Graded Exposure

Working Together To Build A Healthier Generation

Graded Exposure


19 Nov 2019

Graded Exposure – A dripping tap

Bridging the gap towards New Food Acceptance

I have been working on a private one to one basis with parents and children for over ten years now and today the same challenges and questions still keep popping up. 

The familiar themes usually run along the lines of a child who is stuck and faced with some or all of the following

 -a limited diet (safe foods), rigid eating patterns, anxiety over new foods (neophobia), preference for brand specific foods, difficulty handling textures (sensory defensiveness), strong gag reflexes particularly with smelling or looking at unfamiliar foods along with a general unwillingness to change their set eating patterns and behaviour.

Parents are often at the end of their tether, frustrated at the rigidity of their child’s eating habits and begin to blame themselves. A myriad of emotions set in from anxiety that their child is not getting the nutritional requirements for growth, resentment of wasted food and the time preparing it, to a feeling of failure as a parent and a mixture of anger and sadness at the situation. All of this is very close to my heart as I experienced all of the above and more with my first child and new foods are still a work in progress for us (she is six!)

When eating for many of us is such a joy and incredibly satisfying there’s a tendency to overlook the challenges our children are struggling with and we can find ourselves wondering why it’s so difficult and fraught with tension?!?! (We sit poised at the table full of expectation, jolly our child along to try it, begin to get a little irritated and start to coax them along with lots of positive affirmations about the food, begin to make threats or initiate bribery whilst hovering over them with a forkful…..)

The answer is that for some children it’s not as simple as picking something up, popping it in their mouth deciding if they like it or not. There is a whole host of sensory and psychological experiences that go on in the very instance that a new food is presented to them. Just looking at the new and unfamiliar food can be a challenge in itself and brings with it a flurry of anxiety

 “What is that??? Do I have to eat it? I might not like it? It might make me feel sick (gag)! I’m scared! “

We all want quick fixes, instant success, a magic wand and yet we all know deep down that whether we are trying to get fitter, smarter, better or stronger it doesn’t happen overnight, it’s a work in progress that takes time and requires a plan. The plan begins with laying the foundations, practicing techniques, taking a few steps forward and every now and then perhaps one step backwards. Over time the dripping tap effect creates a pool of positive experiences and recognition that provides a strong structure on which to build and grow.

The same is true of children who face challenges with food and eating, if we take the short cuts and rush/force/bribe/bulldoze our way through the process to get to a short term instant result, there are no foundations or lasting positive experiences for our children to draw on later when approaching a new food experience.

It is true that it takes up to 15 exposures of a new food before it might be accepted on a child’s plate or a tentative tiny nibble is taken. It can be disheartening to go through this process and be difficult to see any light at the end of the tunnel. However taking the dripping tap approach and providing your child with little glimpses of food experiences two to three times a week (that don’t involve eating it) really will make an impression and offer valuable skills to your child that will help to build the foundations on which their food journey will continue.

*Ideas can be as simple as:

*Asking for help to place food on a baking tray that you’re going to put in the oven. Offer tongs for dexterity practice and help alleviate any anxiety over getting it on their hands.

* Washing vegetables in a bowl of water ready to prepare for dinner, offer an old toothbrush to scrub them with, do they float or sink in the water?

*Stirring food or spooning out yoghurt into bowls and adding fruit or drizzling honey.

*Pressing the button on the food mixer and watching the ingredients combine

*Helping to unpack the shopping and stock the fruit bowl. Talk about any foods your child comments on, colour, texture, how to cook it (not focussed on eating)

* Let your child watch you prepare vegetables and place the chopped ones into containers/pans for you. If resistant just let them observe and maybe accidentally on purpose let one drop and miss the bowl, their reflex might jump to pick it up.

These might all seem like banal simple non-eating food activities that aren’t relevant but trust me over time these tiny drip drip experiences are filling in the gaps -offering a gentle graded exposure to new food experiences. They are the missing puzzle pieces that were maybe never in the box for one reason or another.

These simple everyday food and sensory experiences are filling the potholes (and in my experience) have usually occurred due to a bump in the road along the way at a developmental milestone stage be it weaning, chewing or reflux to crawling/walking, a prolonged period of illness but also moments of change like the arrival of a sibling or moving house.

Supporting your child through the challenges they face with new foods and eating is not easy and is a journey of exploration over an extended period of time that requires a lot of patience and perseverance. I often say to my clients “put the idea of your child eating any of this far from your mind, right now the focus is not on eating it’s about exploring and building confidence through these small experiences, a dripping tap approach, slowly, surely over time will become something more.” 

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