Dealing with Maladaptive Behaviors at Mealtimes

Picture this: You are at the dinner table. Everyone in the family is enjoying their dinner, when your 18-month decides to start throwing food. She looks at you. She knows this is not what she is supposed to be doing, but she is testing you, and your response. Or how about this scenario: Your 4 year old is tired. It’s dinnertime and after a day at preschool and then swim lessons, she is beat. You serve one of her favorite meals, but this leads to a full-out tantrum. She doesn’t want whatever her favorite meal was yesterday she wants something completely different. How do you deal?

Maladaptive behaviors. These can be so challenging, and frustrating, and they don’t only occur during meal time, but for some children (especially those that may be more selective) mealtimes may trigger these behaviors. Before we dive into how to deal with these behaviors, let’s take a look at the why.

Before I started my practice I worked at a local children’s hospital and co-ran a feeding group, for children who needed some extra assistance with feeding. We talked every so often with parents and caregivers about the antecedent-behavior-consequence model, which doesn’t just related to feeding, but parenting in general. Here’s a quick rundown:

  • A: Antecedent. The event that leads to a specific emotional response.

  • B: Behavior. The action by an individual.

  • C: Consequence. What happens after the behavior occurs.

It’s important to look at this approach because as parents and caregivers we want to provide consequences that lead to desired behaviors, as oppose to undesired behaviors. Consequences can be positive or negative. Are you with me? Let’s look at a few examples. I work with some children that have a strong gag reflex, and sometimes this behavior continues because of the consequence. When a child takes a bite of solid food (antecedent) they gag (behavior) and then the food is removed parents/caregivers provide comfort (consequence). Although this is not the care for all gagging, a child may learn that when they gag, food is removed and they are given something different at mealtime. Or how about a child that throws a tantrum when they don’t get their preferred food. For example, a child is presented with a new food (antecedent), they cry, say “no” kick (behavior) and either the food is removed or they are given attention (consequence).

Our approach from a feeding standpoint, is that in order to change the behavior, we must change the antecedent and/or consequence to get that wanted behavior. The one thing we can not control is the behavior, so we need to work around that. Make sense?

Let’s first look at ways to change the consequence

These are some of the most common unwanted behaviors I hear from parents:

  • Throwing food

  • Tantrums at the table based on food presented

  • Not sitting at the table/ tantrum because said child wants to leave the table

  • Standing in seat (once out of the high chair)

What can we do to make changes:

  • Provide positive reinforcement for behavior that’s desired. When your child is sitting at the table, using appropriate manners, let them know you appreciate it, and be specific. “I appreciate the way you are sitting at the table.” “What a pleasure it is to talk with our family about our day during dinner.” A caveat to this, for most families I do not recommend is praising behavior surrounding eating the food, such as “you tried it! Great job.” Instead, “wow, you touched the broccoli, how did it feel when you touched it?” This goes back to the division of responsibility and helping children develop a healthy relationship with food. They should not be rewarded for eating food.

  • Take away positive consequences for undesired behavior. As described above, when our children do some sort of behavior that is seen rewarding in their eyes, what we are trying to do backfires.

    • Throwing food: Instead of giving your child attention when they throw food, simply take that food away and explain, “I can’t let you throw food. When you do that, you are showing me you are done. I am going to put this food away for now.” And then move on. Remain calm and carry on, sometimes this really is a “fake it till you make it” situation in terms of acting calm.

    • Standing in their chair: Again, it is not about giving attention. Here are some phrases you can use: “Jack, when you stand, you show me you are all done, are you all done?” If you are not met with a yes or no (which most likely you will not be), remove the child from their chair and remove them from the table. BUT this does not meal your meal as a parent ends. Continue to enjoy (if you can) your meal even if your child is all done. But remember, their mealtime is over. Timers can be helpful here as well (see below).

  • Try a timer. Sitting for a long period of time can be challenging for children, and sometimes we don’t know our children’s time limit. You may need a timer for two almost opposite situations. The first is for a child that wont sit at the table longer than a minute or two. Here you want to start by asking the child to sit in their seat for a short amount of time (you may even start with 2-3 minutes) and then gradually increase the amount of time they are sitting. You will want to use positive reinforcement when they are demonstrating the wanted behavior (sitting still). The second situation may be for a child who spends too long at mealtime. Here we want to set a limit on the meal. I have worked with many families with children that spend over an hour at a given meal, here we want to start by decreasing the amount of time on the timer, and let the child know when they only have a few minutes left until mealtime is over. For reference, a typical meal lasts about 15-30 minutes and a typical snack lasts about 10-15 minutes, those depending on a child’s demeanor it may take until a child is a little older to last for this amount of time.

  • Dealing with tantrums. Language around this can be really important: “I see you are having a hard time. It is dinner time now. You don’t have to eat, but we will sit together at the table.” I personally believe letting a child get up from their seat when they appear to be finished is fine. The important point here is that you don’t want to allow the child to come back to the table. Once they get up, dinner time is over - no matter how much they persist. Concerned they didn’t eat enough at dinnertime? Try implementing a bedtime snack.

We can also look at some ways to change the antecedent

These strategies can reduce mealtime stress, although they require some planning up front. When combined with the above, they can create long-term and sustainable change.

  • Create a pre-meal routine to prepare child for the meal.

  • Make sure your meal and snack schedule is structured for success.

  • Think about how you are talking about food. I talk a lot about encouragement vs pressure. “How does the broccoli feel when it touches your lips” instead of “try your broccoli, you will like it.” We want to be using positive language around the table. Taking away pressure to try food. When we look at the division of responsibility, it goes along with this statement. Talk about your day, or a story instead of focusing on the food at mealtime. Many times the antecedent is how we are talking about food.

  • Find what works best for your child. Some children respond to soft, classical music being played prior to mealtime. Others that may have some sensory challenges, might respond to some sort of sensory input or stimulus before a meal. The key is to explore options that may work for your family.

If you’re right in the think of it, I hope you have found this helpful. If you’re at your wits end, don’t hesitate to reach out, and we can see if I might be able to help. Always remember children are individual and it’s important to find something that works best for you and your family.

Want more tips? Download my free guide, 5 ways to help your little one try new food.