Category Archives: Picky Eaters

Tactile Defensiveness

Tactile defensiveness is the hypersensitivity to touch. Children with tactile defensiveness notice touch more than others. They react negatively to unexpected, light touch and even to the anticipation of light touch. The child may react with a fight or flight response by being hostile to those around them or by fleeing from contact with people, finger paints, playdough, etc. Some children will withdraw passively by avoiding the object and people that cause distress. The receptors of the tactile system are in our skin so therefore it is not just our hands that can be hypersensitive to touch but our whole body.

When our tactile system is functioning well we are able to filter out which tactile information is important and which is not. Those with tactile defensiveness have difficulty ignoring input that is not important (e.g. the way their shirt feels, the light breeze on their face, etc.) and may appear distracted. Many children who do not enjoy light touch may actually enjoy deep pressure touch, like bear hugs or heavy blankets.

Signs of tactile defensiveness:

  • Dislike brushing teeth or going to the dentist
  • Dislike getting hair washed or cut
  • Dislike wearing clothing or certain types of clothing, may prefer really tight clothing or baggier clothing
  • Withdraw from being kissed or from a light touch
  • Avoid playing with playdough, finger paints, etc.
  • Immediately want to wipe hands when they get dirty
  • Avoid playing in the dirt, mud, sand, grass, etc.
  • Picky eater

Suggestions when working with children who have tactile defensiveness:

  • Don’t approach or touch the child from behind
  • Avoid light touch
  • Use firm pressure when touching the child
  • Allow the child to have their own space during circle time (sit on their own piece of carpet or on a bean bag chair, rocking chair, etc.)
  • Have the child stand at the front or back of the line to minimize unexpected touch
  • Create a “quiet corner” (bean bag chair, tent, teepee or blanket draped over table) in the classroom or in another supervised room where the child can go if they are starting to feel upset or over-stimulated
  • Provide the child with deep pressure activities/movement breaks throughout the day (easiest to incorporate into daily class schedule as it is valuable for the whole class)
  • Weighted items such as a weighted lap pad or a weighted snake around the shoulders can be used to provide that calming deep pressure touch
  • Encourage the child to participate in sensory play activities
    • It is important to encourage the child to participate but do not force them into doing anything they don’t want to do, we want to gradually incorporate some challenging textures/touch while keeping it fun and enjoyable
    • The child may need to begin by just watching others take part in the activity, then move onto using a utensil (knife, paintbrush, rolling pin, cookie cutters) to play with the substance (fingerpaint, playdough, shaving cream, flubber etc.) and then finally to using their hands to play in it
    • Subtle, gradual exposure is the key to successful sensory play


What do OTs do?

What do OTs (Occupational Therapists) do? Many people have no idea what an OT is when I tell them what I do! Many people think that we help people get jobs, but that is not the case (mostly anyways!). OTs focus on the areas of self-care, productivity and leisure. So depending where an OT is working they are helping people with very different things. OTs are trained in the areas of anatomy & physiology, neurology, child development, mental health, counselling, older adult disabilities, among other areas.

In acute care (hospitals) we focus a lot on self-care, helping people to be independent in their basic daily activities such as getting themselves dressed, having a bath, preparing a meal or moving around their homes/community. We prescribe equipment and provide education about how they can become more successful completing their activities of daily living in a safe manner. An independent study by health policy researchers published in Medical Care Research and Review (Rogers, Bai, Lavin, & Anderson, 2016) found that “occupational therapy is the only spending category where additional spending has a statistically significant association with lower readmission rates” for the three health conditions studied: heart failure, pneumonia, and acute myocardial infarction. Yay OT!

When working with children as we do at Bright Horizons OT, the focus looks very different. We use play as a means to achieving the child’s/family’s goals. In order to achieve the goals, we either use remediation (treating the underlying deficit) or compensation (adapting activities or environment) to make the child more successful in their everyday activities. The goals of OT can be many different things, here are some examples of general goals:


  • Increase ability to pick up small objects and release them
  • Increase ability to use both hands together (e.g. stabilizing the paper while writing with the other hand, holding a jar while using the other hand to twist the lid, etc.)
  • Increase handwriting legibility and/or speed
  • Increase accuracy while cutting with scissors


  • Increase core strength/postural stability in order to increase gross and fine motor skills
  • Increase the child’s support while sitting in a chair at school (proper seating in order to maximize their ability to complete school activities)
  • Making adaptations in gym class/sports/leisure activities to increase participation


  • Increase self-care abilities such as getting themselves dressed, doing up buttons, zippers, tying their shoes, etc.
  • Provide adaptive equipment/education to help make bathing independently or with assistance easier


  • Increase self-feeding abilities (using a spoon, fork, knife, open cup, straw cup, etc.)
  • Expand the number of foods a picky eater/problem feeder will eat


  • Decrease sensitivities to sensory input (lights, sound, touch, etc.) and/or make environmental adaptations to help them cope with these sensitivities
  • Increase the child’s ability to engage in hair brushing, hair washing, hair cutting, etc. for those that are sensitive to these activities
  • Make adaptations/find clothing that the child will wear without being bothered by tags, seams, fabrics, etc.


  • Increase on task behaviour in children who have attention difficulties (teaching self-regulation skills)

These are just some examples of the things that are addressed when you see an OT. One of the greatest parts of our job is we get to look at such a wide variety of areas!

Preventing Food Jags

What is a food jag? It is when a child (or adult for that matter!) eats the same food prepared the same way everyday or at every meal.

The problem with food jags is that kids get tired of these foods and may eventually avoid them permanently.

Tip for preventing food jags:

  1. Make a list of all the foods the child eats regularly.
  2. Put these foods in a menu format where no food is repeated across 2 days.

For example*:

Meal Day 1 Day 2
Breakfast Oatmeal with Bananas Toast with Peanut Butter
Snack Yogurt & Strawberries Applesauce
Lunch Ham Sandwich & Pickles Soup & Salad
Snack Hummus & Carrots/Crackers Muffin
Supper Spaghetti with Meat Sauce Chicken & Rice

The idea behind this strategy is that by not offering the same foods everyday, the child will not get stuck on eating one food all the time and will expand their number of accepted foods.

For children who are very picky eaters and have a very small number of accepted foods, try to not repeat a food over a 2 day period (as shown above). For children that accept more foods, you can try not offering the same food over a 3+ day period.

*This is an example to illustrate how to make a menu, please do not take this as nutrition advice, for that please see my colleague Lacey at Beyond Baby Nutrition!

Please contact me if you have any comments or questions about your child!

SOS Approach to Feeding Conference

I recently attended the SOS Approach to Feeding conference in Edmonton, AB. What a fascinating 4 days jam packed with information about kids who are picky eaters and problem feeders! Here are a few things that I learned:

  • most picky eaters are picky because they either do not have the required oral motor skills (ability to chew, move their tongue, close their lips) or have difficulties with the sensory input (taste, texture, colour, shape, sound, etc.)
  • it is important to assess if there are any medical reasons for the picky eating behaviours (e.g. reflux, food allergies or intolerances) as a child will not want to eat if it makes them hurt or feel uncomfortable
  • it is very important to introduce foods at a pace that the child is comfortable with, stress actually turns off a child’s appetite so it is counterproductive

An OT can help assess your child to determine the underlying skills that they need to work on in order to be more successful in their eating. Please contact me if you have any questions or would like more information on the services I provide.