Picky Eaters

photo of child who doesn't want plate of vegetables

When I teach about nutrition for toddlers and preschoolers, I include a few tips about introducing new foods. Then parents  say “But I’ve got a really picky eater.” About 30 – 50% of parents of preschoolers describe their child as a picky eater!

So, this post will talk about how that may be just a normal toddler phase, plus lots of steps we can take to work on those challenges.

Start with Empathy

Parents will say “Will they ever not be so picky?” I turn this around on the parent, and ask them: “Are there foods that you know that other people may love, but that you just don’t like to eat? If you were out to lunch with a friend, and they kept insisting ‘no really, it’s good! Just try it!!’, how would that feel for you? Or if there’s a ‘weird food’ you’re not willing to try, would you want anyone to pressure you to eat it?”

I don’t think anyone necessarily outgrows being a picky eater. You could eat lots and lots of meals with me and never notice the ways in which I’m a picky eater. We could sit at many breakfasts and I would happily drink my tea or cran-apple juice, and happily eat pancakes, waffles, eggs. You might never notice that I NEVER drink coffee or orange juice and I virtually never eat bacon or sausage. And I never eat the really weird foods – my husband will try anything in any foreign country, but not me! We all have our preferences. But because I manage my own food choices, my friends don’t need to know or care about my preferences. But for our kids, since we’re making all their food choices for them, and we feel responsible for their diet, we keep hitting the wall with their preferences. It can be frustrating, but it’s also important to acknowledge that we may not be able to change them quickly.

But I do think everyone can learn to be more flexible, more adventurous, and can learn accommodations. But let’s start from this place of empathy and figure out how we can offer and encourage without pressuring or forcing the issue.

Relax a Little

Although we all benefit in the long run from a diet featuring a wide variety of foods, if your child goes through a picky stretch where they only want a limited selection, it will be OK.

Toddlers are figuring out independence and control, and are ripe for power struggles. If you turn food into a battle ground, no one wins! If you force a child to eat, they will eat less.

Know how much they need to eat

Babies grow so fast in the first year that they have very high caloric requirements. But then that growth slows down, so your toddler’s appetite will decrease. It is helpful to know how much they need to take in per day – often parents are worried, then discover their child is actually eating plenty.

A child age 1 to 3 needs about 40 calories per inch tall. (source) Another way to think about it is to think of serving sizes as one tablespoon per year of age. (source) At at one meal, a 3 year old might get 3 tablespoons each of peas, noodles, and chicken.

If your child is gaining weight well and has plenty of energy, that’s a good sign that they’re getting enough food.

How much variety do they need

Well, all of us would benefit from a widely varied diet of healthy foods. But, young children may naturally have a more limited range than adults. As long as they’re eating some protein, some calcium sources, and some good sources of fiber and healthy fats, they should be fine.

I had a nutritionist tell me informally that if a kid eats more than five types of food, she’s not too worried. If you’re concerned, ask your child’s doctor.

Get them Involved

Take your child grocery shopping with you, or to a farmer’s market. Let them choose the things they want to try. Let your child help you to prepare the food (scrub vegetables, stir the fruit salad) or set the table for a meal. If there’s a meal where you want them to try something new, let them choose their favorite familiar foods to accompany that new option. Offer choices – not “do you want a vegetable at this meal?” but “do you want broccoli or carrots at this meal?”

Role Model / Communal Meal

Make meal times relaxed and social. Serve the same food to everyone as much as possible. Eat your own food and talk about what you like about your food. If there’s something you are OK with eating, but don’t love, you can say that “I don’t love this, but I know it’s good for me, so I’ll eat some of it, then I’ll eat the other things that I like better.” Don’t talk to your child a lot about foods you don’t like or model picky eating.

Introducing the New Food

Give them a very small taster serving – like a single pea, or a shred of cheese. Allow them to touch it, sniff it, lick it – do whatever they need to do to feel comfortable trying it out. Respond positively to any attempts they make, but don’t pressure them into eating it all. If they choose not to eat it, say “OK, we’ll try again at another meal.” Wait several days before trying again. Plan to offer a new food several times before it’s fully embraced. The first few times, offer just one bite. Over time you can give them a full serving.

Use food bridges – think of something they already like – what new food is like that? Try that one before you try something that’s unlike any of their favorite foods. Think about textures, colors, and tastes. If they like mushy foods, they’ll prefer mashed potatoes to french fries. If they like crisp things, try kale chips and apple slices. If they don’t like green food, try carrots, cauliflower, sweet potato, jicama.

Many parents go for the technique of “hiding” vegetables – blending lots of veggies into spaghetti sauce or dip, or mixing grated carrots into other things. Some nutritionists recommend this, some say it’s better to teach them to like the whole food. If you have a super-picky eater, I wouldn’t recommend this – if your child doesn’t “trust” foods, this will just reinforce that.

It may help to try new foods at snack time when they’re hungry, and not at a mealtime when you’re hoping for the whole family to have a relaxing time together.

Make New Foods Fun

Make trying new foods a fun activity by documenting what faces your child makes when they try a new food. Try adding a dip – many kids will eat anything they can dip. Do taste tests, crunch tests, cut food into fun shapes, go on a food field tip to learn where it’s grown. (ideas here)

Stick to the Familiar in Unfamiliar Environments

When your child is on vacation, or otherwise outside of their normal routine, they may need familiar foods to calm and reassure them. When my daughter was in a picky phase, we took a vacation where she carried a small container of Kraft parmesan cheese to every meal, and if nothing else on the menu seemed OK to her, we’d just order noodles with butter and she’d sprinkle on her cheese, and everyone was happy. When we got back home, we worked on broadening her diet.

Sometimes Foods

If you make any food a “forbidden fruit” that only increases its appeal. Go ahead and have fast food, or ice cream, or candy, or whatever. But do it in moderation, and explain that it’s a ‘sometimes food.’ (We don’t keep ice cream in the house, where it would be tempting to have it more often, but we do go out to ice cream as a special family treat.) A friend of mine has the ‘strong food’ policy – if you’ve eaten some of the food that keeps you strong and healthy, then you can have treat foods. (But don’t sell the treat as the reward for eating the healthy food – that could imply the healthy food is the icky stuff you have to slog through to get to the good stuff.)

But do remember that snack foods are scientifically designed to push kids’ pleasure buttons with salty, sweet, fatty goodness. It’s hard for healthy foods to be as appealing. So, realize that it can be hard to go back from junk food to healthy food. (And I say this as a parent whose kid is addicted to Cheez-Its!)

Keep Trying

Kids tend to be pickier about new foods from age 2 to 5, an age when they may cling to familiar routines. As they get older, they make get more flexible. So once your child starts elementary school, try re-introducing some things they may have rejected in their toddler years. They may be more flexible now. As they move toward their tweens and teens, they may try anything their friends eat!

Beyond Picky

So, my first child ate everything easily. Of course he went through periods of having preferences, and he didn’t always love vegetables, but he was always pretty flexible. My second child was a typical “picky eater” kid and we used all the tips included here to get her to eat. She was especially picky about protein sources, so we had to be especially creative there. As she got older, she was able to articulate that lots of proteins upset her stomach, so now at 22, she’s a soy free vegan and eating an otherwise very diverse diet.

My third child… well, he’s a whole different level of picky eater. I’d been a parent for 17 years when he was born, and I was a parent educator, so I knew all this stuff about picky eaters and how to work with them, and believe me, I tried all these tips. And his diet is still very limited. So, if you’ve tried all these ideas and are feeling like you’re at the end of your rope, check out my other post on super tricky eaters.

Sources for more info:

 

 

 

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The Super Picky Eater

photo of a child disgusted with food

If you have a “typical” kid, just check out my basic overview of toddler nutrition. If you’re one of the 30 – 50% of parents of toddlers/preschoolers who would describe your child as a “picky eater” then check out and try my tips for picky eaters. But, if your kid is a whole other level of picky eater – where you’ve tried all those tips, and your kid still eats a very limited set of foods, then this post is for you.

And I’m here in solidarity with you! I could easily make a list for you of all the foods my 8 year old is willing to eat. And they’re specific – I can’t say he eats yogurt. I can say he eats yoplait brand only and only these flavors: strawberry, strawberry-banana, and blueberry. When I say he eats chicken mcnuggets, I don’t mean any kind of breaded chicken product, I mean ONLY the ones from McDonald’s (or Wendy’s in a pinch).

And if you’re judging me for feeding my kid McNuggets, then here’s the thing – it’s the only meat he has ever put in his mouth in pretty much his entire life. And if you’re judging me for that, well, then you’ve never lived with a super picky eater, and this is not the post for you.

Why are some kids super picky?

There can be a wide variety of reasons. A child with an extremely strong sense of smell may be overloaded while eating – a child with a very limited sense of smell may not enjoy food. A child who had a traumatic experience with choking may be very hesitant to eat after that. Children who have food sensitivities may not be able to articulate them or understand them – they just know that sometimes they feel icky after they eat so they just eat less.

Many extreme picky eaters are either autistic, or have anxiety, or have sensory issues. Or like my son, they may have all three of these challenges.

This blog post, written by an autistic nine year old has given me the best insight into “The Reasons [They] Don’t Like to Eat.

“Sometimes I eat something and it tastes nice; it is the right color and it feels nice and soft in my mouth. But then some days I eat what you tell me is the same and it isn’t the same… I get upset. You ruined it. … You damage it if it has sauce or potatoes on it. Then it is not nugget skins, but some weird thing my brain does not know. So, all nuggets are dangerous. And I get scared again.”

I totally see this with my son. He will love blueberries for a long time – but then he gets one bad blueberry – an under-ripe overly tart one, or an over-ripe squishy icky one. Then for weeks he has a hard time trusting blueberries again. He prefers processed packaged food to real whole foods, because Cheez-Its taste the exact same and have the exact same texture every time. He can trust them. Bananas are a risky proposition.

If you’re having a hard time understanding this, just think about one of your preferences. Maybe you like Coke but Pepsi is really not the same and you’re disappointed if you have to drink it. Or you really like your coffee with half-and-half and Splenda. And if you’re on a trip and they only have skim milk and sugar, it’s just not the same, and it throws your morning off a little. Now, put yourself in the shoes of an anxious child, who doesn’t have the perspective and flexibility you’ve gained from experience, and perhaps you can understand the upset?

If your child is old enough (maybe 5 or older?) try asking them open-ended questions to learn about what they like, what they don’t like, and what worries them about food. Understanding this can guide you in the next steps to take.

Can you force them to try foods?

I have to be honest that I have never tried to force my child to eat. With my older kids, I could do a little wheedling and nagging, and they’d give it a try. With my youngest, the nagging doesn’t work, and I’ve always had the sense that if I tried to force it, it would be bad.

There are plenty of examples of super picky eaters who will gag or vomit if you try to force them to eat something. Then later on, they’ll gag or vomit if that food is even in the same room with them, even if they’re not being pushed to eat it. And their food repertoire becomes even more restricted.

I don’t know if that would be the case with my son. I do think he would have big meltdowns, and I do think it would damage the trust he has in me, and I think it might make eating new foods even more stressful for him.

Encouraging Them to Try to Broaden their Eating

Be sure to check out the tips in my picky eaters post, plus:

Steps to Eating

When introducing a new food, tips will often say “offer just a few bites… expect your child to have to try something 7 or more times before they accept it.” For a super picky eater, we need to take even smaller baby steps. This Steps to Eating chart is helpful in describing those steps… can the child tolerate being in the same room as the food? Can that food be at the same table? On their plate, but not touching any of their other food? Are they willing to try smelling the food? Touching it with one finger? Licking it? Each step closer to eating it is progress!

Food Chaining

Another helpful tool is food chaining. Think of a food your child likes. Level 1 is to give them very similar foods – same taste and texture – for example, with my son, we’ve introduced Tyson chicken nuggets (yes, not the most healthy option, but very similar to McNuggets, but something we can have in the freezer at home). Level 2 is to vary the taste, but keep the texture – maybe dip the nugget in sauce? Level 3 is to maintain the taste but change the texture – so chicken strips made with whole chicken breast rather than the ground / reconstituted chicken in a nugget. Level 4 is to vary the taste and texture – breaded fish patty?

Slow and Steady Changes – Texture and Color

Some young children are very picky about texture. At some food clinics, they will puree all the child’s food, and they gradually move toward chunky purees, then eventually solid foods. Some kids will eat only crunchy foods – so parents try lots of the veggie chips, kale chips and so on. Eventually hopefully moving to carrots and apples for crunch.

Some children are picky about color. If a child preferred white food, they could start with 90% mashed potatoes and 10% sweet potatoes, and gradually increase the orange.

Many picky eaters like very bland foods (white noodles, white bread). But a few are sensory seekers and want very intense flavors – you may need to spice everything up.

Record Progress

Take notes on what they tried, and whether they liked it, and how much they tried. Comment on how much you appreciate their flexibility and willingness to try.

Have them rank things on a scale from 1 to 10. If it’s 5 or higher, encourage them to try it again a few times in the next week. If it’s lower than 5, don’t offer it again for quite a while till you’ve had successes with other foods. A reward system might increase their motivation.

Limit Sensory Input at Mealtimes

If a child is easily over-stimulated, eating is a LOT of sensory input. Try eating in a quiet, calm place without a lot of other stimuli. Don’t talk too much about the food – just put it there and allow them to explore it.

Familiar Food in Unfamiliar Environments

I only ask my child to try new things when he’s having a good day – we’re relaxed, hanging out at home, all is going well. But when we’re in a challenging situation, I make food as easy as I can. To understand why, read this quote from the blog post cited above:

“Sometimes people even want me to change rooms to eat… School does that. You want me to move to some place, sit down, and eat what you have made… No one told me I would smell different things, hear different voices and touch different stuff, and now you even want me to taste things? It is too much, so I just freeze.”

When my son is having challenges at school, I want to make sure his lunchbox is filled with all of his familiar favorite comfort foods and that it always meets his expectations. There are always 5 items – there’s always a yogurt tube, always cheesy crackers, always two fruits and always either a peanut butter sandwich or apple slices with peanut butter. And if we’ve run out of any of those things, I tell him when I pack his lunch, and I explain the substitution I’ve made. I want to be sure that lunch at school is something that re-grounds him, not upsets him. We can try for more food variety in all the other meals in his week. And when we go on vacations or to family camp, we pack protein drinks, protein bars, and peanut butter crackers. I know we can always find fruits and grains he will eat, but these are the ways I ensure he gets protein.

When should you seek help?

If your child is a super picky eater, you should already be talking to their doctor about it for advice and to monitor their weight gain and development.

Also, watch for physical signs of food intolerances or allergies. Many “picky eaters” are later found to have food sensitivities. So, if you see rashes or eczema, or your child has frequent diarrhea or constipation, or frequently complains of a sore tummy, talk with your doctor to see whether any kind of allergy testing or food elimination would be warranted.

If a child often gags or chokes or has problems swallowing, they might benefit from a “swallow study” or work with an OT or speech-language pathologist to build their eating skills and muscle coordination.

But here are some red flags that they may need additional support:

  • It’s getting worse – their list of accepted foods is getting smaller and smaller. Maybe it used to be 20 foods, and now it’s 10.
  • You believe your child would starve or be hospitalized before they’d eat foods they don’t like.
  • They will only eat if someone else feeds them. (In a child who should be old enough to feed themselves)
  • If their pickiness is limiting their life – for example, they can’t go on play-dates or sleepovers or eat out at a restaurant due to food limitations.

If this is the case, talk to your child’s doctors about your next steps.

More ideas

Words Matter

We recently did an exercise in a parenting class that I teach, where I talked with parents about discipline and ways to speak with our kids to increase the chance that they will do what they are supposed to do. How you talk to your kids and what you say effect the chances that they’ll listen.

Here are some ineffective communications techniques and ways to turn them around to make them more effective:

Vague Commands

What you may be saying: Be good. Behave better. Be nice. You better behave well at the restaurant.

Why this may not be working for you: Saying “be good” implies they are bad. And, these vague commands require them to guess what it is that you want them to do. (What does “be good” look like?)

Alternative approaches that may be more effective: Set clear expectations in advance about what good behavior is in that context. “At lunch, you’ll need to sit in your chair or my lap and use a quiet voice.” If issues arise, give very clear, concrete instructions for what they should do. “Please sit on your chair now or you can sit in my lap.”

Try re-writing these sentences:  “Be good at the movie.” “Be nice to her.”

Broken Record

What you may be saying: We’re late, let’s go. Come on, we’re late. Can you just put your shoes on? We’re late, we need to go. Come on!

Why this may not be working for you: If you feel like you’re saying the same thing over and over, you should ask yourself: can they hear you? Do they understand what you want them to do? Do they have the skill to do that? What’s stopping them from doing it?

Alternative approaches that may be more effective: Connect to Correct. Make sure you have their attention first, then tell them what the behavior issue is. Go near them, get down to their level, establish eye contact, and use a calm voice. Once you have their attention, then offer clear guidance – say it once – loud and clear!

Try re-writing this sentence: “Stop jumping on the couch. Cut it out. No jumping. You know you’re not supposed to jump on the couch. Stop it.”

Only telling them what NOT to do

What you may be doing: Don’t throw that / spill that / hit the dog / slam the door

Why this may not be working: If you just say what not to do, they have to first stop their impulse, then figure out what they can do instead. Both are hard for young kids to do!

Alternative approaches: Tell them what to do: “Carefully hand that to me. Move your milk so it doesn’t spill. Pet the dog softly. Close the door gently.”

Try re-writing: “Don’t throw your Legos.”  “I hate it when you slam the door.”

Dismissing their Feelings

What you may be doing: I don’t care if you’re mad – we don’t break things…. You know we need to leave the park now – crying won’t change that… I know you’re excited, but you need to sit down.

Why this may not be working: Dismisses their feelings as unimportant. Until the emotion is acknowledged, it may be hard to move past it. Saying “I know you have this feeling, BUT…” doesn’t count as validating, because that “but” implies you don’t care about their feelings.

Alternative approaches: Validate emotions first, then address the behavior or re-state limits. “I know you’re mad. It’s not OK to break things.” “I can see that makes you sad. I get that – I’m sad too. And… it’s still time to leave the park.” “I know you’re excited and it’s hard to stay still. It’s important to sit down so other people can see.”

Try re-writing: “Don’t cry. You know I won’t give you more candy.” “I know you’re mad that he took your toy, but you can’t hit him.”

Over-using If / Then Threats

What you may be doing: If you don’t brush your teeth right now, then no bedtime story.

Why this may not be working: Could imply you expect they’ll do the bad thing. (Kids are good at living up to expectations!) Could imply you’re looking forward to punishing.

Alternative approaches: When / then – When you do [this good thing], then we get to do [something mutually enjoyable] together. “When you’re done brushing your teeth, we get to read a bedtime story. If you’re fast enough we get to read two!”

Try re-writing: “If you don’t help me clean, then you don’t get to go to the park.”

Note: there is a place for using if/then threats as consequences, but start with when/then.

Asking Questions when you mean to give Commands

What you may do: Would you please stop yelling? Are you ready to sit in your car seat?

Why this may not be working: If you ask it as a question, that implies they can say no, or opt out of what you’re asking them to do.

Alternative approaches: If you’re really offering a choice, make sure they know they can choose either option. If you don’t mean to offer a choice, then give a command not a question. “Use a quiet voice.” “You need to sit in your car seat now.”

Try re-writing: “Do you want to put on your boots now?”

Do Try This At Home

Sometime in the next week, test this out! When you find an opportunity to change your communication from your normal style to trying out a new communication strategy from above, then seize the moment and test this out.

Then reflect on these questions

  • What happened as a result of using this new communication strategy?
  • What did you notice about how it felt?
  • What happened with your child?
  • How might this support a relationship with your child?

Share your experience in the comments!

Here’s a free printable version of this exercise on Effective Communication Techniques to Improve Discipline.

Do the ASQ Screening for Your Child

stick

Why do a developmental screening?

Developmental screenings are a helpful tool for making sure your child is on track with their development. They are a “snapshot” of how your child is doing at this moment. They’re helpful even if you’re pretty sure your child is on track, because they help you get ideas of where to focus your attention in the short-term to make sure they’re well rounded. They’re especially helpful if you have any concerns about your child’s development – a screening tool can either reassure you that they actually are on track, or can verify that they have some challenges that you should seek support for early on.

Developmental delays, learning disorders, and behavioral and social-emotional problems are estimated to affect 1 in every 6 children. Only 20% to 30% of these children are identified as needing help before school begins.(Source)

The ASQ

There are several great screening tools and resources for understanding child development. Today, I’ll walk you through the ASQ – the Ages & Stages Questionnaire, a free online tool, using a method that’s been proven through research with tens of thousands of parents. (Learn more about the ASQ.)

It looks at how your child is doing in five areas: communication, large motor, fine motor, social-emotional, and problem-solving. Learn more about these developmental milestones.

Doing the questionnaire likely takes 15 – 20 minutes. It’s easier to do on a laptop or desktop than on a mobile device. It’s best to do it when your child is around so you can check their skills if there is any answer you’re not sure about. And it’s best if they’re rested, fed, and relaxed so they can show you their best skills. That said, it can also be helpful if another adult is around to help you with distracting the child while you’re filling out questions and can help you figure out answers to questions you’re not sure about.

Note: Some parents choose to download the questionnaire and print it to fill in off and on over the next week, then return to the website to enter their results online so that it will do the scoring for them.

Completing the Online ASQ

Go to https://osp.uoregon.edu/home/checkDevelopment. Click on “Let’s Get Started”

On next page click continue – on next page click to agree to terms and continue, then enter date of birth. Then you’ll get a screen saying something like “For ages 25 months through 28 months – 27 month ASQ” – this is making sure you’re using the right checklist for your child’s current age.

Continue to online questionnaire. (Or download it to fill out by hand and then return to the website later.)

There will be a page where they ask about demographics – ethnicity, education and so on – they ask this because the people who are offering this survey are doing research on who uses the tool, and this is helpful to their research process. They do not do anything with this data which would violate your privacy, and you won’t get any emails from them except the results of this screening.

The next screen will be instructions – they’ll tell you that you need to try every activity with your child before marking an answer – that would be ideal, but you don’t have to… if you know your child can do something easily, it’s OK to just mark it yes. On things you’re not sure about, do have your child try it.

On the questionnaire, you’ll be asked 30 questions – 6 questions per category in 5 areas of child development. You’ll mark “yes” if this is something your child is definitely capable of and has done successfully multiple times. If they have done it a few times or they can sometimes do it but not always, mark “sometimes”. If they’ve never done it, mark “not yet”. The way the survey is designed, we might expect a not yet or a couple sometimes in any given category, so don’t worry if you’re seeing some.

Mark answers as accurately as you can – this screening is not about “making your child look good” – it’s about getting an accurate assessment of where they’re at.

Then there will be a few general questions, like does your child hear well, do they have vision problems. It’s OK to fill those out or to skip them.

Then it will say something like: “For ages 21 through 26 months (24 month ASQ:SE). The ASQ:SE-2 asks simple questions about your child’s behaviors. Before continuing, please read instructions…”

This second questionnaire, the ASQ-SE ,is optional. I would say: if you feel like your child has more behavioral challenges than the average child, or more big meltdowns / tantrums, or doesn’t connect to you and others like you see other children do, or there are other things that make you worry that your child may not respond like other kids do, then do this questionnaire. If not, you can choose to skip it. This questionnaire takes 5 – 10 minutes.

Enter your email address to receive results by email. (If you’d prefer not to give your email, then click to skip this step, and it will take you on to a page where you can “download your ASQ Results letter”)

Understanding Your ASQ Results

Your results will look something like this:

Results for your child BXD born on November 23, 2016
Your child’s development appears to be on schedule at this time.
On schedule Communication, Gross Motor, Fine Motor, Problem Solving, Personal-Social
Monitor None
Not on schedule None

or

Results for your child BXD born on November 23, 2016.
ASQSE Social-emotional development is in a monitor area at this time.
Overall Section You noted a concern in this section. See below for follow-up ideas.

If your child shows as being “on schedule” that’s good news. This test rarely has any “false positives.” If a developmental screening shows that a child is on track developmentally, we can be pretty reassured that all is well. You can just keep doing what you’re doing with them. Or, if there’s one developmental area where you had more “sometimes” or “not yets” then you may choose to do more activities in that area to ensure they stay well-rounded. For example, if you didn’t mark “yes” on all the large motor questions, then spend a little more time at the playground, pool, or gymnastics or dance classes so they can run, jump, kick, throw…

If your child has some things marked as “monitor” – I think of those as “grey areas”. This test can have “false negatives” where the test shows a possible problem, and it turns out that all is well.

If I see “monitor” in one area, that makes me go “hmmmm…. I wonder why.” Here are the questions I ask myself

  • Can they do similar things? The first thing I do is look back at the questions in that section and how you answered them. (The questionnaire with your answers marked will be attached to your email, or you can find it by clicking on “download your completed ASQ”.) Sometimes there were just super specific questions, for example, there’s a fine motor question of “does your child flip switches on and off” or “can your child string beads on a string” and you said no just because they happen to have not ever done this… but think, are you confident that they have enough fine motor skills that they could do something like that? If so, then there’s no reason to worry about it.
  • Is there something about that question that doesn’t apply to their experience? All standardized questionnaires have some biases or assumptions. For example, there are questions about climbing stairs, and there are children who grow up in a town with no stairs. There are questions about forks and some families tend to only eat finger foods or they use chopsticks so may not use forks at home. When the mother of one of my students was doing this questionnaire, and she showed her daughter the incomplete stick figure drawing in the illustration at the top of this post, her daughter said it showed a teacher. This may not make sense to you, but if you’d met me, it would make sense! (I have one leg and this child knew me well as her first teacher.) If the question doesn’t directly apply to your child, again ask yourself “do they know similar things?”
  • Is there a reason they might be behind in this particular area of development at this particular time? For example, if you are a bilingual or trilingual household, your child might test as “behind” in language in ONE of those languages. But if you think they have solid language skills in BOTH languages, I wouldn’t worry. If you tend to solve problems for your child whenever they get frustrated, they might be “behind” in a problem solving skill, like getting themselves dressed. Or sometimes kids are behind in large motor skills in the winter time just because we haven’t been playing outside where there’s room to run.
  • Is there a reason why they might be behind overall right now? If you’ve had any big stressors in your family recently like a move, a new baby, a death in the family, a divorce – these are all things that might have distracted your child’s learning temporarily.

If you find answers to these questions that satisfy you, it’s likely that all is well and there’s no reason to worry. It wouldn’t hurt to put some extra effort into building your child’s skills over the next two months, and then do another screening just to be sure.

If you’ve taken all of these questions into consideration, and your child still seems to be missing some skills, then definitely work on building those skills (see below) and do another screening in a few months, or seek more information now.

If your child is marked as “not on schedule” in one or more areas, you definitely want to explore it more. Ask yourself the questions above to get a clear understanding of the results, then consult with your child’s doctor, teacher, or another professional to learn more. It is possible that when you investigate more, it will turn out all is well, or there is only a very temporary delay. But it’s important to check to be sure, because if a child does have any developmental challenges, the sooner they get extra support, the better.

Resources if you’re concerned about your child’s development:

Resources to build all kids’ skills

Whether your child is on schedule, not on schedule, or in that gray area of “monitor” they will benefit from diverse learning experiences. I have lots of articles on Play and Fun Activities on this blog. Or check out:

 

Note: Easter Seals also offers the ASQ online for free: www.easterseals.com/mtffc/asq/. Theirs works just fine as an alternate, I just prefer the uoregon site listed above because Easter Seals asks for more of your private information (name, address, phone number) and will add you to their mailings.

Ages & Stages Questionnaire

How ASQ works

The Ages & Stages Questionnaire, or ASQ, is simply one of the best tools available for developmental screenings of children from birth to age 5. It has been in development for about 40 years and tested by tens of thousands of participants.

You can purchase questionnaires, or it is now available as a free* online screening tool at https://osp.uoregon.edu/home/checkDevelopment.  A parent may complete it by themselves, or it can be done with a professional. (Parent educator, social worker, child care worker, physician…)

Completing the questionnaire

First, you choose the correct questionnaire for the child’s age: they’re in two month increments for the first two years (2 months, 4 months…. 24 months), then every 3 months (27, 30, 33, 36), then every 6 months (42, 48, 54, 60).

The parent fills out the questionnaire. It asks six questions in each of five realms of child development: communication (what child understands and what they can say), gross motor (running, climbing, throwing), fine motor (hand and finger coordination), problem solving, personal-social (self-help skills and interactions with others).

The form asks simple questions, like “If you point to a picture of a ball (kitty, cup, hat, etc.) and ask your child, ‘What is this?’ does your child correctly name at least one picture?” The parent answers the questions yes, sometimes, or not yet. They are encouraged to try things out with their child as they go through the questionnaire, so they can see what their child’s abilities are for sure.

There is an additional optional questionnaire called ASQ:SE which assesses social-emotional development, such as autonomy, compliance (ability to follow directions), adaptive functioning (sleeping, eating, toileting), self-regulation, emotional affect, interaction (ability or willingness to respond to others), social communication.

Results (and how they’re calculated)

With the online questionnaire, the parent receives a report which lists which categories their child is “on schedule” with, where they should “monitor” and if there are any categories where the child is “not on schedule.”

To give professionals a little more insight into the calculations that lead to these categorizations: The results are scored 10 points for every yes, 5 for sometimes, 0 for not yet, so a maximum of 60 points per category. On the written test, you would then tally it on a table similar to this:

tally

If the child scored as we would expect for a child of this age (on the example above, this would be a score of 40 or higher on problem-solving, shown in the white/un-shaded area of that row), then the child’s development appears to be on schedule. If they scored close to the cut-off (in the gray area, shown as 35 or 40 points on the personal-social row), that would be something to monitor. If they score below the cut-off (a unique number for each category of each questionnaire), then further assessment by a professional is recommended.

This is a screening tool, not a diagnostic tool. If all looks well for the child (all scores are in the white area or the online tool says “on schedule”) then we can be assured that they are likely well on track. If they’re in the gray area / “monitor”, then we ask more questions to figure out why. If there’s a good explanation, then the score probably is not a cause for worry, but you could recommend adding activities to build the child’s skills in those areas and re-screening in a few months. If they’re in the black area / “not on schedule” consider referrals to more resources. The Oregon website offers this helpful ASQ Review Guide to help you determine next steps.

These videos for providers offer more information about how to use the ASQ with parents.

Follow-Up

It’s most effective when this tool is used as the beginning of a conversation with parents. After completing the tool, what do they see as their child’s strengths? Do they have any concerns about their child’s development? Did the screening reduce those concerns (they discovered the child is actually on track) or increase them (child is shown as monitor or not on schedule)? What are some next steps they can do to help their child’s development?

On my post for parents about how to complete the ASQ, you can see how I talk with parents about interpreting their results – whether to worry, how to seek help, etc.

If they completed the online questionnaire, their emailed test results will include links to age appropriate learning activities and play activities.

* The screening is free for parents. Since I know the ASQ is a product that is sold, and is fairly pricey, I wanted to be sure I wasn’t violating copyright by promoting use of the online tool. The website is for the Oregon Screening project, so  I have looked for legal terms on the site to see whether they limit its use to Oregon residents or in any other way, and all I have found is “This site is open to all parents of children ages 1 month up to 72 months.”

The screening is also available free at Easter Seals: www.easterseals.com/mtffc/asq/. I prefer the Oregon screening project, because Easter Seals asks for all of the family’s contact information and will add them to their mailing list.

Kids Do Well If They Can

To resolve problem behavior in children, first attempt to figure out why the behavior is happening. A key question to ask yourself is: are they capable of behaving better? Dr. Ross Greene argues that “if your child could do well, he would do well… If your child had the skills to exhibit adaptive behavior, he wouldn’t be exhibiting challenging behavior.”

Let’s contrast this “kids do well if they can” idea with another common philosophy, which Greene calls “kids do well if they wanna.”

Kids Do Well if They Wanna

If a child is not doing well, this model assumes that it’s because they don’t want to do well. So, that implies that the parent/teacher’s primary job is to make him want to do well. Typically that would lead to rewarding the behaviors you like, or punishing the behaviors you don’t like. If you’re right and he IS capable of doing it, then this may work. If he’s not capable of doing well, all the rewards and punishment won’t change that. The problem behavior might not improve or might even get worse.

Under this model, you first ramp up the punishment, and if it still doesn’t work, you may decide his behavior is fully intentional… maybe he’s trying to manipulate you or get attention or test limits or maybe he’s just lazy and unmotivated. If you start assuming this kid is a bad kid who intentionally misbehaves, his behavior will not improve.

Kids Do Well If They Can

What happens if we instead assume that kids want to do well, but sometimes they aren’t yet able to? Here, the parent/teacher’s primary job is to figure out what’s getting in his way and how to help him get past it.

Instead of jumping ahead to fix the behavior, first figure out what the core issue is. What’s hard for them? Think about the environments / situations where the challenging behavior appears. What are the stressors in that environment and how could you reduce them? What skills are they lacking that would help them to be successful there? How can you teach those crucial skills? What unmet needs in the child might be causing this behavior? Can you address those?

Here’s a nice infographic (source: https://self-reg.ca/infographics/ ) that summarizes these models.

reframe-behaviour-growth-mindset-edition

Learn a lot more about this idea, and about Greene’s model at https://www.livesinthebalance.org/walking-tour-parents which includes several helpful videos of Dr. Greene sharing his ideas.

What’s the Best Summer Camp?

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Each year around this time, parents start asking me about summer camp. They want to know which are the best ones. Just like with choosing preschool, I can’t give you a simple answer to that. Because it all depends on what your needs or goals are.

So, I recommend that before you look at camps, you first answer these questions for yourself.

Needs

What are your basic logistical needs?

  • Scope: Do you need full-time care all summer while you work? Or full-time care for a few weeks out of the summer so you can focus on adult projects those weeks? Or part-time enrichment camps every day? (My youngest is effectively an only child AND he’s full of energy, so I find it helpful to start every day with a few hours of camp to give him social play opportunity and let him burn off some energy while I get some quiet project time. But we still have the afternoons for lazy summer days at the pool, unstructured playtime at the park, trips to the zoo, and so on.) I also know of families where the grandparents watch the children for a week or two in the summer, but take the kids to a day camp during the day, which may be more fun than hanging out at the grandparents house all day.
  • Schedule: What time would it work for you to drop off? What time can you pick up? Realistically what works with your needs?
  • Location: I’ve often enrolled my kids in camps that are quite a ways from home. (Like wilderness camps and farm camps that were both about 40 minutes from our house.) It works for me, because my work is portable, so I just bring my laptop and while they’re at camp, I sit at nearby parks or coffee shops and get my work done. But you may prefer to stick closer to home.
  • Cost: Costs range a lot! And it’s hard to compare costs between camps, as some camps are 5 hours long, some 6, some 7…  For example, even within the Bellevue Parks department, for a 7 year old, the hourly cost could be anywhere between: $9 per hour for theater camp or ballet camp to $11.50 for Lego/STEM to $22 per hour for pottery camp (high materials cost, I’m assuming.) Of course, if you’re just looking for an activity focus for the week, and don’t necessarily need 6 – 8 hours of child care, maybe the total cost is more important than the hourly cost. The Lego camp is $400 a week (9 – 4 each day), and the pottery camp is $242 a week (10 am – 12:30 pm).
  • Age requirements. There are plenty of camps for kids age 6 – 12. It’s harder to find camps for little ones, and if you do, they tend to be EITHER full-time child care OR very short – a few hours at a time. Versus camps for older kids can have a wide range of schedules.

Goals

The next question is what are your goals for having a child attend summer camp? Is it just about child care while working? You may choose to have them attend the same camp every week all summer because having that routine is easiest for you. Is it about summer fun? You may choose lots of camps that emphasize being outdoors and playing, or may send your kid to the same camps their buddies are going to so they have built-in friends. If you want to expose your child to lots of different skills and activities to broaden their life experience, you may choose to dabble through a: farm camp, wilderness camp, theatre camp, art camp, science camp, and multi-sports camp all in one summer. Is there something you want your child to learn that you aren’t able to teach? You may choose that opportunity. Do you want a church-based camp, or a scouting camp? Or do you want a family camp that you can ALL attend together? Each family may have unique goals for each child.

Limitations: You should also keep in mind if your child has limits to what they can do. My youngest is autistic. He’s also very bright, so he can do so well at a camp that the staff  never realizes his challenges. But he has limits… and when he passes those limits, he has giant meltdowns. So, he does best when I enroll him in half day camps, not full day, and when he is one of the oldest kids in the program rather than one of the youngest so the social/emotional expectations are set at a lower developmental level. Know your child, and choose camps that set them up for success. (Note: there are specialty camps that are solely for kids on the spectrum and that really focus on social/emotional skills – those can be a good match for some families’ needs.)

Research your options

Check out your parks department, and those in neighboring cities. They tend to offer LOTS of different camps, in lots of interest areas and locations and may be fairly affordable options. Check the Boys & Girls Club, Campfire, Boy Scouts and Girl Scouts. Your city may have a summer camp fair (in the Seattle area, ParentMap sponsors four or five camp fairs in February and March where you can discover lots of options for summer camps. Check ads in local parenting magazines – but keep in mind that there are lots more great programs that can’t afford to advertise, so also check out word-of-mouth recommendations. Ask your friends, family, parents of your kids’ friends, and parents at the playground about what camps they have loved (or not).

Once you’ve collected names of interesting options, you can do your research online to learn more. Look at their websites and Facebook pages, and also search to see what else other people say about them online.

Questions to Ask

Things to look for when you’re researching your options: what is the typical schedule for the day? How much is structured activity and how much is free play? What activities does your child participate in? How many children attend? What is their adult to child staff ratio? What experience / training do those adults have? (Note: the vast majority of summer camp staff is students, age 17 – 22 or so, with one or two years of summer camp experience.) What backup staff is available in case unexpected challenges arise at a camp site? You may not be able to find this info online, but it’s helpful if they do have this. (I had one camp we went to the first week of their season last year and it was the first year they’d used that site and the young, inexperienced staff faced some unexpected challenges without experienced folks on-site to back them up… they got there, but it took them a while – I’m now inclined to choose long-term camps for the beginning of the season, and save those “start-up” experiences for later in the summer when they’ve worked out the bugs.) Do they have an indoor option in case of weather problems (too wet, or too hot)? I don’t find this a necessity but there was a parent who I talked to last year who was outraged that a camp her child attended did not have an indoor option for a hot, sunny day.

After you go through this process, you’ll have a lot better idea of what you’re looking for in a good summer camp. And one of the nice things about summer camps is that they’re only one week long. It’s a lot less pressure than choosing a school for a full school year. I figure it’s easy to just try it out for a week, and if it’s great, we return every year, if it’s not, it’s a learning experience we move on from.

Camps We Have Liked

Sometimes when I offer parents ‘more questions to ask’ instead of answers to their questions, that can be frustrating for them. So, here are some answers to what I think of as some of the “best” summer camps my kids have attended over the years. (All on the Eastside of Seattle metro / King County)

These are  my personal experiences as a parent, not representative of the views of my employers (Bellevue College and Parent Trust for Washington Children.)

My logistical needs for location, cost and schedule were always fairly flexible, so I was able to prioritize my goals of broad learning experiences for my kids. I put them in part-time summer camps most weeks of each summer, because I find I’m the best parent to my kids when I have a few hours to myself each day to work on my projects – that energizes me to come back for a great afternoon with them.

My older kids did some fabulous camps that I haven’t revisited with my youngest, so I don’t have current info on them. But when my kids attended these camps (between about 1998 and 2013), they were fabulous:

  • Wolf Camp – a wilderness skills camp. Day camp for ages 6 – 11 in Issaquah or Puyallup. Overnight camps for age 9 – 17 around Washington State.
  • Shoo Fly Farm – a day camp which captures everything you would imagine summer childhood on a farm to include – take care of and play with farm animals, making butter and jam, tie-dyeing, and swinging on a tire swing. Registration tends to fill early!! (For 2019, on January 28 all but one of this summer’s camps are already full.)
  • DigiPen Academy – their Project Fun camps for k-12 teach programming skills for video game development. My oldest child did them as a teenager. (He’s now a paraeducator. My middle child who did the fashion design camps is now a software developer… it’s interesting how our kids turn out!)
  • Stone Soup Theatre Camp in Seattle, for ages 5 – 15.
  • Columbia Gorge Theatre Camp. Overnight camp in Portland area, for ages 10 – 18. A huge formative part of both my older kids’ lives, not just their theatre skills. Love it!

Here are camps that my younger child has attended recently and enjoyed (most are camps my older kids also went to years ago.)

  • Studio East. (Also a huge part of our family’s history!) Theatre camps for ages 4 – 19, held at multiple locations in Kirkland. Kids spend a really fun week learning dance, music, lines, and more, and put on a show at the end of the week. Theatre education is great not just for learning theatre but also for social skills and teamwork. They really encourage creativity and include kids’ ideas in the experience.
  • Pacific Science Center camps. We’ve tried lots of science camps. PacSci’s are the best, I think, for science learning. They offer lots of themes, in multiple locations throughout King County. Staff is well-trained, and curriculum well-developed. PreK through grade 8. What I don’t love – they’re pretty indoors and pretty structured for a summer camp experience. And, all their camps for my son’s age (2-3 grade) are full day (either 8:45 – 3:30 or 8:45 – 4.) That’s simply more than my kid can handle. So, he tends to make it through Monday to Wednesday of a PacSci camp, starts melting down on Thursday and on Friday they ask me to take him home partway through the day. I love that they’re starting to note “sensory-friendly” camps on their schedule that are a better match for kids with autism or sensory issues. I wish they’d realize that a shorter schedule would also help.
  • Wilderness Awareness. Day camps for ages 4 – 13, overnights for 11 – 18. Day camps in Kenmore, Issaquah, Seattle, and Carnation. Nature games, story-telling, songs, hikes in the woods, animal tracking, and more.  Camp Terra at Cedarsong Nature School on Vashon is supposed to be fabulous, but we’ve not been able to attend yet.
  • Pedalheads. Because of my disability, I’m not able to teach my son to ride a bike, so I love having a bike camp option. They offer everything from 60 minute long camps for 2 – 3 year old beginning riders to full day camps for older kids with strong skills. Many parents experience that their kids start the week not knowing how to ride, and are riding independently by the end of the week. My son ended his first week still on training wheels, and in the one week he took the next year, he could just barely ride without training wheels. But he still had a great time both weeks. They also have a Heroheads sports camp he has taken twice and greatly enjoyed. (The photo at the top was taken there.)
  • Skyhawks offers many camps at many sites. Many are focused on a single sport, but I really like their multi-sports camp. Although we’re a physically active family, we don’t really play team sports, so I like that my son gets to spend a couple weeks each summer being trained in baseball, basketball, and soccer skills so that if a buddy on a playground asks him to play he at least has a clue.
  • Family Camp. With my older kids, we thought about attending a family camp, like the YMCA camps at Camp Orkila and Colman, or Cascades Camp, or North Cascades Institute. But, we never did. Then, four years ago, we started attending Eliot, a week-long family camp for Unitarian Universalists. Partway through that first week, I looked at my partner and said “I guess we know what we’ll be doing for one week every July from now on.” It is a joy to spend a week at camp, singing, tie-dyeing, dancing, listening to Harry Potter under a tree, swimming in the lagoon, and re-connecting with people we see every year at camp, who range in age from birth to 90-something. We love family camp!
  • Bellevue College Parent Education programs usually offer a few summer camps each summer for ages 3 – 5. These can be especially helpful for young ones who are just about to start drop-off preschool or kindergarten to get them used to being without you at class. This year, they’ll be offered at Pine Lake Coop preschool in Sammamish and Bellevue Overlake Coop. Details coming soon.

New Camp: Mercer Island is offering an Adventure Playground Camp for the first time this year. They’ve had a loosely supervised Adventure Playground the past few years (read about it at that link) so I look forward to my son trying out the camp!

Flexible Options:

  • Arena Sports – these win for most flexible camp option! 5 locations. Half day OR full day, with extended care options, for ages 3 – 12. They play soccer and active games, they play on the bounce house. As a friend once described an activity: “it sweats ’em up good.” We would attend these on weeks when we had plans on some days but had some free, and I wanted to have my child burn off some energy.
  • Steve & Kate’s Camp – It’s been held on the campus of Bellevue’s The Little School for many years (although they’re at different sites for 2019). The advantage is their flexibility. It’s a huge age range from pre-K to 7th grade. You don’t need to sign up in advance – once you’ve registered for the year, you just show up there in the morning, whenever you want to for as many days as you want to. And when kids are there, they have virtually complete freedom to choose from many different activities (film-making, bread-making, games, robotics, sewing). It’s a “free range” approach. Works great for many kids – I have a friend who says it’s an incredible opportunity for his daughter to learn skills and use her creativity! But for my kid, he basically sat in the “lounge” reading books or watched other kids programming on tablets. It was fine for days I needed child care, but it’s lot more expensive than Arena Sports.

We’ve also done various one-shot camps that were great but we never happened to return to. Like one year I visited friends in Portland for a week while my kids attended Do Jump circus camp. There were summers where my child’s interests of the moment led to Fashion Design or Nature Illustration camp. We  attended several camps sponsored by the zoo and our local parks departments. So, the ones listed here are just a sampling of what our family has done, but there are SO MANY MORE great options out there.

What have I missed? What other camps in King County have you had a good experience with? Add a comment below. (If possible, include with  your recommendation: what ages it’s for, where it’s located, and what you loved about it.)

And if you’d rather just spend time hanging out at parks with your kid, read my posts about local parks, or if you have a toddler too young for camp and need ideas for activities, check out cheap dates with toddlers.