Is My Child a Picky Eater or Problem Feeder?

By November 16, 2020NESCA Notes 2020

Co-authored by: Abigael Gray, MS, CCC-SLP, NESCA Speech-Language Pathologist; Feeding Specialist, and Lauren Zeitler, MSOT, OTR/L, NESCA Occupational Therapist; Feeding Specialist

Do you have a child who presents as a picky eater? Have you ever wondered if their difficulties are more than just “picky eating”? Are mealtimes stressful for your family? There is someone out there who can help you!

Many children may be perceived as “picky eaters” while they are figuring out their food preferences. The important thing to understand is when your child would no longer be considered a “picky eater,” but instead a “problem feeder,” and therefore may benefit from feeding therapy. The chart below describes the general differences between the two. Every situation and child is different. If you have concerns, we always recommend reaching out.

There are other concerns that indicate a child may benefit from feeding therapy beyond the variety of food they accept, as described above. These concerns include:

  • Gagging, vomiting or choking when eating or drinking or shortly after
  • Poor posture while sitting at the table for meals
  • Difficulty using utensils within age-appropriate timeline
  • Issues with food control involving the mouth (e.g., chewing, closing lips around spoon or straw, drooling, pocketing food in cheeks, etc.)
  • Eating small volumes of food or taking more than 30 minutes to eat
  • Only eating certain textures of food (e.g., purees, crunchy solids, fluids)
  • Difficulty weaning from a bottle to solid foods
  • Transitioning from tube to oral feeding

Feeding therapy involves:

  1. Intake: you will be asked questions about your concerns to match you with a feeding therapist.
  2. Evaluation: before the evaluation, you will fill out a questionnaire about your concerns and goals for therapy as well as your child’s medical/developmental history. To obtain information about skills and behaviors, the feeding therapist will observe your child eating a variety of foods/textures and gain input from parents/caregivers. This will help the therapist determine whether your child presents with a feeding disorder and would benefit from feeding therapy. Recommendations will be made in a written report.
  3. Therapy: ongoing weekly therapy will be child-driven, and goals will incorporate your family’s priorities. Therapy will be individualized to address your child’s specific needs and goals.

For more in-depth information on this topic, register for the upcoming free webinar, “Is My Child a Picky Eater or Problem Feeder?” on November 18, 2020 from 10:30 – 11:30 AM Eastern Time. Register in advance for this webinar here.

If you have any concerns about your child’s feeding or questions about feeding therapy, please complete our online intake form, or email NESCA’s Director of Clinical Services Julie Robinson at


About the Co-authors:

Abigael Gray has over six years of experience in assessment and treatment of a variety of disorders, including dysphagia, childhood apraxia of speech, speech sound disorder, receptive and expressive language disorder, autism spectrum disorder and attention deficit hyperactivity disorder. She has a special interest and experience in working with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake and reducing avoidance behaviors during mealtimes.






Lauren Zeitler is a licensed Occupational Therapist in Massachusetts, specializing in pediatric occupational and feeding therapy. Ms. Zeitler joined NESCA full-time in the fall of 2020 to offer occupational therapy assessment and treatment for children of all ages, as well as to work in conjunction with Abigael Gray, MS, CCC-SLP, on the feeding team.







Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.