Eating and PDA Part 3: Practical Accommodations For Restrictive Eating

If you've heard me talk about autonomy, equality, and lowering demands before and thought, "But what does that actually look like at the dinner table?" — this episode is for you.

This is the third episode in my series on eating and PDA, and it's the most practical one yet. I'm walking you through six concrete accommodations you can experiment with if your PDA child or teen struggles with restrictive eating: autonomy, equality, lowering demands, sensory accommodations, strewing, and novelty and dopamine. Throughout the episode, I share anonymized client anecdotes and real examples from my own life as a mother of two PDA sons — including how our family navigated mealtimes during the hardest years and what things look like now.

This episode is meant to be an experiment you can try out and observe, not a prescription. I hope it it's helpful for you.

Key Takeaways

Why Restrictive Eating Happens | 00:00:00 Before getting into the practical tips, I revisit the causal logic for why eating is so often impacted in PDA children and teens. Control around eating tends to be the outcome of cumulative nervous system stress, and is often an attempt to reset autonomy and equality when a child can't find it in other areas of their life.

Autonomy Around What, Where, When, How, and If | 00:03:43 I break down autonomy into five buckets — what, where, when, how, and if a child eats — and explain how each one shows up in practice. This includes examples from my own home, like allowing my son to eat in front of a screen for years, delivering food on demand, offering a buffet of options, and giving treats before or with meals without attaching conditions.

Equality and Why It Matters at the Table | 00:22:41 I walk through what I mean by equality as a nervous system accommodation around food — not as a philosophical concept, but as something you can observe and act on. I share the story of how our family friend houseguests helped re-establish family dinners, and how my son Cooper started joining us at the table by running a drawing game where he was the judge and ranked all of us — an equality accommodation I sustained for about a year.

Lowering Demands and the Sensory Intersection | 00:27:56 I explain what lowering demands actually means in the context of eating: doing things for your child they could technically do themselves, in service of helping them access food. I share examples like packing a 16-year-old's lunch, delivering pizza reheated to the exact right temperature, cutting crusts off bread, and wiping out Tupperware to eliminate even a molecule of moisture.

Strewing, Novelty, and Dopamine | 00:35:51 I cover strewing — leaving food out without expectation — and why it works differently from direct offerings. I also share how we used novelty and dopamine in my son's feeding therapy, including a "game show" approach to sampling every variety of apple, and cutting apples into stars or making apple pasta with a Zoodler. I end with my hypothesis about why PDA individuals tend to seek dopamine, and what that means for how we can think about introducing foods.

Relevant Resources

What Is PDA — Background on PDA as a nervous system disability

Understanding PDA — Deeper dive into PDA frameworks and accommodations

Paradigm Shift Program — Our signature live coaching program where we walk with families as they implement accommodations and move their family forward.

Full Transcript

[00:00:00] How many times have you heard about pathological demand avoidance and autonomy and the need for equality and lowering demands and thought to yourself, how do I actually do this? Well, in today's episode, which is the third in a series about eating and PDA, I am gonna give you practical tools and examples from my own life and some anonymized client anecdotes around how to actually accommodate your PDA child or teen if they have struggles with restrictive eating. So as always, I wanna introduce this as not a dogma or the right way to do things, but rather potentially the right fit for your unique child and family. So I want you to approach these ideas as an experiment that you can commit to and try consistently for a few weeks or maybe a couple months, and then observe what shifts in the relationship with your child. Do you feel more connected? Do they seem more engaged? Do things seem to be improving? Second, how is their nervous system activation? Are meltdowns increasing or reducing? Are we having less or more shutdown episodes? And then finally, how is their access to basic needs? So in this particular episode, we're talking about eating as a basic need. And before we will and before we get into the practical tips, I wanna just remind us of the causal logic for why eating is so impacted because it's important to understand that the practical tips I'm gonna give you are very much in the moment of eating.

[00:01:52] What we can change in our behavior as parents to facilitate eating and support our children staying in the thinking brain and not having a nervous system response to eating. But to really shift eating as a basic need, especially if it's a sticky basic need, meaning it's the one that they struggle with the most versus, you know, toileting, sleep, hygiene, safety. We want to remember that control around eating, especially restrictive eating, is going to be the outcome of cumulative nervous system stress that is putting your child or teen past their threshold of tolerance, and they're trying to reset their, like, autonomy and equality in their nervous system. This is a subconscious drive, but you're gonna see it, the control coalesce around a basic need when they're at the point where they can't necessarily find autonomy in other spaces of their life. So as we're exploring these in the moment techniques today, I wanna invite you to also go back to the first two episodes in this series to reflect on more of the logic behind why. Okay. So practical tips. Let's get started. So I am gonna talk about six practical ways that we can accommodate our children's threat response around eating and give you examples. So first, we're gonna talk about autonomy. Then we're gonna talk about equality. Then we're gonna talk about lowering demands and what that means, as well as the intersection of sensory aversion and lowering demands.

[00:03:43] Then we're gonna talk about strewing or making offerings, and we'll wrap it up with ideas for introducing novelty, dopamine heavy potential foods or presentations of foods, and sensory intense experiences which can be regulating to a PDA child or teen. And then I will finish up with validation and some mindset work because I know that all of this is not gonna feel easy and you're gonna be thinking as I'm talking, which I would have seven years ago, oh my gosh, I can't believe she's actually suggesting this. Doesn't she understand that this goes against the conventional wisdom? Doesn't she understand that if for example, I'm delivering food to my child all day, there's crumbs everywhere, it's more work for me as a mom, etcetera. I understand all of that. I have been through it as a mother and I know this isn't easy, but I'm delivering these ideas to support you get getting unstuck because I know that many families get in an entrenched situation where they really can't make progress with a PDA child. Alright. Let's start with autonomy. So first, we wanna define what that is. Autonomy means that your child's subconscious perception, meaning they might not be aware of it, but what their amygdala is telling them is that they have freedom, choice, and ability to really decide around something. Okay? So that's what we mean by autonomy because remember, the way that I define PDA is a survival drive for autonomy and equality.

[00:05:24] Okay? So that's the lens through which we're understanding why these kids are getting so activated, why they're avoiding food, why they're controlling the intake of food, etcetera. Okay. So, you know, as a mother, if someone seven years ago had been like, provide your son with more autonomy, I'd be like, what the f does that mean? Right? So one thing that can be helpful is breaking it down into buckets. So I want you to think about autonomy in terms of allowing your child to have freedom, choice, and autonomy around what they eat, where they eat, when they eat, how they eat, and potentially, if they eat. Right? And that's gonna intersect with the first part of the autonomy. So what do I mean by the what piece? Like, does this mean that we just allow our children to only eat sugar all day and never provide them or force them to eat healthy food? So I'm gonna be totally candid here that some of the families that I'm speaking with, if they have a PDA child who is deep in burnout with restrictive eating and eating as their stickiest basic need, they may be observing that the majority of what their child is willing to eat is like popsicles and chips. So there's absolutely no judgment here, but there's obviously variation. So here's how we wanna think about what. So according to responsive feeding, and I'll cite this in the show notes, One of the ways that we can think about our role with kids and teens and eating is that we provide the food, so what's on their plate.

[00:07:10] We decide what's on their plate. We decide, like, how much is on their plate, and we decide when it's being set out for them, and often in what location. Right? So this is a really cool way of doing things and for a lot of kids, just having that division of roles where the parent decides those things and then the child decides what and how much they eat. Right? So that can be a very, supportive and scaffolded way where we're dividing the roles between parent and child and there is some autonomy baked in. However, it's often not enough for a PDA child because of this survival drive for autonomy or a PDA teen. So I wanna give you some examples of how what I'm saying differs from this role based logic. So let's say I'm sort of in the mindset or working with a therapist around responsive feeding or like I did with my son, which we use the SOS feeding protocol to help him through a sensory lens. And that would mean, like, I would decide to put out preferred foods and maybe some, like, trying foods like a raspberry or a piece of spinach. And I'd have a bowl that he could spit it into if he got, you know, a sensory aversion.

[00:08:34] And I would offer three meals and three snacks at particular times, but outside of what I was offering him, he was not gonna be offered more in between those snacks or those meals. He was not gonna be offered a whole another plate of things I hadn't already prepared, which unfortunately for my son, a PDAer, actually didn't work. So with my son, I had to get to the point where I wasn't just setting food out. So for my son, I had to get to the point where I wasn't only wed to these times of day or these particular amounts of food that I had eaten and then restricting if I would bring more to him. Right? So let's say, you know, I put out toast with peanut butter, I put out a dum dum, and I put out some Lay's potato chips, and he said to me, I don't want this. Right? With us with a responsive feeding or a role based feeding protocol, we would say, okay. You're welcome not to eat. But for a PDA child, that can register as like, mom is in the position of the decider. She is above me, and I don't have autonomy around this eating, and therefore, I'm gonna have a nervous system activation which is gonna make it harder for me to eat and there will be more control and fixation. So as hard as it is, now and with my younger son in burnout, I will say, I'm happy to make something else.

[00:10:00] What about this? And I offer something using declarative language. And I know this is a lot more work on the parent, but when you have a child who is not eating, you're willing to view this as an accommodation. So some examples of autonomy around what is just thinking outside of the box in terms of, like, can you give them a full buffet of options? So for example, like with my younger son, I'll do like, file Greek yogurt with honey on it. We'll do some veggie straws. We'll do some mandarin oranges, and I might also put a popsicle on his plate. And he might only eat the popsicle and the yogurt, and that's fine. But if he asks me twenty minutes later for a snack, I'm not gonna go back to, like, I already gave you this snack or you already had your meal, now you have to wait for the next time. Okay? And if he asks for something that's outside of what I have provided, I give him autonomy around what he is eating. Okay? So this is an accommodation that goes deeper than the role based feeding. Okay? And you have to be discerning as the parent or as the therapist, like, is this a child with a degree of threat around autonomy that's so strong that even these cool therapeutic protocols that work for most children, even neurodivergent children, might not work for a PDAer.

[00:11:40] So other counterintuitive things that we do, sometimes I'll give either of my boys like dessert with their meal and they get to decide like, okay, I'm gonna eat dessert first and that's fine. I might also let them have a treat before the meal time to give them some dopamine and some autonomy around what they're eating. Also, putting them in a position where they feel above societal expectations of like, we don't actually eat ice cream for breakfast, but they get to feel above that expectation and me and it lowers the threat response so that paradoxically, they can actually eat the actual meal I'm giving them. Okay? So that's autonomy around what. Now, where they eat. This is another one. You know, as we started the the SOS feeding protocol, we were really trying to sort of train my son to eat at the table and we wanted to establish that as a norm. We wanted to develop frustration tolerance around it. But the more we did that, the more he would refuse eating and the worse it got. So we started exploring the where of autonomy. So this might look like your child eats in front of a screen always for the time being. Right? And that's gonna be jarring for some of you to hear. My son spent years eating most of his meals in front of a screen.

[00:13:11] Now he sometimes comes to the dinner table and joins us, but for him, because it was such an intense experience and he would like gag and he had some trauma around it because I had like doubled down on more traditional ways of making him eat, he needed to reduce the sensory intensity of the eating experience. So when he was eating, he would be distracted by having this screen that he had autonomy over to like watch whatever he wanted. It would lower his threat response and he would be able to eat more than if he weren't on a screen. So this is an empirical question, meaning you have to observe the data in your own home rather than taking, like, what I'm saying as the gospel truth. Right? So for some families I've worked with, their children eat less when they're on a screen and they've observed that and they know that their kid gets more dysregulated. So we want to also be in our own agency and our own critical thinking of like, is this a tool that's facilitating eating or is it not? Other other ways we can give autonomy around eating is where the child eats. So can they eat in their bed? Can they eat in the car if they're having trouble eating most of the time? Can they eat where while they're walking around the home? Obviously, not like jumping and crashing and going on the trampoline because we don't want choking.

[00:14:46] But can we introduce movement that might not feel intuitive for us as parents? Can we let them eat ice cream in the bathtub to sort of like break up this power struggle that we have going on around food? So again, this is examples, ideas to experiment with and observe whether or not it helps. Okay. So the next autonomy accommodation would be when. When your child eats. So this is a big one. Right? Like, for most of us, and for me for a long time, even after I realized my son was neurodivergent, I didn't know he was PDA, I was still holding on to, like, I get to decide when you eat. We're not just gonna eat whenever. We're not just gonna eat wherever. You can't just, like, ask me for snacks every five minutes and have me delivering them. But because of how bad my son's eating got, we had to explore this. So can we drop this idea that eating has to happen on a schedule? Can we drop this idea that eating has to happen at three square meals and two snacks and they have to be at these particular times and we might even be setting a timer. What does that do? That activates their threat perception because they don't have autonomy around it. They don't get to decide when they're eating. So, you know, if you did breastfeeding, which I did for a year with Cooper and I did for almost a year with William, you might remember the debate around, like, scheduled feeding versus on demand feeding.

[00:16:30] Right? And for me, I didn't really have the capacity to make any informed decisions based on the debate. I was just in survival mode and Cooper ate constantly because it was a way he regulated himself. And you see this pattern later in life, even if they're teens, there is an oral regulation component where they might be wanting to eat snacks that are crunchy all the time as a form of getting dopamine and regulation. So like, your child or teen might always wanna be eating, for example, Hot Cheetos or Doritos or maybe even an adult in your life who you think is PDA. They might, you know, have Snicker bars all the time at random moments. They might have ice cream for dinner themselves and you've always just thought, oh, that's kind of quirky, but whatever. They're an adult. So this is an example of them eating whatever they want, wherever they want, whenever they want. And it's harder for us to wrap our minds around this with kids, but something to experiment with is allowing your child to eat on demand and not trying to force them into a structure. And yes, I know this is annoying. I know it's frustrating. I know it makes your house more messy, But again, these are things we're doing for a season, especially if your child's in burnout or if they have eating as their stickiest basic need.

[00:18:05] Okay? So how? How is like the delivery mechanism of the food into their mouth? Can we give them more autonomy around this? This is something that you might not think about, but when we're correcting like, hey, don't use your hands or hey, why are you using your fork like that or why are you eating with a chopstick and stabbing your food. Right? Like, we observe these things and we think, well, I need to correct that or they're never gonna learn it, but if the goal is eating, then we have to drop that and give them autonomy around how they eat. So both my boys, when, you know, they're out and about in the world, they're 11 and seven, they're perfectly capable of using utensils. They're perfectly capable of sitting down and having a meal, often without their iPad. Like, they are capable. However, in the home, I don't harp on using utensils or not stabbing things with chopsticks because the goal is eating. Right? And as parents, we have to get out of this mindset of like, but how will I train them to eat appropriately and according to etiquette in public? But remember, we're just trying to lower the threat response so they can access this basic need. We're treating it as an accommodation for a nervous system disability. Albeit fluctuating, but one that does disable our children and teens from accessing what they need to stay alive, like food.

[00:19:41] Okay. So other ways we can think about this. I've worked with families who have had to deliver nutrition through, like, smoothies and sippy cups, had to deliver milk in heated up baby bottles, like, past toddler land. So we're talking seven, eight, nine. It doesn't matter the age because the purpose is allowing them autonomy around how they get their nutrition and hydration. So you can ask yourself, you know, are you beating yourself up because your seven year old or your nine year old still uses a sippy cup but it seems to be the only way to get constant hydration in them and they don't use it outside of the house or at school. Who cares? It's okay. Like, they're eventually gonna move on or they won't. And, like, if it helps them eat, it's okay. If it helps them drink, it's okay. Okay. Can they use their hands to eat if that's easier? Now, the if they eat, we sort of spoke about that within the what category of autonomy, but we actually can't control if other people eat. Like, I know that there are therapeutic protocols like family based therapy for anorexia. I know that there are things we can do, but ultimately, unless you are putting in a feeding tube, like, you cannot force someone to swallow and digest food. You can't. Just like you can't force someone to sleep unless you medicate them.

[00:21:19] Right? Like, giving them something to make them fall asleep. So, you know, I wanna use caution when I'm framing this as a like accommodation because ultimately, you're gonna know if your child's control is coalescing around eating and they're exerting autonomy around the if of eating. And we don't wanna get to that point. We don't wanna be at the point where we're exploring hospitalizations or partial hospitalization programs or feeding tubes, which some of our clients have done. And some have been successful and some have it's backfired. Right? So these are ideas that are providing another pathway that might not have been laid out to you as an option. Okay? So let's talk about equality as the second accommodation that we wanna consider. So what do I mean by equality? When we hear the word equality, we often think of like philosophy or normative things, like it's good or bad. But I want you to just think about it like operationally. Like, does my child feel equal to or above me? Does my child feel equal to or above others in their life? And often, especially with young children, but also with teens, they're moving through life feeling below others. Their teachers, the kid who's gifted at sports and they're not, the most popular kid, the one who, you know, runs faster on the playground, their sibling who's getting more attention for whatever reason, below you because you have more power, stature, and authority in deciding for them.

[00:23:00] Right? So it's intersecting in the equality sphere. Why does this matter? Because when they perceive that you are above them or that someone else is above them or even that a societal rule is above them, their survival brain will tell them, you are not safe and I'm going to activate your nervous system including the physiology of it. So cortisol, adrenaline, blood rushing to the extremities if we're gonna have to fight or flee, you know, tunnel vision. Potentially, we're gonna have heart racing. We might have face flushed from all of this blood rushing to the extremities. All of this is happening on the inside. Right? So we want to preempt or prevent or even offset this activation. So I wanna give you an example that played out in the most tedious way in my own life when Cooper was finally exploring, like, us again at the dinner table. So this was probably he was probably like seven, eight, probably like seven. And we had some family friends living with us from Columbia, South America. I've met them during my field research, during my doctorate, and they these two women in their early fifties lived with us for six months to try and help me like get back on my feet because I was so burned out, distressed, couldn't really function. And so they would help make the meal and set the table and so the expectation would be like, we are gonna create the rhythm of a family dinner even if Cooper sits on the couch or goes upstairs to his room and is on his iPad.

[00:24:59] So we would do this consistently and I was able to do this because I had other women helping me And one of the things we noticed is that Cooper would always come to the table with his iPad and eat with us and he started looking up these YouTube videos that teach you how to draw and, like, you fold the paper and then when the paper opens, looks like a mouth to the whatever, like, or robot that you're drawing. And so he would get the crayons and the oil pastels and all the paper and a timer, and he would hand it out to all of us. And he would set the video on so we could all watch the tutorial, and we would have to each of us draw our own version. Then he would walk around ranking and judging us. Okay? As like, as the judge, as the decider, as the one who is above us. Right? So he's feeling safe in his nervous system because we're allowing him to do this really annoying equality accommodation because like at the end of the day, what do I want? I wanna sit with my husband and my friends, maybe my mother-in-law. I wanna eat a good meal and I wanna talk about adult things.

[00:26:17] Like, I don't wanna be watching a YouTube video and practicing my, like, fine motor skills and then having someone tell me I suck at drawing. Like, obviously, I don't wanna do that but I did it for like a year because it was helping him access the family meal and helping him access eating and he was so happy and it facilitated connection and now he's 11 and he doesn't do it at all, but this is this like natural tendency, which can feel like them trying to control you, but they're trying to exert this equality accommodation. So the reflection for you would be how can I make my child or teen feel above me or above someone or something else with respect to eating? Maybe you emphasize the fact that like, they're a better cook than you if they're older and cook their own food. You can use self deprecating humor. If they really like something, you make sure they have the most of it and you emphasize that they get more dessert than you do. Right? So we're just giving opportunities to reset the nervous system so they're not in that threat response. Okay. Let's move on to accommodation number three, which is lowering demands. Now, there are many versions of lowering demands in the internet sphere or on social media and I'm just gonna, as I always do, define what I mean by lowering demands so that you can operationalize it in your home.

[00:27:56] Meaning, you can actually do it. You know, like, what to do, how to move your body, what your behavior is. So lowering demands are doing something for your child or teen that they can physically do for themselves, that they can cognitively do for themselves, or developmentally do for themselves in another moment. So what does that mean? So let's say you have a teen and you absolutely know that they can cognitively and physically pack their own lunch, right, for school the next day. They they have the executive functioning. You've seen them do it before. They have strong preferences, so you're like, dude, if you want that stuff in your meal, make it for yourself. Right? Or they don't wanna eat what you're eating, so you tell the teen, great. Why don't you make it for yourself? So those are both losses of autonomy when you're telling them to do that and demands on their nervous system. So how would we lower the demand around eating for this teen? If you're capable of it, if you're physically and cognitively capable yourself, you would make their meal for them, even though they can do it themselves. That would be a lower demand. You could pack their lunch for them, even if they're 16 and they can do it themselves. Right? This is an accommodation so that they can eat, so that they can access school.

[00:29:27] A very common lower demand that we do in our home is, especially when my son has come home from a long day at school, he sits on the couch and he's like, I want hot Cheetos, water, and I want granny bread, which is like what his grandmother makes him. I toast it. I put peanut butter on it. I cut off the corners and I deliver it. Super lower demand. He can totally do it himself. I've watched him do it. His legs work. It's fine. But I'm mindfully choosing to lower this demand because I know that it's not worth the cost to his nervous system or his eating of trying to make him do it. He's also used up a lot of his nervous system activation at school. Right? So other examples are, you know, in the morning when I wake up. Again, my ideal and what I did as a child was I poured myself cereal. I went to the refrigerator. I got out the milk. I poured myself milk over the cereal. I got my own spoon. I ate my own meal, and then I delivered the empty bowl into the kitchen sink. Okay? I do all of those things barring actually putting the spoon into the mouth of my children, which in the past with my son, Cooper, I did do of, like, putting food onto a spoon and delivering it into his mouth because that's how much he couldn't access eating.

[00:31:00] Right? So, you know, if you're stuck in this place where they're just not making progress, we have to lower as many demands as possible in service of accessing the basic need. So delivering food on command is a big one. Pairing food, reheating food. So now we're getting into some of the sensory intersection with lowering demands. Right? So let me give you an example. My sons really like Jet's Pizza here in Michigan and we get from Jet's Pizza. We have the same order every time. A round pepperoni cheese pizza with no sauce and light cheese. Okay? And they make it for us just like that, and then it gets delivered and it's hot and it smells good, and within five minutes, it's not hot anymore. And so what do I have to do with every piece of pizza? I heat it up. Okay? And I deliver it to my kids. Now, when my older son is out with friends or at a school event or a birthday party and there's pizza, he, you know, takes off the sauce on his own. He doesn't eat it piping hot every time because he wants to fit in with other kids, but when he's home, I accommodate that. And now that he's older and he has a bigger threshold of tolerance and my husband and I might be eating, we might set a boundary which looks like, hey, bud. I can get that for you in five minutes after I finish my pizza piece, but if you want it right now, you can grab it yourself and heat it up.

[00:32:41] Right? So that's what a boundary around that looks like. However, I don't like to introduce talk of boundaries when I'm trying to shift your total way of thinking and paradigm about how you're even thinking about eating and your PDA child. First, we have to, like, change the paradigm, and then we can set boundaries once we've like reestablished the relationship and gotten our kids out of burnout, gotten their basic needs, accessed again, etc. Okay. So another sensory need is cutting off the crust of all bread. So my kids have very specific sensory preferences around bread. They only eat their grandmother's homemade bread and we are blessed with her presence in our small town and her ability to deliver six fresh loaves of bread every week. We freeze some of them. But every day, I make the peanut butter sandwich for my son to go to school. I cut off the crust for toast for both of them. Is it annoying? Yes. It is. Does it facilitate eating? Yes. It does. Okay. So I want you to hear this and think about like what are ways that I'm resisting lowering these demands because it's hard and I feel like they shouldn't need that. But remember, they're neurodivergent, they have a fluctuating nervous system disability, and their sensory experience is also gonna be intersecting with how much threat they're perceiving.

[00:34:18] Right? So the more cumulative stress, the more deep in burnout, the more hard their day is or the hard their moment is if you're having a power struggle around food, it's gonna amplify the sensory. Right? So, you know, with the heating up the pizza example, my son, if he's in a good space, might be able to eat the pizza without it being piping hot. But if he's had a really hard week or a hard interaction with like me or his dad, in order to eat, he might need it to be exactly the right temperature. Temperature. And yes, this does pose challenges for him eating at school. Other things like I have to wipe out Tupperware or plates that we're using to make sure there is not even a molecule of moisture that is gonna be getting onto crunchy things or onto bread. Because if there is anything like that, neither of my children will eat it and will react with disgust. More so with Cooper than with William, but both of them have that sensory experience and with like fruit. Like, one of the things I do to prepare apples when I'm slicing them, like I have to make sure there's nothing mealy, that it's the exact right texture. I have to make sure that we're actually delivering the food in a way that's not gonna just be rejected or avoided because of the sensory.

[00:35:51] And yes, that puts more demands on us as parents, but again, this is also a way of facilitating exposure or increasing frustration tolerance because right now, for many of you, it's so low. Their ability to interact with food that even like doing all this stuff to make the perfect pizza delivery is is actually exposure. Because in another moment in time or if they keep getting worse, they might not be able to like even be near the pizza. Okay? So we wanna start thinking about this differently. Accommodation number four, strewing. Now, if you have a PDA child or teen who has eating as a sticky basic need or, you know, they just have picky eating or sometimes control coalesces around eating, you might have noticed a pattern where like whenever you prepare something for yourself, like let's say you made yourself nachos with like care and cilantro and maybe some radishes and you put on the hot sauce and it's like perfect. It's exactly where you want it to be to eat these nachos. And one of your kids who like won't eat anything or your PDA kid or teen comes over and is like, can I have that? And you're like, what? Like, what are you talking about? You don't like anything on this plate, but they like wanna try it. Right? Or you might see that they're around other children or they're friends if they're a teen and, you know, they won't go within 10 feet of a hamburger and then you like are at a barbecue and they're having front fun with another kid or another teen and you see them like chowing down on a burger.

[00:37:36] That is the logic of PDA and can be sort of bottled up as an accommodation. So what's happening? In these moments, there is full autonomy and no expectation that they eat the thing Because you're preparing it for yourself or other children are eating it or their friends are eating it. So there's no demand, there's no pressure, no expectation. However, there is also a visual cue and a sensory cue that it is available. Right? So it means they might not have had the idea and if someone else had introduced the idea, their brain would reject it because that's a demand or a loss of autonomy. However, because you're eating it and you actually don't want them to eat your nachos, they're gonna have neuroceptive safety around it and they're also gonna have the ability to stay in their rational brain and process like, oh, that kinda smells good. Oh, that hot sauce kinda smells like my Hot Cheetos. Right? They can actually process it without having this huge avoidance. So this is why we do strewing. So strewing is leaving out or offering food in areas where we're not like imposing this big expectation on it, but we're leaving it out so they can see it.

[00:39:05] So this might mean like, if your kid likes veggie straws, putting what they're like avoiding eating them, You can just set a bowl between you and the child and start crunching on them and see if they want some. Or this is the strew that I was talking about when we were eating with our friends at the dinner table. We didn't ask my son to come sit or join us. He just saw that this is what was happening without the expectation that he join. Right? So we can do things like if you have a teen who won't leave their room, or is getting up in the morning and not eating before school. It could be you're just preparing a buffet of all the options that they like and you're leaving it there outside their bedroom door or on the table for them without saying anything, and especially not saying anything if they don't eat it. Right? You wanna repeatedly offer it so that it's just there. Okay? So that's what I mean by strewing. Another way that this works is when you feel like nothing you're doing is working to support eating, focus on your own eating. Focus on your own cooking and try and find some enjoyment in like, okay, my kids won't eat, but my husband and I really like making this particular soup. So we're gonna like make the soup. Right? And so what my husband and I have found is that when we do this, the kids come over, they want they're interested in like cutting up the carrots or peeling the carrots because it's a strew.

[00:40:47] We're involved. It's available, but there's no pressure. Okay? So those are the strewing accommodations. So the fifth and final is introducing novelty dopamine and sensory intense experiences to eating. So let me give you an example from my own life. When my son was doing successful feeding therapy with his occupational therapist, after we had dropped the SOS feeding protocol, but we're really just focusing on the sensory play and exposure to food with full autonomy. He would like to do things like, okay, let's get an apple. Like every type of apple from the grocery store, like Macintosh, Gala, Gala, Fuji, Cosmic Crisp, Granny Smith, all the different types of apples, and we would bring them to the occupational therapy clinic, and we'd, like, pretend we were on a game show and and, like, pretend like we were sampling these apples. Like, which one is best? Like, as if we're food critics. Right? And that's actually the way we discovered that my son really liked the texture and taste of cosmic crisp apples. But by introducing, like, some playfulness and some new opportunities to explore other types of apples, we were introducing novelty and dopamine and a sensory intense experience. Right? Where, you know, one might be really sour, one might be really crunchy, and that is regulating to a PDA child or teen.

[00:42:27] So even within the cosmic crisp apple category, we would try and introduce novelty and to produce more dopamine for him by, like, using a Zoodler to make almost like pasta out of the apple that he could eat. We would cut the apple into stars. We would cut it into different shapes, just so he would continually have a little bit of novelty around the things he was eating. So, you know, parents have done all sorts of things where they've like done, you know, fancy cups to drink the milk out of or they've had picnics or done different designs for the food made. My mom loves to bring over, you know, themed things that you can make out of, like, rice crispy treats for Halloween and rice crispy treats for Easter and, of course, having the dopamine of, like, sweets included. Right? So my hypothesis about why PDA individuals, not just kids, PDA children, teens, and adults seek dopamine. One reason is that many are ADHD, but the other reason is that I think the core component of PDA, which is nervous system based, is that they constantly feel discomfort or pain in their body and dopamine distracts from that. So that's why we see gravitating towards screens, buying things on Amazon and sugar. Because it's like a hit of dopamine that distracts from the discomfort in the body. So, you know, we can, to the extent we feel comfortable with this, lean into this and allow a little bit more ice cream, a little bit more dum dums throughout the day, a little bit more like fun, especially if we're trying to break through a power struggle that has become entrenched around food.

[00:44:26] So, a couple mindsets that we have to work through as parents when we are experimenting with this different paradigm around food. So first, you're gonna be wasting a lot of food and that's really hard. Right? And it's mentally very hard. It's financially very hard. One of the ways that we try and mitigate this is really small portions because I know that often, you know, something might get thrown out or not used. The dog will slobber on it. The dirty hands will touch it, but not eat it and then we'll have to throw it out. So, you know, I've had to do a lot of mindset work around guilt and shame that I feel for being wasteful. We do now have an in kitchen digital composter called The Mill, which makes me feel so much better because we like feed chickens and offset stuff going to the dump. But, you know, I really had to shift my mindset to, like, my son has a disability and I'm doing the best I can. Right? So that I wouldn't constantly feel guilty about, like, oh my god, Casey, you have so much privilege and here you are like buying these foods that your kids are not gonna eat.

[00:45:41] But it requires experimentation and that novelty piece does make a difference. And like, if you are parenting a PDA child, you know that like, unlike maybe your friends who have autistic kids that are not PDA, like, you will go all in at Costco on buying like a 100 bags of the Cheetos that your kid likes and then they will just drop it. Right? And then they move on to the next thing and they'll only eat that and it's like as soon as you start buying in bulk to save money, they're like, nope. Never gonna eat that again. Right? So, you know, go easy on yourself. Remember, this is not a behavioral disorder. This is something that is being driven by their nervous system. You know, I think that one of the main mindset blocks that comes up all the time for me and for other parents is, if I don't make them do this now, they'll never learn. If I don't teach them to cook now, they'll never learn to cook. If I don't make them eat a variety of things, or if I don't teach them to tolerate me making a smoothie in the kitchen, now how will they tolerate it as an adult? So we really wanna get out of that mindset and focus on the now. And I know because I now have seven years of experience as a mom, but also over five years working with families on this.

[00:47:06] They do learn to cook. They do learn to eat. It's just on their own terms and it's not linear. Right? Like, my older son now often brings us breakfast in bed and he like scrambles eggs and makes my coffee and cuts up apples and makes toast for us and it's so sweet and they are the most disgusting eggs I've ever tasted and the whole entire kitchen is a mess. However, he's learning. Right? And so I don't give him feedback unless it's solicited And every time, it improves a little and he's getting more confident. Right? And this is from a kid who like I never thought would learn to cook because anytime I was like, hey bud, do you wanna cook with mama? Let's make cookies. Let's make bread together. It was like, no. I'm not gonna do that. Right? Demand avoidance or I'm gonna equalize because I don't have autonomy and you're pressuring me. So, you know, if you're a parent with a PDA child or teen, you know this. You felt it in your body and observed it in your home. But when we take a different approach focused on the nervous system and autonomy, we really give them the space to experiment and expand their frustration tolerance and introduce exposure on their own terms. Right? Remember the strewing example with the nachos. That's exposure.

[00:48:34] Right? But it wasn't me exposing my child intentionally with a goal in mind. It was just an offering, a strew, because I was doing it and then the child chose to expose themselves to a new food on their nervous system timeline, on their trust timeline, which is gonna take longer than what you want and it's not gonna be linear and you're gonna question yourself and it's all okay. Okay? So finally, I wanna end this one by reminding us all, we are raising children with a fluctuating nervous system disability. It's complex. It's not well understood and it does disable your children. So, think of all the things I said as accommodations, not behavioral strategies to change their behavior over the short term. And then the last reframe I want to leave you with is the reminder that you're not just parenting, you're providing care and caregiving to a neurodivergent child. So try and stop comparing yourself to people who are just parenting. Okay? You're a caregiver and a parent. And the caregiver aspect is what we just went through in this episode. And it's a lot of work and your friends aren't gonna be doing it and it can have a profound positive impact on both your child and your life because you will stop these constant struggles around eating that don't get anywhere. Alright, my friends. I am glad we got to chat about eating. I will record our final episode in this series around feeding autonomy and PDA in an occupational therapy setting. Alright. Have a good week, everyone. Bye.

Topics Covered

PDA and eating
restrictive eating PDA
pathological demand avoidance food
autonomy and eating PDA
PDA child won't eat
PDA restrictive eating accommodations
lowering demands around food
equality accommodation PDA
strewing food PDA
novelty and dopamine PDA eating
sensory aversion food PDA
responsive feeding PDA
SOS feeding protocol PDA
PDA burnout and eating
feeding therapy PDA child
PDA teen restrictive eating
nervous system disability eating
PDA parent tips food
picky eating PDA
PDA mealtimes