Anxious Eaters Defined

Marsha Dunn Klein, OTR/L, MEd, FAOTA

December 9, 2019

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Question

Who are anxious eaters?

Answer

There can be a lot of different terms that are used, but for the purpose of this talk today, we are going to refer to these children as anxious eaters and look at the worry aspect of what is going on with their eating. We are going to talk about children who are worried about a very specific look, a very specific sound, smell, texture, or taste for foods. Changing from any of those sensory variables is very worrisome for this crowd, and we are going to look at the big concepts of worry and change when those are difficult for these kids. Some of these kids have a diagnosis of food neophobia. This is a term that was coined a while back, Leanne Birch popularized it, and they talked about the fear of a new food introduction. I like that term a lot for these kiddos because many of them are actually fearful and overly worried about new food presentations. However, Leanne Birch and others talked about this as being a typical stage in toddler development. However, I think the children that we are talking about today are not typically developing toddlers that get a little bit picky for a while and then outgrow it. These are children where the food worry is really real.

Diagnoses:

  • Food neophobia

  • Sensory processing disorders

  • Autism

  • Obsessive-compulsive or anxiety disorder

  • ARFID (Avoidant Restrictive Food Intake Disorder)

  • What they ALL have is worry

Some of these children have sensory processing disorders, like diagnoses, but we have many children with sensory processing disorder diagnoses who do not have any eating issues. So, this term does not work that well. Many children with a diagnosis of autism do have picky eating and anxious eating issues; however, again, not all children with feeding challenges have autism. Some of these kiddos have obsessive-compulsive or anxiety disorders that are diagnosed or undiagnosed. It might fit with the Avoidant Restrictive Food Intake Disorder (ARFID) crowd, but there is a lot of controversy and discussion about whether that term fits all of these children, and who should treat them. 


marsha dunn klein

Marsha Dunn Klein, OTR/L, MEd, FAOTA

Marsha Dunn Klein OTR/L, MEd, FAOTA is a pediatric occupational therapist who has spent a career specializing in pediatric feeding challenges. She received her bachelor's degree in occupational therapy from Sargent College of Boston University in 1971. She received a master’s degree in education with an emphasis on special education in 1975 from the University of Arizona. Marsha has co-authored Pre-Feeding Skills editions one and two and Mealtime Participation Guide, Homemade Blended Formula Handbook with Suzanne Evans Morris and Feeding and Nutrition for the Child with Special Needs with Tracy Delaney. She lives in Tucson, Arizona and travels to present locally, nationally and internationally on pediatric feeding issues.


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