Total session: 4 sessions over 9 weeks

An 8 year old boy was referred to me who was small and underweight for his age with food issues. His Mother reported the variety of what he ate was limited along with very small portions which would take him a least an hour to eat with his Mum encouraging him all the time to hurry up.

Both the boy and his Mum wanted him to go to parties and to tea with his friends or go out for days as a family without worrying what he would eat. The boy really wanted to go to Pizza Hut for his friend’s birthday, but couldn’t physically eat pizza.

One of the first things to find out was if any of the following were an issue regarding food; colour, consistency, smell, texture, sweet or sourness, spicy, crunchy or lumpy.

We then went through all the foods he would eat and finding out if he could mix these foods together. He would eat, cheese, ham, bread with butter, but would not eat a sandwich made of these ingredients. I then wrote down the various food groups (fruit, veg, meat, cakes, dairy, sweets and salads) and together we wrote out a list. We put a mark next to the ones he did like, the ones he didn’t like and the ones he had never tried.

Giving him the control he chose by himself 5 different foods that he wanted to try over the following week. I asked him if he had any ideas of how he could speed up his meal times. He came up with timing himself for 15 minutes at each meal time on his new digital watch. I suggested that if he could eat his dinner in under 15 minutes each day for 1 week what reward would he like for completing this? His suggestion was for a £1.99 Lego figure as part of a set he was collecting.

I asked what his Mum or Dad could do to help him achieve this. He asked not to have such big meals and for Mum not to keep going on at him. Both Mum and her son agreed that if he chose the meal size he thought he could eat and ate all that he had chosen within 15 minutes each evening Mum would not moan at him. Breakfast had never been a problem for this boy as he had always eaten well at that time of day.

When looking at the list of foods he’d chosen there were quite a lot he would eat. Over time both he and Mum had become so anxious about meal times the problem became a huge issue with tears and shouting at most meal times. I asked Mum to ease off and let him take some control for a while and see if the cycle of behaviour changed.

Over the next few weeks my client chose new foods to try when shopping, had a spoonful of different food types from his parents plates, all without the pressure of having to finish it. He also took responsibility and recognised that he may need to try things a few times before deciding if he liked it or not. He put ham, cheese and a wrap on his plate and ate them individually at first and then put a little of each in his mouth. He then put them all together and ate a ham and cheese wrap. This encouraged him and for the first time ever Mum bought him a ham sandwich from a shop whilst out for the day.

Gradually over the weeks he took control, chose the amount of food he had at meal times, ate at an acceptable speed and introduced new foods eating them more regularly. He helped his Mum cook pizza and other dishes where he knew he liked all of the ingredients and put them together to create a new dish. He and his family were so much more relaxed around meal times and they were no longer dreaded.

By the last session he had been to a friend’s party at Pizza Hut and the family had also been able to eat out together without any issues. He still eats smaller portions than peers of his own age, but food itself is no longer an issue.

Throughout all of this time different supporting CD’s were used each night.

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