to start small, and it'll seem like little steps. But within weeks to a month, you'll start seeing improvements, not just in eating, but their attitude and their behaviors, they start feeling more confident. Yeah. So that's the area also, like I was joke that I'm a professional cheerleader, because I want these kids to really feel good about themselves, and they know that there's something different about them, and that it could be a stressful time.

Penny Williams 6:46

So yeah, yeah, I think we add so much to that stress as parents, from the best intention, we want our kids to be healthy, we want them to feel good, right? But we don't always go about it in the most compassionate and understanding way. And seeing it as sensory issue then gives you so much knowledge and a place to really work from right a foundation to sort of try different things, I would guess that you have your clients start small and try small bits to sort of get them more acclimated to different textures and tactile senses.

Sarah Appleman 7:25

Yes. So the first thing that I do is, you know, like, I'll have them touch a different thing. So it could be some playdough, or rice and beans, and I observe their facial expressions and how they do it. So for example, if I had I do give a therapy through zoom and in person, so you can actually like look at their facial expressions and how they limited their touch. So if I have I tell parents to get like about a shoe size box or container and pour dry rice or dry pinto beans, you know, into it, and you get a good amount. And then please something in it like a puzzle piece, or one of their favorite dinosaurs, you know, one of those little models do you stick it in there. And I always tell the parents remember, we set them up for success, not failure. So if there's going to be a kid that you kind of already know that they're, you know, tactile defensive, you're not going to like bury it really deep, because that will just intimidate them. So I tell parents, you don't have something sticking up. Let's see how they do. And you could see the actual kid, like, just Okay, I'm gonna do it. But like their thought process, it's like, I want to do this and I want to be successful, but I don't like it, how do I do it, and they'll take their thumb and they're, you know, point their finger at just the very tip, they'll touch it with grimacing face. And I'm like, okay, we know that. That's the problem. So we start really small, and we start giving them a spoon and a cup so they don't have to directly touch it. They could scoop and then pour it and then oh, well look poured on mommy's hands or daddy's hand or their baby brother or sisters had you know, oh, look, that's awesome. Okay, great. Now we're going to pour it on your hand we sing, you know, it's raining, or anything that I singing is definitely the best. So you know, sing, and help them get used to it. And then we put it away and reward them with something that they want to do. And so they start having this positive behavioral association with the task that's non preferred to Okay, you know what, I can tolerate this, I'm good at it, and then I get something I wanted to. And that changes the, well, you can't do that until you do this. And that's that same mentality that comes to feeding. Yeah. So yeah, you know, you'll see them really grow and be like, Oh, okay. And I tell the parents all the time, it's a give and take, you know, you have to let them do something and then you have to have them do something for you. You know, back and forth, huh?

Penny Williams 10:00

Very small increments, or baby steps for sure, just a little bit of challenge at a time will over time help them to acclimate right to those sensory inputs that they find unacceptable or painful. I mean, I know some kids who are sensory avoiders where things just like water on their skin actually is painful for them. And I think it sounds so hard to believe. But right, and I think parents get tripped up there, because we just don't know any better. And so it's so important to really see that if your kid isn't succeeding at eating the food you want them to, or whatever it is that it's because there's something that's preventing them from doing it, not because they just don't want to do it for you, right? We tend to take things personally, right?

Sarah Appleman 10:49

We all are multitaskers. I mean, parents today aren't the same parents from 50 years ago, mothers are multitaskers to an extreme where we have to, you know, do our job and take care of the house and take care of the kids. And then if you have pets, and then it's like constantly going, so if you're going to take time to make dinner, and then the kid doesn't want to touch it. And I'm like, you know, you're like, Dude, seriously, I come on, you know. So it's definitely balance. But that's, that's it. So if you know if a kid is tactile defensive, so the skin is the largest receptor, right? It has from your head to your bottom of your feet. And if there's something it's originally used for protection, that's the purpose of it. So if you're talking to someone and you feel like a pat versus a light tickling touch your reaction, your brain is going to pause what you're doing, and turn to the exact spot that was being touched. And you're going to notice if it's beyond you, where you have to take care of that situation versus it's a child tapping, you know, and in a split second, you have to take that information and process it and then have an output, what's the conclusion? What do you do? How do you handle if a child is so tactile, defensive that it's impacting on their food, it's definitely going to also impact on social skills, it's going to impact you know, on their play skills, which is crucial for further development. So yeah, I would start for example, instead of forcing the kid to eat, that's part of what I do is like their activities to do to prep the food, and to have them meal prep. And so if they see other people eating their food, and they get used to those textures, it's almost like, okay, they're touching, they're smelling, they're working their fine motor skills, and they're creating, and then they get a positive outcome, they're more likely to do it again. And then the second time, maybe you got a little bit of flour on you no big deal. And I teach a kid to like, you know, go back and forth with their hands, no big deal. And then they tolerate it more and more. But each session each time, there's that increase in confidence and independence.

Penny Williams 12:53

Yeah. And I think just taking away the stress. So taking away the battle, stop battling about it, stop stressing about it. Because we just worry so much about our kids right in their health. And if they're just eating plain noodles, and dinosaur chicken nuggets, right? how healthy are they right? We're so worried about it. But our kids feel that worry, they feel that stress, they're taking that on for themselves, too. And then it makes it even more undesirable. I think, you know, it just escalates the situation where really, we just want to completely take the pressure off. And I love that your book is really about that, you know, playing with your food is something that you don't expect your parents to allow you to do. And so it brings in fun, and it takes off the pressure and the stress.

Sarah Appleman 13:44

Right? Well, that's exactly why like, you know, all of us grew up with Don't play with your mama literally gonna take that and make that title. Because, you know, I actually had someone contact me through social media that was like, Oh, it's interesting, because I was taught not to play with my food. And I'm like, Yes, but it's not, you know, wasting food. Like, that's really the difference. It's that interactive way, like plan to help your child eat not to, you know, take a food and waste it so, so it's like, oh, okay, that makes more sense. But I have kids now that it's so interesting, because people are talking about and getting it out there. And I had someone from Chicago notify me that their child now instructs everyone because they got the book to help and is like, No, no, wait, before you eat first, you know, do this and then smell and then maybe lick it first to see. And then you could chew it. So he tells all that, you know, he's a young kid and he's just so used to playing with the book and it helped him that he's now trying to help others with it. I love that cute like I love getting or I get pictures with kids, you know as young as two years old, because sometimes new parents don't have a child let's say to compare or developmental math. stones that their child supposed to achieve. So they don't know, you know. And so I give outlines of simple things from you know, lacing Cheerios, or if you're, you know, because they're gluten free and healthier, or if you don't care as much, and you want Froot Loops, and you can make patterns, and you could just that I hand coordination, and that fine motor skill of lacing is something you use, you know, way into adulthood, you know, lacing your shoes. So these are things that get them used to just smells and textures. And then also working on skills simultaneously.

Penny Williams 15:33

Yeah, we've talked about getting kids to help you with the cooking right in the kitchen. And we've talked about kind of this, using food and noticing different things about it, maybe playing with it as far as stringing it up or feeling it in your hands and sort of manipulating it. What other strategies are there for parents to try with their picky eaters?

Sarah Appleman 15:58

Yeah, so one of the things that I just received from Florida, really positive feedback that I was happy to hear. And I actually have seen a lot of success with it. Again, like you said, forcing a child isn't helpful. But having your child partake, and actively participate is much better. So on the website, play with your food, book, calm, you can get free principles. And we have like strawberries, you know, little images. And you can pick the fruit or you can make your own. That's the best part. This book isn't like the Bible, you know, it's just a guideline, so parents can take what they want. So if you have a gluten free diet, you could easily change the other section. If you're a vegetarian, you know, I give vegetarian options. But everything is so fluid and easy to work with that you could adapt it however you need. But one of the things I like is like a memory game. So you cut up two to three different matching cards. And when the child turns over a match, they get to match and eat that fruit or vegetable, whatever you're working with. I usually start with fruit. So I had a mom that I was doing a zoom session, and her child very picky eater, very tactile, defensive. And he got to this point where I was like, okay, we can now introduce this game, you know, we said, Yeah, you got the strawberry match, okay, go get a strawberry. And we said, you don't have to eat it, you know, just smell it, lick it. And then if you want a tiny bite, and he ended up eating the whole thing, and then her son who was diagnosed with autism, our older son came in, because we were cheering and so excited. And he started to participate. And then she texted me later the week, both my children love this game, and have now been eating fruits and vegetables. So you know, something as simple and fun as a memory game or a matching game, I have another one that we can have different color bell peppers, and we line them up, and then you close your eyes, and someone either gives it to you or you could try to take a bite, they feed you. And you have to guess what color pepper? Yeah, and if you win, if you get it right, you get to eat that whole pepper. So kids are like, Yeah, one and they're eating bell peppers. Right. So it's just fun, you know, changing it, making it more interactive and light, you know, yeah.

Penny Williams 18:12

And I would think that if you have a child who's still aversive to a certain food, you can play these games. And the first thing they do is maybe just smell it the first time, what and then they just look at so it doesn't have to go straight into eating it. You can use these games really also to get through those steps of building the the ability to tolerate it.

Sarah Appleman 18:35

Right. And that's one of the things you do is I tell parents all the time, like children at this age, are looking at peers, parents teacher, you know, what are they doing? How are you as role models. So if you are trying to get your child to eat broccoli, and they hate the smell, and they hate the texture, fine, teach them, have them help with a plastic knife to cut it up for your family, steam it, cook it however you want pour sauce however you want. And then it goes on the table. And everybody eats it. They don't have to they help preparing. And if you do that, you know over a couple of days of whatever vegetable you want to introduce, because they're desensitized to the smell and the visual, they're more likely to eat it as well. And especially if everyone else is eating it.

Penny Williams 19:20

I love that. And I never thought about that, like desensitizing them to the smell and the sight of it. That's amazing. Yeah. And I noticed on your website, there's lots of images of parents and kids together doing these games or cooking together. And I think that's a really powerful piece of this, of playing with your food is that when they see you doing it, they're more likely to join in. Instead of you know, I want you to do this and whether I do it or not. I just I want you to do this. So engaging them It offers co regulation. So for kids who really struggle in that way, by sort of mirroring each other or participating in something together, there's kind of a rhythm to that that is really helpful to build regulation skills even and outside of the whole aspect of food aversion. And picky eating is just doing things together, always helps with the relationship. And when the relationship with your child is better, the results you get are better, right? Absolutely. Yeah. What else do you want to share with everyone about picky eating anymore? strategies? I know there's so much in the book and so many great resources on the website. Yeah,

Sarah Appleman 20:39

I think the biggest thing is slowly incorporating skills, because like, there are parents who didn't even notice that their child had, you know, a weak graph. And that lets you know, this is what I'm saying. Like, as a therapist who worked and specializes in sensory as well as visual and fine motor, and all of that, it's all connected. So if you have a child who is unable to stir a pot, right, because they keep dropping the spoon, or it's just hard for them to get fatigued, how is that same child going to be in a classroom, you know, with writing, coloring, cutting, getting dressed, all of that is so important, all those pre skills. So getting in the kitchen, having a good time, you're enhancing so much. And that's our goal, right? As parents, we want these kids to be independent, and functional, and happy and secure. So that's really why I did it is to help. I've had so many parents over the years, that thing got you I've helped their children and had wonderful success. And they all were saying you have to write it. And I'm like, Oh, sure, between what time in the day it is, you know, working mom, how but I did, I just sat down and did it. And some of the kids that are actually in the book were former children that I used to work with. And it's great because these parents had, you know, come to me with really children or poor balance, or visual processing, on the spectrum, any of that. And I was able to build this positive report and build that confidence, they no longer needed me and they're being successful 567 years later in school, and they remember it, you know, and they remember all the how to code and help. And now they have little siblings, who are also doing it, you know, and helping, and they're teaching them. So it's just a wonderful experience. It's not just about the actual cooking and the baking, it's the process of it, and learning your child's skill level and how to make them feel more independent and confident.

Penny Williams 22:46

Yeah, and this makes me think that if your child has a food issue, or is a picky eater, and you haven't investigated sensory issues, that might be a signal that you're sure that you should have an evaluation with an occupational therapist like you and find out if there's other sensory issues that can be worked on as well. I know for my own son, occupational therapy was amazing. And we did it to different courses of it at different ages, for different focuses, because he had such a great rapport with his therapist and the other people who worked in that particular office. And he really just loved to go there. And so it didn't feel so hard to challenge different sensory issues. And I've seen so many different occupational therapy, places that are like this, where kids feel accepted, and they don't feel so different when they go there. You know, they're seeing other kids like them, and they're working on things, but they're also just having fun. A lot of ot can just be having fun, and not realizing that, you know, your therapist is challenging your aversion to swinging for instance, or something, right,

Sarah Appleman 24:00

it was so funny, because honestly, until COVID happen, so many parents, I think would see what we do and be like, what are they doing like this is so like, you're playing with my kid not realizing like I always joke that it's like, I'm like Mr. Miyagi, where I'm like doing certain things, and then all of a sudden, their kid is able to ride a bike, you know, like, so I joke around all the time about stuff like that. But this year, especially in COVID, when I'm through zoom, and I'm like showing them or telling them different instructions how to hold their child or do that. And every mom or dad is like, Oh, my I'm so tired. Like, they literally took the phone and show like the husband passing out on the couch. And I'm like, that's why I'm sweating. I'm like, it's not easy. It's making it look effortless and making it look like fun as a successful therapist, but it is not easy at all. Yeah, you know, when we're playing a game, what do we do? Let's just say it's Next for Well, if you have a kid who keeps missing, you know, or visually challenged, they're frustrated, and you have to work. And you have to tell everyone as a joke, I'm also a professional loser because I have to lose four hours a day, every game I play that I am so not competitive anymore, it has wiped out any competitive nature. But it right like I just every day, I have to lose to a two year old, a 10 year old doesn't matter, but building their confidence and doing it. So, you know, we might have a child who has vestibular issues and balance and coordination problem. And they're walking on a balance beam and then standing on a Bosu. And then they have to throw a ball. Well, we're doing that to incorporate their whole body and it's, you know, I hands, feet, everything, then when you feel strong, and accurate. Now you're going to, you know, stand on the ground to hit a ball, it's way easier. So yeah, so it's definitely fun. And, you know, you have to constantly be creative, but it is worth

Penny Williams 26:02

Yeah. And it's such valuable work, really, I can't say enough great things about occupational therapy for kids with ADHD or autism, it's really, really valuable. And again, it's something that like, if the parent is trying to get them to do it, they're like, I don't want to do that for you. But if they go to this fun place, with this person, that they really enjoy spending time with this therapist. It's so different. It just changes everything. And it really gives them a sense of confidence, like you said, as they work through different goals, but also a sense of community, we got really from doing occupational therapy as well, because I learned so much about my kid from his therapist in that way, you know, just great. I love hearing aha about things that we had struggled with before that. And suddenly they made sense, because someone could tell me why they were happening. And I think that's really the crux of our whole conversation here is always looking at why is this happening? Why is my kid refusing to even have broccoli on his plate? Why will he not even come to the dinner table? If there's jello on the table? Like, you know, it's always about what's going on behind that. And I love this idea of playing with your food because it takes that pressure off. And it really opens the door for fun and creativity and for building the relationship with your child rather than stressing it more and degrading it. And that's so amazing.

Sarah Appleman 27:32

Well, thank you. I did I worked hard using like, you know, all my experience and fun. I tell everyone, I'm not a trained chef. These are just, you know, yummy recipes that people like but yeah, it was actually a lot of fun like trying exactly like incorporating my knowledge of therapy and sensory and all that into a creative activity plan. You know,

Penny Williams 27:55

so fun. For everyone listening, you can get the show notes at parentingADHDandautism.com/133. For Episode 133. There, I will have links for the website, the book, the downloadables that we talked about that go along with the book on Sara's website, and other ways to connect with her and her work. And I really encourage you if you have a picky eater, check out this book, be open minded and really be okay with trying something different. Because what you're doing is probably not working. So this is a great thing to try. Right. This is a great next step that will really be helpful. Thanks again for being on the show Sarah and really giving us some great insights and some strategies that parents can walk away right now with and really help their kids. I appreciate that. Well, thank you so much for having me. It was my pleasure. With that we'll end the episode. I'll see everybody next time. Thanks for joining me on the parenting ADHD podcast. If you enjoyed this episode, please subscribe and share. And don't forget to check out my online courses, parent coaching and Mama retreats at parentingADHDandautism.com

Transcribed by https://otter.ai

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