What is ILT?
If you are reading this, the chances are that you have a child who is struggling at school. Maybe he or she is finding it difficult to master skills such as reading, writing, maths or spelling. Maybe he or she can do all these things but comes home with reports about unfinished work, or work left at home.
The teacher complains about her being disorganised, untidy or even aggressive towards other children. Or maybe she is described as being unfocused and a daydreamer who never seems to listen. And maybe you agree with the teacher because you see the same behaviour at home.
Labels such as ADHD, Dyslexia, Auditory Processing Problems, Sensory Processing Disorder are mentioned. What’s going on?
Food allergies, sensitivities or intolerances can play havoc with a child’s ability to benefit from teaching. Before we go into this, let’s clarify what causes food (and environmental) allergies and sensitivities.
Genetics seems to be an important factor in the risk of developing allergies. It seems that children with (true) ADHD who have food allergies are also likely to have parents with similar problems.
Nutritional factors are also significant for the development and severity of all forms of allergy. When a child has less than adequate nutrition, his immune system cannot function as it should and is more likely to misfire when faced with various stressful elements in the digestive system. For example, children with deficiencies of omega-3 are more likely to suffer allergies; deficiencies in magnesium and zinc are also know to promote allergic responses. The overall quality of the diet may also play an important role. Too much processed, stale, chemically altered or nutritionally depleted foods may well promote an allergy.
Another factor is toxicological stress. Children who are regularly exposed to pesticides that are toxic to the immune system, heavy metals (lead, mercury, cadmium), plastic residues and solvents may be more prone to allergies.
Developmental markers may also play a role. Breastfeeding may significantly reduce the risk of later developing food allergies. Ideally, babies should be breast fed exclusively until at least six months of age – longer if possible. The reason for this is that a young infant’s gut is naturally leaky and for a good reason. Large molecules, for example the antibodies in the mother’s milk, can cross through the gaps to enter the baby’s bloodstream to protect her from infection while her immune system is still immature. This is a vulnerable time and if other molecules enter the blood, the developing immune system may see them as threatening and becomes non-tolerant of them. This is exactly why mothers are encouraged to not only breastfeed but to carefully and slowly introduce solid foods one food at a time, starting with foods least likely to generate an allergic response. This ‘educates’ the baby’s immune system and helps the body develop a tolerance towards each food as it is introduced.
Intestinal parasites are worth a mention as well as they may also cause upsets in the digestive system and underlie the emergence of allergies. For this reason, regular treatment is advised for the whole family and not just for the fur children!
Non-food allergies such as hay fever can raise the severity of food allergies. If these types of allergies are particularly active in some months of the year, such as Spring, pre-existing food allergies may become more predominate at the same time.
When the immune system is not involved in a child’s reaction to foods, we refer to them as having a food intolerance. Knowing the difference is important because it will impact on the success of treatment. The most frequent reason behind food intolerance is inadequate digestion of particular nutrients. Lactose, or milk sugar, is probably the most common example of an intolerance due to digestive difficulties.
Take a long, serious look at your child. Sometimes allergies and food intolerances show up in his or her physical appearance. Some children can show a characteristic ‘spaced out’ or even an almost ‘demonic’ look when they suddenly become impossible. These looks can sometimes be accompanied by sounds such as throat clearing or clucking. This last noise is typical of a dairy or milk sensitivity. Some slur their words or begin to speak very rapidly. A few children whine or repeat the same phrase over and over. In addition, they may develop a hoarse voice or red ears or cheeks after exposure to a certain food or chemical.
Other signs include dark rings under the eyes, which can be grey, black, blue and even reddish. Nose rubbing, skin-scratching, wriggly lets, small horizontal wrinkles under the eyes and facial twitches and tics are very common in some children.
Abnormally rosy cheeks are particularly characteristic of allergic children between the ages of two and four years (and of adult women who have multiple food or chemical allergies).
Some children show hives, which look like mosquito bites or more generalized rashes.
And lastly, a bloated or abnormally large abdomen may also be a sign of problems – not always of a food allergy or intolerance but possibly of a yeast infection or parasites in the gut.
Next week we’ll continue this theme and describe the behaviours that so often accompany food intolerances – and are mistakenly thought to be ADHD, oppositional or even defiant behaviour caused by mental disorders.
Parents and teachers alike will agree that children who struggle at school usually feel bad about their academic abilities. Most of them will certainly have some emotional problem related to the learning difficulty.
While this is probably considered to be a ‘known fact’ amongst educators, another fact, gleaned from practical experience, is that the priority seems to be on the diagnosis and remediation of the learning difficulty or disability. The need to address the emotional aspects takes a backseat.
The way emotions and learning difficulties or disabilities interact is a complex subject and not always easy to unravel. Essentially, there are some guidelines to keep in mind:
- Emotional distress may be caused by learning difficulties.Learners who fail to thrive at school may suffer from anxiety, depression, loneliness and low self-esteem – especially regarding their academic abilities
- Learning difficulties may aggravate social and emotional functioning.If a child struggles with mental processing that is severe enough to cause a learning problem, they may experience problems in nonacademic areas as well. This typically shows itself in behaviours that don’t conform to the child’s social environment. The result is escalating emotional concerns such as feelings of being misunderstood, sadness and anxiety – all on which may already be present because of the learning problem.
- Emotional issues can disguise a child’s learning disability. This may happen if the child resorts to defiant behaviours such as ‘acting-out,’ distracting behaviours such as being the ‘class clown’ or complaints about physical ailments.Adults’ focus might be on the undesired actions and the learning difficulty could be overlooked.
- Emotional issues may aggravate learning difficulties.Constant failure to succeed at school may lead to stress or feelings of inferiority which can intensify the learning problem. A child who, for example, consistently struggles with certain academic tasks may decrease the child’s ability to pay attention and concentrate on the work.
- On the other hand, a child with learning difficulties who enjoys good emotional health may find it easier to cope with challenges. This can enhance school performance.
This last finding emphasises the importance of ensuring that children with a learning difficulty or disability are well supported emotionally and socially. On the positive side, parents and teachers usually do try to understand the complexities of the interaction between emotional functioning and learning difficulties. Most do try to ensure that the help the child receives is not limited to academic remediation.
Content for this post was based on an article entitled ‘Understanding children’s hearts and minds: Emotional functioning and learning disabilities’ written by Jean Cheng Gormon and available at: www.idonline.org/article/626292/?theme=print.
“WE’VE TRIED EVERYTHING – NOTHINGS HELPS, NOTHING MAKES THINGS BETTER”
“I JUST DON’T KNOW HOW MANY MORE MEALTIMES LIKE THIS WE CAN TAKE…”
These are real quotes from parents who felt like they had come to the end of the line in terms of finding solutions to their child’s picky eating. The internet can be a fantastic source of support for parents, but there are so many articles out there, often offering conflicting advice. It can be really hard to know what to trust, and sometimes, too much information can just feel plain overwhelming.
Recently I came across Jo Cormack who specialises in childhood eating challenges. She gave me permission to reproduce this article. I would earnestly suggest that you visit her website and take advantage of the help she and her team offer. Details are at the end of this post.
You’ve had your child’s weight and growth checked and it’s all fine. You’ve ruled out physiological causes of their eating issues, like allergies or physical problems with chewing or swallowing. Everyone tells you that they will grow out of it; that it’s only a phase! – Just put the food in front of them and wait for them to eat it, because “they won’t starve”.
But for some children who are extremely wary of unfamiliar foods – the ones who cling to their safe foods like a life raft in a stormy sea, and who really, truly need to know that the food they are offered is firmly within their comfort zone; these children need a bit more help. I call these children cautious eaters.
No amount of gentle (or forceful) persuasion, bribery, creative presentation or talk about the nutritional benefits of food will convince a genuinely cautious eater to eat something that they don’t feel comfortable with. In fact, research shows that trying to encourage children to eat can actually make their picky eating even worse.
Serving cautious eaters foods that they don’t feel okay with in the hope that they will eventually get hungry enough to relent and eat something, can end in several terrifying days where children simply don’t eat. This is deeply distressing both for them and for you. Not to mention dangerous.
It is so tough on parents when they don’t know what their next move should be. We can deal with pretty much anything if we feel that we know what we need to do, and we have the support required to do it. There is nothing worse than that feeling that you know your child needs your help, but you’ve simply run out of ideas.
I understand this anxiety and desperation: The urge to feed and nourish our children is one of the strongest instincts a parent has, and to be honest, most of the parents who reach out to me are already at a very low point with their child’s eating… sometimes things have to get to rock bottom in order to ignite a change.
Help is at hand
I want to share an incredibly valuable strategy that I use in my clinical work when I feel that a child’s picky eating is caused by a genuine fear of unfamiliar and disliked foods. It is all about laying the foundations for helping a child enjoy a varied diet, by teaching them to tolerate unfamiliarity.
Before I get into what this strategy looks like, I want to explain a little bit about how anxiety can be be at the heart of a child’s eating issues, because seeing your child’s eating through this lens can be a complete game-changer.
CHILDREN CAN BECOME ANXIOUS ABOUT FOOD FOR MANY REASONS:
- Perhaps they have sensory processing issues and their experience of eating certain food is so overwhelming to them that it is actually frightening
- Perhaps they have a naturally cautious and anxious temperament; for them, an unfamiliar food (just like an unfamiliar situation or person) can be really challenging
- Perhaps they have got into the habit of using their eating behaviours as a way of feeling in control. The idea of not being in control of their eating may be very scary as it takes a coping mechanism away from them
- Perhaps they are not used to being offered foods that they don’t know and like. If parents consistently stop offering foods at the first signs of rejection, children quickly learn to fear the unfamiliar
This is not an exhaustive list of the reasons why a child may be anxious about disliked and unfamiliar foods. But it has a common theme:cautious eaters feel safe when their food is familiar and unsafe when it is not. If they are expected to eat foods which are not on their safe list, this is extremely anxiety-provoking.
Laying the foundations for change: a 3 step approach to helping your cautious eater
1) Empathy.Before you can truly be there for your cautious eater, you need to try to understand how it feels to be in their little shoes.
It can be a bit of a shift of mindset to understand that your child’s response to food is not ‘bad behaviour’ – that it doesn’t necessarily fall into the categories of boundary testing or (developmentally normal) struggles for autonomy that run-of-the-mill picky eating can often be understood as.
Your child isn’t trying to get attention, they are simply really, really scared of foods which are not on their safe list. Especially for children with an unusually high degree of sensory sensitivity, the experience of eating foods that are challenging in terms of taste, texture, appearance or smell, is just so intense.
Many young children can’t verbalise these fears. They may act out, and express their feelings through aggression or alternatively they may withdraw. The first thing you need to do in order to help them is acknowledge that their anxiety is very real indeed and is not a choice. Research is increasingly linking anxiety in children to eating struggles. However hard it may be to imagine being scared of the wrong brand of crackers – appreciating that your child’s reactions may be anxiety-driven can be very powerful.
2) Make sure that you have a good understanding of your role in relation to feeding your child. You may well already be familiar with Ellyn Satter’s Division of Responsibility (DoR) model. If not, you can learn about it on theEllyn Satter Institute website where you will also find a very useful downloadable pdf about DoR. There are also lots of great articles written by feeding professionals about how DoR can help your family, like this article from Natalia Stasenko or this oneby Sarah Remmer, which includes a fab kitchen printable. If you are more of a book worm than a blog reader, this short, accessible bookby Katja Leccisi, provides a great overview of how to understand your feeding role.
3) Teach your child to expect variation.This is the killer strategy that will make all the difference. You are seeing things from your child’s perspective, you have educated yourself about your role in relation to feeding your child. But you are stuck, because your child will only accept a limited list of foods.
You need to begin to teach your child to accept and expect the unfamiliar, in the context of their safe foods.
Much of my work with picky eaters draws heavily on cognitive behavioural therapeutic theory. Cognitive behavioural therapy (CBT) teaches us that if we avoid something we are scared of, that fear becomes stronger. If we confront our fear and manage to do something that is outside of our comfort zone, the fact that nothing catastrophic happened – it didn’t give rise to a traumatic experience – tells our brain to produce a slightly smaller anxiety response next time that situation comes up.
A key aspect of successful exposure therapy is about making sure that you set people up to succeed and not fail. This makes sense if you thing about it; if you try something scary and find that the outcome is very upsetting because the goal was just not realistically achievable, you reinforce your urge to avoid that situation and your fear increases.
Setting your child up to succeed
You need to introduce variety in a way that will be manageable for your child and which they will not experience as intimidating. You do this by drawing up a list of their safe foods and devising teeny weeny baby changes to the foods on the list. These changes are not meant to be hidden from your child; we’re not talking about sneaky changes that they may not notice as this erodes trust and will defeat the object.
The kind of baby steps I’m thinking of, are ones that your child will both notice and cope with. For example, if your they like plain pasta, take a pasta shape that you know they usually accept and cut it in two (when it’s cooked… cutting dry pasta is no mean feat).
Combination and deconstruction
I use the twin concepts of ‘combination’ and ‘deconstruction’ as a jumping-off point for devising tiny changes to your child’s safe foods. Combination is all about pairing two safe foods in a way that is new for your child, and deconstruction is literally about taking food apart and re-presenting it in a slightly altered form.
For this strategy to work, you need to understand that you have a lot of work to do before your child is even ready to try new or disliked foods, BUT that there is plenty of room for manoeuvre within the context of their safe foods. Some children will naturally be confident eaters, but cautious eaters need to learnfood-confidence. And they need to learn it from within their comfort zone.
How this strategy works in practice
At meals, introduce a tiny change to one of your child’s safe foods. Don’t draw attention to it, just make it available to your child. Don’t praise them for eating it; this may increase pressure and fuel anxiety. Just remain focused on keeping your meals relaxed and upbeat. Perhaps initially try introducing change to their best meal of the day. For example, many picky eaters do best at breakfast – perhaps your child has toast. Cut it into fingers rather than squares. If they like raspberry jam, try sieving it before you put it on their toast so that the texture is very slightly different.
Laying the foundations for change (by helping your picky eater get used to unfamiliarity via constant tiny changes to their safe foods) will set the scene for the longer term task of introducing variety into their diet. It can take weeks – months even – for children to begin to feel comfortable with unfamiliarity. Introduce it at their pace, tune in to them and their responses.
You need to be patient, you need to be persistent and you need to be creative. Above all, you need to be in it for the long haul. But every time your child eats one of their safe foods in a new and different form, you are inching incrementally closer to giving them a positive relationship with food that will last a lifetime.
Jo does add a caveat to this advice. She says that the approach is very effective but only once your family’s mealtime dynamics are right (meaning that meals are family occasions where the conversations includes all members) and when optimum feeding practices are in place. If not, these ground rules need to be attended to first.
For parents wanting to know more about how to parent in relation to picky eating, Jo hasVisit a new membership site which you could link to: https://jocormack.lpages.co/your-feeding-team-sign-up-now/. She has a formidable, experienced team ready to help you.
Visit her website at www.jocormack.comto learn more.
Our sense of smell is one of the earliest to develop – being operational at about two months after conception. We can’t actually use this sense in those early days because the forming nasal passages remain blocked until some 28 weeks into the pregnancy. When this blockage clears, we can and do pick up smells in the environment – one of the most significant being the smell of the amniotic fluid in which we grow. Incidentally, this is the reason why newborns are not instantly whisked away to be washed as in the past. They are put onto Mom’s chest, allowing amniotic fluid to be transferred to her body and thus giving the baby the comfort of having a very familiar smell to help overcome the traumatic birthing event and make the transition to a strange new world.
We understand that the early developing senses (others include touch and taste) are crucial to our survival and well-being and even though we no longer have to rely on our sense of smell to warn us of danger or tell us what foods we can safely eat, it has implications for our functioning and even our learning.
Smell (or more correctly, the olfactory system) is unique in the way it sends information from the sensory cells in the nose to the brain. Firstly, it is the only sense that cannot be prevented from reaching the areas of the brain that interpret and give meaning to the incoming smell. Most other senses rely on the Thalamus (the brain’s ‘gatekeeper’) to admit them to the higher cortex. Not so with smell because the neurons carrying the information bypass the thalamus. This means that all smells that we have ever encountered travel to the brain and are registered there. The area of the brain dedicated to processing smells is intertwined with the limbic system, which is responsible for our emotions. For this reason, smells last for ever in our memories and are connected to emotions. Smells from the past can trigger feelings and memory, as well as impact on mood and behaviours. This is why certain smells vividly bring back the past and the emotions that accompanied an old event.
The fact that smell is the most significant trigger of memories may be a clue to how it can be used to support learning. When we study, we try to store information, facts and figures in our memory. What if we use smell to help register and then nudge those stored memories back into our conscious mind in order to answer questions or solve problems? It’s worth trying.
If a student finds a smell that she or he considers pleasant and soothing, having that smell present in the study area will form connections between the smell and memories being formed while studying. If the same smell is taken into the test situation, it is theoretical possible that the smell will help access the memorised content
To do this, using good quality essential oils may be the best way to go. A cotton wool ball soaked in the chosen oil can be carried along to a venue in a closed container, and surreptitiously sniffed on occasion.
Smell, being an important sense, has other implications for our functioning, which will be discussed in a following post.
Baby-led weaning or spoon feeding? The difference it makes to your child’s eating habits is actually very small
This article appeared in a Science newsletter on April 2nd2019. We thought it might be of interest as so many children these days present as ‘picky’ eaters who are difficult to feed.
It was written by Sophia Komninou, The Conversation
When it comes to avoiding picky eating and meal time tantrums, parents are usually ready to try any method that promises their child will become a better and less fussy eater. This is in part why methods of giving solid food to infants have received a lot of attention in the last few years. Some think that the way babies are introduced to solids can change their attitudes to food into childhood or even for life.
The most common method used to give babies their first solids has long been to offer a puree or mash using a spoon. This helps parents make sure their babies receive adequate energy and nutrients for their development – something many are often anxious over.
More recently, however, baby-led weaning has gained popularity – and divided parents. This method sees babies selecting finger foods – such as carrot sticks, broccoli trees or other pieces of whole, baby-fist size pieces of food – and feedingthemselves. While there have been unsubstantiated claims that this method can improve a baby’s dexterity and confidence, research has associated baby-led weaning with their ability to recognise when they are full and being less fussy with their food. This makes it an appealing choice for some parents.
However, as with most things baby-related, the reality is that many parents don’t use just one method of feeding. It changes depending on the time, day or situation they are in. Which is why, for our recently published study, we wanted to compare how different styles of feeding affects a baby’s eating habits and attitudes to food.
Is baby-led weaning better?
We looked at four different categories of toddlers, whose parents introduced them to solids using either: solely baby-led weaning, mostly baby-led weaning with occasional spoon feeding, mostly spoon feeding with occasional finger foods, or just spoon feeding. We asked the parents questions about their feeding strategies and eating behaviours of their toddlers, like fussiness and food enjoyment.
Usually, in a statistical analysis, we look at whether there is a difference between groups. But what this doesn’t tell us is how big the difference actually is. To solve this problem, we looked at the size of the difference between the groups (what we call the effect size). It helps us understand whether the difference actually matters.
We found that the magnitude of difference in a toddler’s fussiness and food enjoyment is minimal across the four groups. This means that baby-led weaning, spoon-feeding or anything in between might not actually be the solution to future mealtime battlegrounds some parents hope it will be. That may seem to be in contrast with what the research shows so far, but it doesn’t negate those findings. Babies will be less picky about their food if they are fed using baby-led weaning as opposed to any of the other types of feeding, it’s just not by that much.
Socio-economics at play
When looking at the strategies parents use to feed their children, our study did show that those who follow baby-led weaning are less likely to use food as a reward or encouragement, and have less control on eating overall. This helps their toddlers learn to make eating decisions for themselves based on whether they are hungry or full. These parents are also more likely to breastfeed for longer, introduce solids after six months and eat more frequently with their toddlers.
However, the key difference here is not that the children were fed using baby-led weaning but instead the type of families who usually follow it. Our findings show that these parents are usually of a higher socio-economic status and more educated, which makes them more likely to follow a distinctly different parenting style and be able to afford to spend more time and money doing so.
Overall, our results suggest that the way a baby is introduced to solids will make very little difference to how fussy they will become, or how much they will enjoy food. It is important to remember that how children eat depend on a lot of factors, including their genetic background, their past experiences with food and their interaction with their parents.
Research findings are important when communicating complementary feeding advice to new parents, but headlines and quoted study results can often be misleading. So remember that when reports of research say there is a difference between one method over another, it’s not the whole story. The size of this difference – something that is not often communicated – matters too. The most important thing that parents can do is to try their best and introduce solids in a way that is more appropriate for their family, rather than stressing about a specific method, as research suggests might make a only a very small difference.