“Picky Eater”: Sensory Feeding Disorder or Oral Motor Deficit?

Samantha Bolton M.S., CCC-SLP
Samantha Bolton M.S., CCC-SLP

LKS & Associates
Feeding Specialist

A “picky eater” can create stress during meal times, dismantling the caregiver’s and child’s trusting feeding relationship. When a child is consistently refusing foods, reluctant with new foods, or has dietary deficiencies due to a limited diet, it is essential to consult with a Speech-Language Pathologist who can properly evaluate, diagnose, and implement strategies to treat the underlying issue. Is it a sensory feeding disorder or an oral motor deficit?

What is Sensory Feeding Disorder?

When a child avoids certain foods due to the smell, taste, texture, or appearance, we identify this as a sensory feeding disorder. These sensory processing difficulties in the mouth ultimately limit the number of foods the child will eat. Because the texture, temperature, or taste is too much for them to process, they avoid that food. It can change the dynamic during mealtimes, create weight gain issues, and limit the number of nutrients a child receives.

What is an Oral Motor Deficit?

An oral motor deficit is an impairment with strength, range of motion, or coordination of oral structures. Through my experience working with children with sensory feeding disorders and oral phase dysphagia, I have noticed that children often labeled as “picky eaters” can have jaw weakness, causing them to avoid difficult-to-chew foods. A child with underlying jaw weakness might be misdiagnosed as having a sensory feeding disorder or labeled as a “picky eater” because certain textures (e.g., hard vegetables or meat) are difficult to chew.

How can LKS & Associates help?

At LKS & Associates, I evaluate all areas of feeding. An evaluation begins with taking a thorough feeding history. All areas are discussed, from bottle and breast-feeding experiences to transition to table foods. The caregiver’s concerns are reviewed in-depth, including details about why the child is a picky eater, their preferred and non-preferred foods, and how they react during mealtimes. This information is vital, as it allows me to see any connections between the non-preferred foods. Following this discussion, I complete an oral exam, assessing structural integrity, tone, range of motion, and strength. Gathering all of this information allows me to differentiate between a sensory feeding disorder or oral motor difficulties. If the picky eating is due to an oral motor deficit, then targeting that underlying oral motor issue will ultimately decrease the picky eating. When children realize that they can safely and easily eat hard-to-chew textures, they begin to refuse less often and learn to enjoy those foods. If left untreated, sensory processing difficulties and underlying oral motor deficits will limit the number of foods the child will eat, ultimately limiting nutrients essential for proper growth and development. 

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