My child eats fine… they are just picky!

This is the first thing most parents say when I walk into a home for a feeding evaluation. Most people assume that feeding issues occur only in children with a developmental delay, problems with gaining weight, or some type of physical/mental disability. While this is typically true, as a speech-language pathologist I have discovered that many typically developing children may in fact have severe food aversions.

What is a picky eater?

Simply put, a picky eater is a child that is very selective about what they will eat. One of my favorite feeding books, Food Chaining: The Proven Six-Step Plan to Stop Picky Eating, Solve Feeding Problems, and Expand Your Child’s Diet, describes picky eaters as children who will usually eat 30 or more different foods, and will want to eat certain foods for many days at a time. Toddlers, anyone?! They are the kings/queens of picky eaters, going days at a time only wanting chicken nuggets or macaroni and cheese. A few days go by and they eventually get tired of eating that particular food, and move on to something else. Sometimes you even find that they suddenly refuse a food that used to be a favorite! (A tactic I am sure they invent only to drive their mothers crazy!)   However, when that particular food is presented again at a later date, they will usually accept the food without an issue.  These children may not have an obvious medical condition but may have contributing factors leading to their pickiness, such as food allergies or acid reflux.

What is a problem feeder?

A problem feeder is a child who eats 20 different foods or less, sometimes only a handful of different foods. These children may have a strong reaction to foods they dislike, such as crying, throwing tantrums, gagging, and vomiting. They may even reject entire food groups, such as not eating any fruits or vegetables at all. Meal times for the family of a problem feeder are stressful and exhausting experiences. Problem feeders may have some type of medical condition such as a sensory processing disorder, autism, delays in oral motor skills preventing them from eating certain foods, and/or acid reflux, to name a few.

How do I tell the difference, and what do I do about it?

If you find that your child is exhibiting characteristics listed above, then you may be looking at a problem feeder. So, as a parent, what is next?  You should seek the help of a speech-language pathologist. A speech-language pathologist will be able perform a feeding evaluation for your child, letting you know exactly what is going on and help you put a plan in place for feeding success.

If you have any concerns with your child’s feeding ability, development, and/or progress, please contact Deborah L. Curlee Communication Consultants at (865) 693-5622. We have a team of experienced speech-language pathologists that would love to meet with you and discuss options for your child. Meal times should be an enjoyable experience for all family members, and we are eager to work with any family to help achieve this goal. 

–Chariti Skinner M.S. CCC-SLP

Reference: Fraker, C., Fishbein, M., Cox, S., & Walbert, L. (2007). Food chaining: The proven 6-step plan to stop picky eating, solve feeding problems, and expand your child’s diet. New York: Marlowe & Company.

What is A “Speech Disorder”?

Parents often ask, “What is a speech disorder?” and “How do I know if my child has a speech disorder”?  Young children often mispronounce sounds but, over time, typically acquire sounds by listening to how people say them, figuring out how to move their tongue around in their mouths, or learning how to alter the way they produce a sound to say it correctly. 

We know that the “r” sound is a harder sound for children to pick up easily or, sometimes, even on their own as the sound itself is fairly complex. “R” requires the tongue to be placed high in the roof of the mouth, and then and moved while producing the sound. They are also various “R” vowels involving different placement that increases the complexity. This is why parents and teachers may think it’s “cute” if a child uses “w” for the “r” sound, saying “wode” for “rode” or “eawwing” for “earring;” this is the most common substitution for “r” used by a child with a speech disorder.

Most children can pick up harder sounds such as “r” or “l” on their own while, for others, learning how to make the speech sounds correctly may be more difficult. Some children may have many sounds they are missing, making their speech hard to understand, while others may be missing just a few sounds that children their age typically have already mastered. Depending on what standardized testing scores show, the sounds missing and how they affect the child’s ability to be understood (called “intelligibility”), and which sound errors the child has may determine if a child has a speech sound disorder.

When should children be able to produce various sounds?

According to Linguisystems sound chart, children should be acquiring these consonant sounds by the following ages:

Sound  Age  Sound  Age
p 3 years t 5 years
m 3 years r 6 years
h 3 years l 6 years
n 3 years ch 7 years
w 3 years sh 7 years
b 4 years j 7 years
k 4 years s 8 years
g 4 years z 8 years
d 4 years v 8 years
f 4 years th 8 years
y 4 years zh 8 years

However, it’s important to note that not all researchers conclude that these are the ages when children should have mastered these consonant sounds, as some studies have indicated that children should have acquired consonant sounds earlier than the ages indicated in Linguisystems, Guide to Communication Milestones by Janet R. Lanza and Lynn K. Flahive (2008).

In Linguisystems, Guide to Communication Milestones, the authors indicate that researchers have used two different methodologies to determine the age of speech-sound acquisition, which is why there is not universal agreement in the field of speech pathology as to when children acquire particular sounds by what ages. For example, some studies concluded that sounds produced correctly 100% of the time were considered mastered, but for others, producing the sound 75% of the time was the criterion. Also in some studies, mastery of the sound was based on words that were produced spontaneously, while in others, mastery was based on the child’s ability to imitate sounds. Although there is variability in criteria for mastery of sounds in various studies, there is some general agreement about when children should have achieved mastery of individual sounds. Let’s walk through the progression in which children typically acquire each type of sound production:

Sounds that are produced by “nasalizing” (air coming out through the nose) are acquired earliest, typically around three years old. These sounds are “m, n, and ing.” Sounds produced by air pressure building in the oral cavity and then released quickly in a “burst” of air by using lips, tongue, or palate to produce the sound, such as “p, b, t, d, k, and g” are called “stops.” According to Linguisystems, these are typically mastered by ages three through five.  The sounds “w” and “y” are also typically mastered around this time.  The next sounds that are typically acquired are those called, “fricatives” which are produced by a continuous air stream released while using the teeth or tongue to produce sound. These include “f, v, s, z, sh, and zh.” After these are mastered, the next sounds typically acquired are the voiced (using the larynyx) “th” and voiceless (the larynx is not used) “th.” Sounds that begin like a stop, but release air similar to a fricative sound, called “affricates,” are the next sounds to typically be acquired. These include the sounds: “ch” and “j .  Lastly, per Linguistems, the “liquids,” or sounds where the tongue is positioned in the mouth to make a vowel-like consonant, are acquired, such as the “l” and “r” sounds. These can be the most difficult for children to pick up on their own and ones that can be commonly worked on when children need speech therapy.

If you are concerned about your child’s ability to produce sounds and would be interested in scheduling a speech evaluation to assess their skills, we’d be glad to have you come see us. We are able to administer standardized tests to compare your child’s speech sound abilities to other children their age, based on normed data, and therefore determine the need for speech therapy. You can call to schedule an appointment by calling our office at 865-693-5622.

If you are not local, please look on American Speech-Language-Hearing Association’s website for a local speech-language pathologist near you.

–Debby Curlee Hall M.A. CCC-SLP

Additional References:
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