![]() ![]() Occupational therapists are in the unique position to work with the client and their family to decipher what occupational roles are impacted by picky eating and therefore how the occupations are impacted. Early identification and intervention are important to support parents, as research has indicated that mothers, with children who have feeding problems, have higher levels of depression and anxiety. Frustrations were identified when health professionals suggested that a child who is a picky eater needed to increase their intake without suggestions about how to do this. A contradiction may exist as caregivers have reported worrying about their child’s limited intake even when they were reassured by health professionals that their child was in good health. By the age of 24 months, a typically developing child is able to independently feed themselves and is able to use a fork and an open cup for drinking.ĭiscrepancies exist between the parental level of concern regarding picky eating and the health professional response. As a child develops, they play a more active role in this process and are more able to exert control over what they eat. In Australia, family mealtimes are considered frequent and important. Feeding and eating are central to the framework of family life and are strongly embedded within culture and tradition. Feeding is defined within the Occupational Therapy Practice Framework as setting up, arranging, and bringing food or fluid from the vessel to the mouth and includes self-feeding and feeding others, whereas the occupation of eating is defined as keeping and manipulating food or fluid in the mouth. It is also considered a co-activity in the early years of a child’s life, that is one that requires active participation by both the caregiver and the child. The act of self-feeding is seen as a complex activity and numerous issues can disrupt its execution. Occupational therapists are health professionals who consider all aspects of the person, including psychosocial, cultural, and environmental factors when considering impairments. These thereby impact participation in everyday activities that are related to mealtimes. ![]() This definition suggests that picky eating results from a combination of intrinsic (client-specific factors such as personality, body functions, and structures) and extrinsic (those that are external such as the environment and others within it) factors. Ekstein defines picky eating as a child’s unwillingness to eat familiar or new foods that is severe enough to interfere with daily routines and the parent-child relationship. One reason for the disruption of eating and feeding is picky eating. Consuming a wide variety of foods, including items such as vegetables and fruit, has been established as important for health and has been shown to reduce the risk of chronic diseases. The World Health Organization recommends that in addition to an adequate variety, amount, and frequency of foods, feeding times should be periods of learning and love. There appears to be a complex interplay between intrinsic and extrinsic features which impact caregiver responses and therefore on the picky eater. In conclusion, there is a lack of published papers addressing the role of occupational therapists in the assessment and identification of picky eating in children. Most commonly reported extrinsic features that decrease the likelihood of picky eating are family meals, responsive parents, and involving the child in the preparation of food. Extrinsic features which appear to increase the likelihood of picky eating are authoritarian parenting, rewards for eating, and pressuring the child to eat. The most common reported intrinsic features of the child who is a picky eater included increased sensitivity particularly to taste and smell and the child’s personality. Often additional assessments were included in studies to identify both the intrinsic and extrinsic features and presentation. The most common assessments used to identify picky eating relied on parental reports and recall. There were 80 studies that met the inclusion criteria, which were then mapped using content analysis. A robust screening process took place using the authors pre-agreed inclusion and exclusion criteria. This scoping review comprises a comprehensive search of key health industry databases using pre-determined search terms. Occupational therapists work with children and their families by looking at both intrinsic and extrinsic influences and are therefore well-placed to work within this context. ![]() Picky eating can impact this complex activity and has numerous extrinsic (or external) and intrinsic (or internal) features. The health benefits and importance of family mealtimes have been extensively documented.
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