Fort Worth, Texas,
09:46 AM

‘My Kid Won’t Eat.’ Is It Time To See A Child Psychologist?

The reasons your pediatrician or speech therapist would recommend a mental health professional

When children are very young, they may have difficulty eating for a number of reasons. Chewing and swallowing may be hard or painful. Certain foods may feel weird in their mouth; too slimy or too dry and crumbly for example. Other children have reflux or medical issues that cause discomfort when they eat particular foods.

By the time parents and pediatricians recognize and treat the problem or recommend a feeding evaluation, that child may have had years of unpleasant eating experiences. So what happens? They refuse to eat. They throw tantrums at the table. They make mealtimes miserable for the entire family.

What’s a parent to do? You thought your child was “fixed.” The medicine has taken away the pain and the speech therapy has dealt with the sensitivities. Why isn’t he eating? But he has to eat, right? So parents now resort to other methods. They punish and they bribe or even worse, become short order cooks. These solutions may seem to work for a short time but ultimately the issue will linger. Why? The child is scared. He isn’t just defiant or stubborn. He is terrified, and the newest toy or video game won’t be enough to battle that anxiety.

When other options fail or it’s too late, a pediatrician or speech therapist may recommend seeing a child psychologist.

I know it must be confusing and frustrating to parents when they are shifted off to another professional, especially a psychologist. It does not mean that your child is crazy. We are not going to push medications on your child or push parenting classes on you. Though you may have heard differently from other professionals or well-meaning in-laws, we know it’s not your fault your child isn’t eating. For most of the children that end up seeing psychologists, a number of factors over time have played into the development of fears and avoidance.

There are also times where a child may start out eating anything and everything put in from of him then one day just starts refusing. Green beans were fine yesterday and now anything green is off-the–literal-table. Why? Did something happen? Some kids experience food trauma. Maybe they were given milk that was a bit past its expiration. Maybe they choked on a bite of sandwich. We all have had negative experiences with food that may have left us avoiding it for some time, but eventually we try it again. It is different with these kids. They don’t have the benefit of fully developed logic to combat that single negative experience. Instead, one atypical incident becomes the rule.

So now you are face to face with this psychologist. How can she help? My job is to help the entire family (even well-meaning in-laws) understand their child’s specific fear and to set rules and limits at mealtimes. My job is also to work with the child to break down the Big Scary Food into less scary baby bites. We teach relaxation skills and offer coaching to change the way the child thinks about food. Sometimes the anxiety may get in the way of the child’s progress in speech therapy. In these cases, my job may be to help the speech therapist with motivational techniques that can get the child to participate.

Who knew eating could be this complicated? Most of us have no difficulty putting away a burger or plate of lasagna. But for families living with a child that has a feeding disorder, the stress can be debilitating. Having a team of professionals to guide treatment and provide support is essential for the child’s success. It won’t happen by dinnertime, but there is hope. You can pack away that short-order cook apron and you can stop the McDonald’s chicken nugget runs. Your child can learn to eat again.

About the Author

Alaina Everitt, Ph.D., is a licensed psychologist at Cook Children's, who sees patients in Denton and Lewisville. Cook Children's Behavioral Health services provides a broad range of care that focuses on children from ages three years through 17, and their families. We also have some limited services available for children age 2. As part of family-centered care all of our professionals are qualified both through education and experience to work with children who have behavioral and emotional challenges. Our psychiatrists are board certified in child and adolescent psychiatry and our psychologists and therapists are all licensed independently in Texas.

About Cook Children's Speech Therapists

Speech/language pathologists focus on oral motor, speech, language and communication skills to enhance development, restore function and to prevent disability from pediatric conditions, illness or injury. Patients and physicians can make an appointment or referral by clicking here.

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