Hopeful about picky eating treatment with new OT

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My son just started with a new OT. On a whim I checked to see if she had an appointment slot available just before or after DS's speech therapy in the same office suite. It turns out she did, and that she treats picky/problem eating.

We tried the SOS (Sequential Oral Sensory) approach with another OT when DS was 6 and it was a disaster. That OT treated him like a preschooler, and he wasn't in the least amused by activities like painting with food and playing swords with carrot sticks. There was no fooling him that the goal was ultimately to get him to put foods he didn't like in his mouth. When he became violent towards her she fired us as a client, "After 3 months we've made no progress..."

At school DS's OT and SLP added goals of trying new foods and chewing with his mouth closed to his IEP last year. He'll take a bite of pretty much anything and promptly spit it out already. I didn't see much point, but if they wanted to try more power to them.

After the intake with the new OT, she actually identified specific problems with the way DS chews -- apparently most people use a rotary motion but DS is just mashing straight up and down, and that he has problems pulling his top lip forward enough. She said she didn't think the traditional approach of getting him to smell, touch, and play with food to become more comfortable with it was what he needed at all. She thinks he is defensive because of bad experiences with gagging due to the way he manipulates food in his mouth. Not sure how she is going to help him with all that, but I feel like someone finally understands what is going on and is treating that. Her approach is going to put DS in control -- HE gets to decide what foods to try and when. She's also very intellectual and analytical, which I think is a good fit for DS. We'll see how it goes, but I'm hopeful...

Interesting.

I'm optimistic as well.

I think your new OT figured it out.


Give it a little time, probably less than you expect. He's probably built a bit of defense mechanism. Large carrot chunks would be unpleasant to swallow.

It could be texture based, however. I really don't think so, this time.


Check his face? If he makes a sour-face, it's the food (taste/texture). If he simply frowns, the chewing is more likely the problem?

But honestly, i think your concerns have been addressed by the new OT.

Since he doesn't use the rotary motion when chewing, maybe there is just something wrong with his jaw or his teeth?
I know that animals like goats chew with that excessive motion. On the other hand, cats cannot use the rotary mastication at all because their jaw is locked too tight. Cats can only bite off food, not really chew it. Doesn't matter for them since meat is easy to digest.
Does he eat food that doesn't need a lot of chewing, like mashed potatoes or soup?

I hope it works out