Some children face difficulties eating or managing mealtimes due to sensory sensitivities, physical/oral motor challenges, or behavioural issues, which can make mealtimes stressful for the whole family. Developing the skills to feed yourself is important for both the independence it promotes and for social inclusion as meal times are an important aspect of family and social life. The resources in this section provides strategies to improve feeding skills, reduce mealtime anxiety, and create a more positive and manageable eating routine.

If your child is facing challenges with eating, he /she may:

  • be reluctant to self-feed or ask for help
  • be very messy when eating and spills food
  • use their fingers for eating, instead of cutlery
  • look uncoordinated or awkward when trying to use cutlery
  • try to bite off a larger piece instead of cutting their food up.

How you can help

  • Ensure your child has good positioning to support self-feeding. When seated, ensure that your child has their feet supported and they can comfortably reach the table. They should have the freedom to use both hands.
  • Ensure that their elbows are tucked in and try not to allow your child to raise them out to the sides of his/her body.
  • Try to set out the dishes and cutlery the same way to develop a routine and help your child locate items at each meal.
  • Take a look at our Setting up for Mealtime guide to support children who find meal time challenging and struggle to remain at the table

Spoon

  • When learning to use a spoon, using spoons with thick and, or textured handles, are easier to hold and a short handle is easier to control. Also, use a bowl or plate with a raised edge so the child has something to scoop against.
  • When using a spoon, initially start by practicing with foods that stick to the spoon, such as yoghurt or custard, to reduce spills.
  • You can support the child by helping them to fill the spoon and guide them to bring it to their mouth and reduce how much support you provide over time.
  • Have a look at our Learning to Use a Spoon guide designed for children who find it difficult to load a spoon or to feed themselves with a spoon without adult support.

Knife and fork

  • Learning to use cutlery is a common difficulty for children and it usually takes a child until they are 7 years old to be able to feed themselves with a knife and fork. When learning to use a knife and fork, ensure the knife is in the dominant hand, and the fork is in the non-dominant hand.
  • Support the child to position his or her index fingers along the shaft of the fork and knife. You may need to use hand-over-hand assistance to achieve this position.
  • Cutlery with built-up or curved handles, such as Caring cutlery and Kura cutlery, can help with grasp and correctly holding the cutlery. These have thicker handles and indentations to ensure index fingers are correctly positioned on the fork and knife.
  • The movements - first "stab" the food with the fork to hold it in place, next place the knife next to the fork and "saw" with the knife backward and forwards in a sawing motion. Use consistent verbal prompting such as "stab" and "saw". This skill can be practiced outside mealtimes using putty or Play-Doh. Initially start with soft foods, such as banana, cooked carrot, pieces of melon, cooked potato, fried egg, pasta and pancakes.
  • When learning to use cutlery, make it more manageable by practicing with a few cuts at each mealtime and increase this over time. Remember that learning to use cutlery can be messy and takes a lot of practice.
  • Watch our video on Learning to use a Knife and Fork Together for some ideas to build the skills required to use cutlery.    
  • View this Watch Me Do It video to see a movement demonstration of how to use cutlery. 
  • The Watch Me Do It site also contains video demonstrations recorded from a first-person viewpoint to help children with Developmental Coordination Disorder learn everyday movement skills such as opening a packet of crisps, peeling a banana, opening a bottle and chopping vegetables.

Some children struggle with eating a variety of foods due to sensory sensitivities, oral motor challenges, or anxiety around new textures and tastes. The ideas below can offer strategies to gradually expand food acceptance, improve chewing and swallowing skills, and create positive mealtime experiences. 

Food chaining is a feeding therapy approach used to help children — particularly those with sensory issues or picky eating habits — gradually expand their diet. It works by introducing new foods that are similar in taste, texture, colour, or shape to foods the child already accepts, creating a "chain" of familiar to less familiar foods to reduce anxiety and increase acceptance. Our guide on Working Towards New Foods: Food Chaining offers ideas for gradually introducing new foods.

Messy play allows children to learn through sensory exploration and supports their social interaction and coordination skills. Gradually introducing food textures during play, separate from mealtimes, helps children build positive associations with food and feel more comfortable engaging with it. Find out more in our Messy Play: Restrictive Eating Programme.

In this article on Dealing with Picky Eaters, OT MOM helps us understand picky eating from an OT perspective and offers tips to support picky eaters to explore new foods. 

Your Kids Table contains some meal and snack ideas for picky eaters and has more information on sensory issues with food.

Woodfield Road Clinical Psychology Service  The Woodfield Road Clinical Psychology and Occupational Therapy Team run a group to help parents and carers with children aged 0-7 workshop with common issues around feeding. For further information, contact the team at clcht.psychadmin@nhs.net.

ARFID Awareness UK are a charity dedicated to raising awareness and furthering information about Avoidant/Restrictive Food Intake Disorder.