How to Make Food Fun For Picky Eaters & Children With Sensory Issues

Episode Transcript

Dr. Nicole Beurkens
Hi everyone, welcome to the show. I’m Dr. Nicole, and on today’s episode, we are talking about fun ways to help picky eaters and kids with feeding issues get more comfortable with new foods. If you have a child who has a limited repertoire of foods, whether they have been diagnosed with a feeding issue or not, it can be super stressful because we are feeding kids all day long, it feels like. And I get tons of questions from you all every week about how to deal with various issues surrounding food, eating and your kids. So today I have invited Occupational Therapist Sarah Appleman on the show to talk with us about how getting kids to play with food is key to helping them become more comfortable eaters. Let me tell you a little bit about Sarah.

She’s a published author, speaker, and pediatric occupational therapist. She holds a master’s degree in Occupational Therapy and specializes in early intervention for children diagnosed with sensory processing dysfunction. She co-owned Paws for Peds in Long Beach, New York and created a handwriting curriculum utilizing a multi-sensory approach to handwriting. In her newly released book Play with Your Food, Sarah combines her passion of working with the special needs population with baking through fun therapeutic interventions, activities and tips. She guides caretakers and kids to enjoy participation in the food preparation experience with fun games, while improving the food tolerance of picky eaters. Can’t wait to get into all of these tips and ideas. Sarah, welcome! Thank you for being here.

Sarah Appleman
Thank you for having me.

Dr. Nicole Beurkens
Okay, so I definitely want to hear about how you got into OT and feeding issues and all of that. But actually first, I have to know, and our listeners need to know more about the name of your clinic Paws for Peds. Okay, tell me about this, this was like an animal therapy…

Sarah Appleman
So years and years and years ago, I worked at P.S. 107 in Queens, and I was working with a great group of physical therapists, speech therapists, and occupational therapists, and I always wanted a dog. Since I was a kid, I was always waiting for that under the Christmas tree present with the bow. Never got it, but that’s okay. It’s okay. So I always wanted, and I had this passion of one day I will get one and train one to work with kids. And I did when I was working there, and I brought in this puppy. And all the kids — we had written permission and everything and I trained the dog and children who are wheelchair-bound, who we were working on transitioning to get out, who were unmotivated, were climbing out of their chairs to get on the ground to play with the dog. And I’m like, “Okay, we have something special here. What can we do?” So I just left the Board of Ed, went in and opened up a facility, and we had tortoises, we had a lizard, we had PT, OT, speech, behavioral psychologists, just the whole gamut. It was really, to this day, all of my family from there, we still keep in touch and we love each other; and it was a really cool experience.

Dr. Nicole Beurkens
I love that! Tortoises, puppies, lizards. Fantastic! And I know so many of you listening can relate to what Sarah’s talking about with animals just bringing out things in your kids. Oh, that’s awesome. Okay. Alright. So that was my first inquiring mind’s need to know. But let’s talk more broadly about how you got interested in doing pediatric OT and specifically, like the sensory and the feeding stuff. Was there something in particular that sort of led you down that path? Well, I always loved, ever since I was a kid, I loved babysitting and helping out with my mom and I just had that natural touch. Everybody, if there was a fussy baby, they would give them to me when I was like 9-10 years old, and I would just be able to calm them. So I knew I had to work with children. And then I saw struggles within my own family. I had a brother who had some issues, and I was like, “I wish someone had been there to cheerlead.” I always joke, I’m a professional loser, because I lose every day, every game, everything to build these children’s confidence up, because it’s got to start somewhere. So I used to be competitive, not anymore, because I just lose for 22 years. I just lose every day. So I knew I wanted to do something in that field. I was looking into different avenues, but OT just spoke to me because I was allowed to be creative and come up with really fun solutions to everyday problems. So I was like, that’s my thing. And of course, they always say God gives you what you can handle, which I’m still thinking about. So I had my son who was an emergency C section, he had visual problems, he had some tonal issues, he had a lot, and this was something he had with eating and textures, and we had to come up with fun ways to do this. I mean, he’s amazing now.  He is almost 17, and he’s a great student. But in the beginning, everybody always said, “Oh, man, you were a tough baby, tough child.” He’s like, “I know, I heard about it all the time.” It’s interesting. So I had to put my therapy hat on at home and really work with him. So this was like always in the back of my mind to create something fun working with kids and letting other parents overcome their child’s frustrations and picky eating.

Dr. Nicole Beurkens
Yeah, and when you’ve come at it from a personal standpoint, it gives you a whole different perspective on it, right? Like, it’s easy for us professionals to have the perspective of what needs to happen, and it’s different to be in the parent role and dealing with it with your own child. And so I think it’s so great that you have not only the professional angle on it, but also you’ve been there as a parent. You get what parents are struggling with dealing with this stuff with their kids, and I think that’s so powerful. I love what you said about creativity and coming up with creative, playful solutions to everyday kinds of problems, because whether a child has been diagnosed with something or not, we encounter challenges with our kids. Show me a parent and a kid, and I’ll show you challenges. That’s just how it is. And I love this idea of looking at how we can creatively solve some of these things. And I think when we talk about feeding stuff, in particular, so often, the idea that people have about what feeding treatment, or feeding therapy or dealing with that needs to look like is sort of this very clinical behavioral type of approach, and what I have found now in 25 years of practice is, well, sometimes there’s elements of that that can be helpful where we really get traction, is in the everyday moments of what’s going on, in the home, with food, between parents and kids. Like that piece is just so important.

Sarah Appleman
Absolutely. I mean, that’s one of the things parents also ask me, they will be like, “Oh, I made this for dinner, and my child doesn’t want it. What should I do?” Simple things like that. It’s hard to find something everybody in the family is very enthusiastic about to eat. And that’s why when you go to a restaurant, you pre-look at the menu, and you’re like, “What will I get? What will I order?” because you don’t want to get there and feel flustered or hungry, and then you get upset. So we all, as adults, deal with this problem every day and it’s like, how do we tolerate it? How do we deal with it? And then, what are expectations for our child to be able to have that high level of cognitive thinking and problem solving? So we have to kind of guide them as to what expectations are and how we can achieve it in a positive way, rather than, “Well, if you don’t eat that, you don’t…” It’s like there’s that negative control thing and the bumping of the heads. It doesn’t work.

Dr. Nicole Beurkens
Yeah, that meeting halfway, saying, “Okay, this is an issue. Let’s understand what’s going on there.” Because I think so often, parents just get exasperated. I see it happening with professionals too, where it’s like, “You just need to eat this. This isn’t a big deal. You just need to do this.” And we have to really put ourselves in their shoes and understand all of the underlying things that go into a kiddo being able to eat comfortably and to feel safe around lots of different foods and to expand their palate. And I want to get into that in a minute because certainly as an OT who specializes in sensory things, you’ve got a lot of information to share around how those sensory processing issues impact food intake. Again, whether a kid’s been diagnosed with an issue or not, this sensory piece is huge. So I’d love to have you talk with us about that.

Sarah Appleman
So this is one of the biggest things. First, I like to always tell parents that there’s a correlation between children who are autistic or on the spectrum and sensory processing. And I always say this to them, I say: If your child is autistic or diagnosed on that spectrum, they definitely have sensory processing. But if your child is diagnosed with sensory processing, that doesn’t mean they have autism. So they are not synonymous. And it’s very important for parents to understand that sensory processing is the ability through your senses to take in your environment, process it, and then have an output, very simply put. So if you and I are talking, and suddenly an alarm goes off, or something happens, we are going to put what we are talking about on the back burner and focus on that immediately, because we have to make sure for survival purposes, what’s the most crucial thing for us to pay attention to? So that’s what it is. The problem is when all the bells are going off, and you’re like, is this a big deal? Is this a big deal? These children cannot focus because their body is reacting negatively toward that sensory input. So if a child hates — watching people try on clothing at stores with kids, it sounds like they are being murdered. It feels so painful to them because their body doesn’t understand what that texture is, and it’s really harmful to them. You’re like, what’s the big deal? It’s just sweatpants or jeans. They can’t process that. That’s how this whole process started for me, it was watching that, and saying, well, of course there’s going to be that part of that correlation of a decreased appetite and decreased tolerance of smells, touches, textures, temperatures, if they can’t tolerate playing with play dough, or getting their hands dirty.  It’s like, “I’m dirty, I’m dirty”. How are they going to eat? So that’s where I decided to come up with this. It’s a desensitization and fun activity to help guide parents. This could be why your child is reacting that way.

Dr. Nicole Beurkens
So important, that processing piece of the brain. We take it for granted, we don’t think about it, but every second, our brain is taking in all of this information from our senses, from the world around us, and it’s making sense of it so that we can understand it and organize ourselves around it, and like you said, have a response that is appropriate. But in kids with these sensory processing issues, their brain gets confused. It struggles to make sense of all of this information, and it all keeps coming in. The world around them doesn’t stop, right? It all keeps coming in and the brain gets so overwhelmed, and then of course the normal human response to feeling totally overwhelmed is to just shut down to it, to avoid it, right? Like, we all do that. And I think you’re so right, that this happens so much with the food stuff, but because that’s not our experience of it, we don’t understand that that’s what’s happening for them. And so we are like, “What’s the big deal? It smells like…” whatever, or it feels like this. And we don’t realize that those sensations, that information is so overwhelming to them, that that’s why they feel like they can’t be around it or put it in their mouth or see it or whatever, because it creates such overwhelm for them. So I think that’s really important, and I love what you’re talking about here with a strategy being really to help them get more used to that, to acclimate them to it so their brain can make sense of this information better, right? Because isn’t that the crux of what we are doing with therapy around this? Whether it’s feeding or any kind of sensory processing work, we are helping the brain be able to make better sense of these inputs.

Sarah Appleman
Yeah. It’s funny, because I always do a thorough history. They are like “Why’s your initial evaluation like four pages?” I’m like, “Because if you don’t get a good enough history, you miss out on a lot.” So when I first interview, parents are like “Why are you asking me if my child has handwriting issues or whatnot?” And I’m like, It’s all connected. How they sleep, how they eat, how they move, it’s all connected. So, so many times when I have a kid who is tactile defensive, the parent will all of a sudden, almost like a flashback be like, “Oh my God, when I was young/when my husband told me when he was young”, or whatever, and I’m like, exactly, but we have learned to adapt, acclimate to our surroundings so that we could be functional and not disruptive every day, because if we were like, “Oh, no, I have to cut and orange for my son. I’m sticky”, and we had a meltdown as an adult, that would be very problematic. But they would say, “I remember when I was on the soccer team, and I didn’t want to touch the oranges.” And I’m like, “Why didn’t you want to touch them?” And they are like “Oh, well, they were sticky”, and I’m like, “Well, do you remember any other things?” And then all of a sudden, they are like, “Oh my God.” So I say, “Look, this is great because it’ll help you and your child bond and grow from it.” And that’s the other thing. Think about it. When I was a child, I didn’t eat Brussel sprouts, I didn’t eat broccoli. Now I love it. So there’s so many things that as you get older, whether it’s visual or auditory, you’re desensitized to it, and then you try it, you’re like, “Oh, that’s not bad. Oh, that’s good.” And then it becomes part of your diet. But if someone to this day came in, and was like, “You can’t have whatever, if you don’t finish your broccoli,” I don’t know if I would do it. I would shut down.

Dr. Nicole Beurkens
Yeah, because the typical behavioral ways of approaching that just assume that the kid is just intentionally saying, “No, I won’t do this.” And I think that’s a fundamental shift for all of us as parents and practitioners to understand is, I’ve yet to meet a kid in 25 years of working with kids, who just decides, “Yeah, I totally could eat that. I’m comfortable with it, it’s fine. I don’t have an issue with it. I’m just going to make a major fuss about it every day.” That’s just not what happens. If a kid is really limited or feeling really scared of branching out, or putting up a fuss about new and different things, it’s like putting that detective hat on to say, “Okay, what’s really going on here?” And what you’re talking about is one of those pieces being needing to help them get more comfortable with the sensory aspects of it. And I’m assuming this is why you feel like it’s really important for us to have our kids in the kitchen with us, doing things from early on, right?

Sarah Appleman
Well, that’s a piece that I want to touch on. It is exactly what you just said. The differentiation between a sensory processing meltdown versus a behavioral meltdown. And yes, the behavior, the outcomes of a sensory meltdown, are going to be those negative behaviors. That’s something I’ve had to teach even new grad therapists where I work and mentor. They are like, “Oh, well these children are just melting down and the need control.” And I’m like, “No, you have to differentiate.” Yes, the outcome, if you see two kids on the ground, throwing a tantrum, can’t process the information, and it’s overwhelming, and they are shutting down. The other one is testing boundaries or whatnot. They may look the same, but they are very, very different. And that’s exactly why. Listen, if you could put your kid even a one-year-old, playing, developing fine motor skills and textures, you put a bowl and have them play with the fruit, wash the fruit, to help mixing, pouring, you’re developing bilateral skills working both hands together, which you need for sports, and handwriting, and dressing. And then you’re also prepping them for real life. That’s our goal, to create independent children and have those skills. So yeah, just bringing them into the kitchen and getting them used to that environment, so they have the sight, smell, touch, everything. It’s just very, very beneficial. This is what we do. They feel like “I’m helping”, and it gives them some control and makes them feel good to be participating.

Dr. Nicole Beurkens
Sure. And I think the other thing that’s so great about involving kids in food activities, food prep, cooking, putting groceries away, whatever it might be: The focus is not on the eating. And so it takes some of the fear out of it, I find. When we sit down with a plate or a bowl of food in front of a kid, immediately they are like, “Okay, the thing that is supposed to happen here is I’m supposed to put this in my mouth and eat it”, which can put up a lot of fear for a lot of kids but this having them in the kitchen with us doing things like you said, like cutting or stirring or putting things away or washing — the goal, that’s not about eating. That’s about doing something else. And so I think that that really brings the anxiety down, because so many of these kids develop such heightened anxiety around even the idea of having to eat something new, so this feels safer to them as a way to engage with it.

Sarah Appleman
Absolutely. I mean, that’s part of it, initially, it is helping to organize, put things away, and then moving on to the food prep itself. And then if you do that in a fun way too, like now so many people, thanks to being on lockdown and doing stuff, you have like a million different people going, “Let’s see what we could do with blueberries today!” A million different ones to design a pancake. If you’re being creative throwing that down on the table, and you’re proud of what you just tried, I mean, pending that the outcome looks somewhat relatable to whatever it was you were attempting to copy. But if you’re proud, like, “Look, I made this smiley face” or whatever it is, or a design, how people were doing it, and then you’re proud of it, and your kids are enjoying it, gives you as a parent that pride that you won, so it works on both sides.

Dr. Nicole Beurkens
Well, I think that’s a really important point about how the parent feels too, because so often, kids get stuck in really rigid eating habits partly because of the emotions that we bring to the table with them, right? And we just get locked into these battles and rigid emotional zones with our kids around food, and parents can feel so demoralized. So I love what you’re saying that actually playing with food and doing activities with food, not focused on sitting down and having a meal takes the pressure off the parent too, and allows for us to feel some success around just engaging with food with our kids without a lot of drama.

Sarah Appleman
Yeah, that’s been my fun part. It’s like, “Okay, what can I do that would work?” Because that’s a challenge for me, it’s like, “What can I do? Everyone wants a big cookie in the winter or whenever it is. What can I do to make it more fun for both the parent and the child? And so whether it’s fruits, vegetables — because parents ask, “How do I get my kids to eat fruits and vegetables as their goal”, versus “My kids eat anything other than dinosaur chicken nuggets, or McDonald’s french fries?” Because that’s like, the thing that they eat.” And I’m like, “Oh, no, you’ve got to get away.” Because when your child doesn’t digest the food properly in the gut, it affects their behavior, attention, their muscle tone, their sleep patterns, their everything. So I’m very big on getting them to eat, even if it’s only a little bit, but different foods that will provide them with proper nutrition and help them.

Dr. Nicole Beurkens
Well, that’s one of the big things, because I talk a lot about nutrition on the show and everything that I do. And so many parents say, “Okay, I hear what you’re saying, I understand now how important nutrient dense food is, I get that nutrition is super important for my child’s brain to function well”, but then the inevitable next thing for so many of them is “But my kid won’t eat these things. I can’t get them to.” And so I think that’s where these strategies that you’re talking about are so important for all of you who want your child to eat different things and eat in a more nutrient dense way, but you’re not sure where to start with that. I think these tools are great. So Sarah, I’d love to have you share a few of your favorites, maybe from your new book or just from your experience. Give the listeners, give us some examples, some starting points. When you say play with food or get kids in the kitchen, get them cooking with us, what are some of your favorite activities or games or things to do?

Sarah Appleman
I believe in colorful things. It’s very appealing to our eyes. And for people who are overstimulated, this is not the one I would start with, but I love putting out fresh fruit and at different times, you have strawberries, cantaloupe, cut up grapes, you could visualize how pretty that is to be displayed in your head. It’s very appealing. And I play memory games. So you can make it on your computer, print it out. And I literally watched this happen over one of my Zoom sessions, and I’m like, let’s try it. You have the booklets. play with it. And so this boy, he didn’t eat any fruit, and he has a brother who is older who was also diagnosed, on the spectrum. So they the two of them were there. And he matched it. We started simply if he matched the strawberry or matched a cantaloupe or matched whatever, an apple, he got to eat it. And of course, the key is putting at least one thing in there that they like to eat because you don’t want to have them just “Oh my god, there’s all this new food.” So I had them, he matched it and he was like “Yay!”. You won. That’s a positive. “Wow look, okay, now you take that strawberry.” You don’t have to eat it. Smell it, lick it, play with it, whatever.” And then as it kept going, there was excitement of “Oh my god, I got a match”, there was that association.

So that’s one of my most favorite games to start because it is fun. I’ve done that as Candy Land too. So if you have a board game and they land on a color, they could choose two of their colors, and they can pick which one they would like to try. So you’re going to have different colored apples, you could have different grapes, you put it out there and it’s fun. They land on it. What are you going to try? So that, right off the bat, is just getting them used to the new stuff, because I just spent four hours in the kitchen again, which I didn’t think I’d be doing. But I did, coming up with a bunch of new activities. Because I play games all the time with kids. So one of the things I did is I cut a pear. I had a kid help me put grapes onto a toothpick on the pear, and made it look like a porcupine. And I play a porcupine game where they have to pull it out for fun. I’m like, “Oh my God, we could do this in food.” So we did that, and they could peel off and eat the grape or whatever. You could also do different things. You could do blueberries, raspberries, it doesn’t matter. But that presentation of a porcupine, and them making it, they are looking at it, they are touching it, they are smelling it, so by the time it’s time to maybe eat it, they are more likely to try that. So those are just some fun ideas that I use.

Then if you want to get more advanced in the kitchen, one of my favorites that everybody loves is homemade pizza. It’s very tasty. It’s really not that hard, because you could either get pre-made dough, or you can make your own pretty quickly. The rolling it out and the pinching of the crust, the tolerance of — so I had a boy I did this with, he hated flour, he did not want to touch it. And so I said don’t. That’s fine. Just sprinkle it with a spoon, and then roll out. And of course over time when you’re rolling it, that moment, that spot, “No, you have to touch the flour” No, it will naturally get dirty as he’s rolling it and touching it, he’s going to get it naturally without even realizing it. So “I don’t want to touch that.” I said, “Fine. You have control, use a spoon, sprinkle it on, roll it out.” And as he pinned it, he noticed like, “Oh, I have flour”, I’m like, “Yeah, see? No big deal.” And I always tell parents to have ready a wet towel, and give pressure to each finger as you squeeze also, it helps calm them. After a few times of that massage, they don’t care anymore. They are okay, it’s very calming for them. And then we make pizza faces. So you could use different vegetables or different things around that you want to make a happy face, a sad face, have your child make something and then you have to copy, so they are getting, again, that control. So that’s one of their all-time favorites, pizza, or the fun fruits, vegetables.

Dr. Nicole Beurkens
 I love it. And I’m thinking, as you’re talking about the game stuff, for all of you listening: You’ve got games, probably, that you play with your kids. Board games or whatever kind of game, and thinking, just even thinking about how you can incorporate food into it. Right? What’s coming to my mind is can I use different types of food as the tokens on the board? Or can you use it like, you said, the game of using tweezers or your fingers to pull things off and put them in the container? Can you make something out of food to do that with? Thinking about the stuff you’re already doing, activities and games that your child already likes and feels comfortable with, and how can you work some food items into that just to get that exposure? I think that’s such a great idea.

Sarah Appleman
It’s fun too. I play a pancake stacking game. I’ll put the pancakes on one side. I think it’s called pancakes pile up, and that visual cue, and then what’s on the bottom, what comes next? So it’s organized, but it’s also great for fine motor skills and balance, where the kids have to use their hands to hold it, and I’ll have one on one side and one on the other. And then I’ll say, “Look at all these different types of pancakes. What would you like to try? What do you think?” And then they will go home and they will make pancakes, and then they will stack them so they could draw their own card at home, and it could have chocolate chip on the bottom and strawberry or blueberry or banana. And then they could play that, working on auditory processing, or if they are old enough to write “Well on mine, I would like two chocolate chip and one banana.” So they have to either draw it or write it and then copy that. So you’re doing a whole lesson plan just in breakfast. So there’s a lot you could do.

 Dr. Nicole Beurkens
That’s making me think of when I talk with families all the time about the benefit of having kids cook with you. Yes, there’s the food exposure, and there’s all of that. But as you mentioned earlier, there’s also the life skills development. And then we can talk about all of the other skills with that, too, like reading and writing and math. To me, having kids in the kitchen with us and cooking is one of the most beneficial things from making good use of our time and energy — we have to do it anyway. There’s so many skills and benefits that come from it, it’s hitting so many different areas with one activity. And it can grow with kids too, as you said earlier, for a young child or developmentally young child, they might just pop in and out, a minute here, a minute there, helping to pour or stir or whatever. But older kids can help you actually sequence through the recipe. What are we going to need next? Get out everything that we need. Have them do it. And so I think that having kids in the kitchen is valuable for so many reasons.

Sarah Appleman
And I always tell parents: I get it. I work, right? We are multitaskers all the time between doing household chores, and taking care of kids, and our jobs. And I get it. So I also say do it on a time where it’s going to be not stressful, because if you’re stressing, or you’re worried about getting the kids out, this may not be an ideal time to try this. But if it’s on a weekend, or if it’s on a day where you know it’s slower, and you’re home with the kids, that’s a good time to have a positive intervention of whatever you want to try, without feeling stressed or anxious yourself.

Dr. Nicole Beurkens
It’s a great point, because yeah, weeknight dinner hecticness is not the time to have your kid in the kitchen with you, probably. So yeah, that’s an excellent point. I want to go back to what you said about playing the games and some things like that. I have worked with parents long enough to know that with the best intentions, one of the things that parents tend to go wrong with, and I’ve seen professionals do it too, is entering into activities like that thinking that the thing that constitutes success at the end is that the kid ate the items. And I just want us to really touch on that for a minute because that is not necessarily what constitutes success. And if we go into those things with that as the only thing that is going to allow us to feel like this was worthwhile or a success, we are actually creating more problems, right? So can you talk about all the different ways that success can look, depending on the kid and their issues, with those activities?

Sarah Appleman
That’s a great point because I find when you’re in the situation day in and day out, that it’s hard. I set goals, right? I come in, I do an evaluation, and we talk about what are your child’s goals? And if a child has low muscle tone or poor coordination, and they can’t even self-feed, they can’t pierce the fork into the food, right? So these are things that you need as a parent to say, “Well, what is the outcome? What do I want to achieve? What are my goals? And set realistic — here’s another thing. That’s why I love that show, Nailed It. I find it hysterical because that’s how so many parents who are not artists feel. Like you expect me to create what with my child? And that’s creating more stress and anxiety. And then what do we do? We are going to avoid it. As adults, we give up. So the most important thing is to set realistic goals, be aware of what your goals are. So if your child has that low tone, and pouring is an issue, or to build up their strength mixing — I tell parents, even before you could get them into the kitchen, like doing simple tasks, get out the playdough. I’m a huge advocate of playdough because it is textured, it is scented, they could make pretend food, and kids love it because again, they are not going to eat it. And it’s going to work on a lot of those skills. Watch. It’s also not just the outcome, it’s how the quality of movement and the quality while they are doing it is. So if you see that your child is struggling to cut playdough when they should be able to easily, a one-year-old versus a three-year-old. And you’re like, “Oh maybe I need to work on that first and then come back into the kitchen”, and work on whatever you’re working on. So it is really important. I’m not saying bring your kid into the kitchen and magically they are going to tolerate flour. That’s part of what I wrote about. Desensitize them even before you get them into the kitchen. So if you know they hate flour, start with a good play dough, kinetic sand. Make your own — like that’s an easy task. Flour and water, cornstarch and water, food color. Anything that you could do, and they can mix it. And that’ll carry on because then you could go, “Okay, let’s make pancake batter.” Very similar. Or cake or cookies, something that they do like, but they will be able to tolerate it. So start with the proper course of what your goals are, how to help them along that way and bring them in for that outcome.

Dr. Nicole Beurkens
And I think that’s so important, the breaking down of that, because our ultimate goal might be, the endpoint goal might be for them to, let’s say, eat a blueberry, or eat a piece of melon, or eat a green bean. But there’s going to be a lot of steps for some kids leading up to that. And so to your point, being aware of what’s a realistic and appropriate goal right now? It might be that we are just going to get comfortable with sticking blueberries on the toothpick to make our animal. That is success right now because look, he was uncomfortable with even being around the blueberries, or initially, he didn’t even feel like he could touch them. And now he’s able to pick them up and put them on there. That’s a huge success. And I think it’s so important for parents to look at those things as wins, as opposed to going “Well, but he still didn’t eat them. That’s down the line. Celebrate and focus on all the intermediate goals, because if your child is a super picky eater or has feeding issues, and the only thing that’s going to constitute success to you with an activity or therapy, or whatever is “Did he put it in his mouth and eat it?” Then that’s a big problem for your kid and for you. So I love what you’re saying about breaking it down and recognize all those intermediate goals that work up to the real goals we all have for our kids, which is to comfortably eat a varied diet.

Sarah Appleman
When I sit down with the kids, I’d say — you just said green beans. In my head. I’m like, “What do we think?” It looks like grass, trees. So you make your little mashed potato pile, and you could stick these in it. “Oh, my goodness, look at that!”, something as simple as that. We used to do this all the time, we are like, “Oh, I’m going to eat the tree and get strong” and take a little bite. See if they copy you. Great. If not, you’re enjoying something that they created with you, and then maybe the next time you introduce it, they are going to be more likely to. And that’s the thing. Also, I always say it always goes on their plate. So if you’re sitting at the table, and you’re not going to give them a huge mound of vegetables, but you’re going to give them maybe one or two pieces, and it has to be on their plate. Do they have to eat it? No. But it has to be there so that it’s close to them. They get used to it, they visually see it. And then you do that for a number of days. So you could have a tiny piece of broccoli, it doesn’t matter, over, and over, and over. After a while, it’s not threatening to them. They see it, they are fine. You can even create different fun things where it’s like, “Okay, here’s that piece of broccoli. I don’t know, does it taste better with ranch dressing? With cheese on it? With a Hollandaise? Look at all these different pretty drippings. I’m going to lick that one. And so it’s just introducing it. Again, not “Here, eat this pile of broccoli.” But “How would you like to eat that? What do you think goes well with it?”

Dr. Nicole Beurkens
That’s right, and getting them acclimated, because what that’s really doing is allowing their brain to start to make better sense of how it looks, how it smells. And when our brain can make sense of something, we are not scared of it anymore. Right? And so this exposure allows the brain to make sense. Some of you might be thinking, “Well, my kid would totally melt down even if I put that on their plate.” Okay, then start with it in a bowl on the table that you progressively get close to them. However you need to do it and wherever you need to start, I think the point here is: If we never expose kids to things that they are uncomfortable with in the realm of food, we can’t expect that they could ever become more comfortable varied eaters because we are not giving them any opportunity for their brain to be able to process that information better. So there has to be some level of exposure, and maybe you have to start with it sitting all the way across the table and it gets closer, and eventually it’s on their plate. Whatever you need.

Sarah Appleman
I will give them more power. Let’s say you’re working on squeezing, right? You get big tongs. And you’re like, “Okay, you don’t have to eat it, but help hold it. Then let’s put it on everybody else’s plate.” So they are forced to at least participate in dealing with it, having everybody else eat it. And then if they do that a couple of times — I tell parents, have your kids at the table, have them pour the drinks, have them put the ice cubes into the cup.

Dr. Nicole Beurkens
I think it’s that issue of helping finding that sweet spot of where it pushes them a little bit, but not so much that they just shut down to it, and can’t handle it. And that can be tricky, but this idea of using, particularly as you’re talking about fun activities, things that they already enjoy, and figuring out how we can bring some food into it. I think that that’s great. I know that we have to wrap up here, so I want to make sure that you share with people — Tell us a little bit about the book, where they can find it, because it’s a great book with lots of pictures in it and great ideas.

Sarah Appleman
Yeah, so it’s called Play with Your Food, and it’s on Amazon, and the @PlayWithYourFoodbook is the Instagram. I get asked a whole bunch of questions, so we are doing common questions that I’m asked, and I answer them, and then we are working on other means and stuff. So I have a TikTok, I think it’s just SarahAppleman, where I show how I do some of the stuff, how I create simple things. Very simple stuff that’s fun. So we are going to be uploading all those. We have free handouts. When parents are struggling, I just want to help. So we do free handouts, we do free blogs, all this stuff is for free so that parents can learn more about their child and how to make those improvements. It’s just a fun-filled, really great way to understand sensory and how it impacts on eating.

Dr. Nicole Beurkens
What’s the website, because I know I went to your website, you’ve got lots of great downloads and things to play games and all of that. So what is the website?

Sarah Appleman
so there’s going to be a change, but it was playwithyourfoodbook.com, but I know that there was like a third party handling it originally, and then there was something weird. So now we are going to be revamping and redoing it. But for now, I think that’s still present.

Dr. Nicole Beurkens
So people go to playwithyourfoodbook.com. Okay, great. And that’s the title of the book. And then your Instagram is @PlayWithYourFoodbook. Okay, fantastic. And in the book, it’s filled with lots of ideas, right? So those of you looking for specific activities, if you’re like, “Okay, I understand what I want to accomplish here, but I am not creative, I don’t know activities, I can’t come up with games.” That’s what this book is. Lots of activities and specific games and things that you can do with your kids around food.

Sarah Appleman
Yeah. The introduction also talks about the entire reason why I made it, how I made it, and then a little bit about sensory so they can understand it better. And then each thing, like eating, let’s say fruit, right? So taking out fruit, making a few things. It tells you what you need, the directions, how it helps, and then a therapeutic target. And then there’s also a notes section. So you could say, my child liked this, they didn’t like this, this worked, or this didn’t. So it’s like a guide for the parents to be able to do — it’s their own workbook on it. Oh, yeah. There’s lots of fun information, lots of fun activities, lots of recipes. It’s a recipe book too, so it has pretty much everything you’ll need.

Dr. Nicole Beurkens
Fantastic, because I know so many people are like, “Okay, give me some activities. I’m not creative.” So this is your helper with that. So definitely go check that out. Sarah, I really appreciate all the work that you’re doing in your career around this. It’s such an important topic and important issues, and thank you for spending time with us today.

Sarah Appleman
Thank you so much for having me.

Dr. Nicole Beurkens
And thanks, as always, to all of you for being here and for listening. We will catch you back here next time.