A Westchester Mom asks the question:
I have children with attention difficulties and because of this, I feel that their ability to detect hunger and fullness cues are dulled. Can this be taught?
Moms, Laura and Elyse respond:
All children, whether they have attention difficulties or not, can benefit from a quiet, calm and soothing environment that’s free of distractions, but it’s just as important to time all meals and snacks too. Here are a few tricks of the trade that can help teach your child how to recognize internal satiation cues over time.
Set the mood. Give your child a 5-minute warning that their meal will be served. Take this time to turn off any screens that may be on, and maybe turn on a little light, relaxing music in the background. The atmosphere can be a critical element as you begin to create a calming environment.
Take control. Because a hyperactive child may be impulsive, I recommend keeping the food on the counter or stovetop to prevent impulsive behaviors during the meal. Once your child is ready to eat, you can then go ahead and plate their food. It’s okay if your child requests seconds, but it’s a good idea to ask what their stomach feels like before going ahead and serving more. In other words, ask what their hunger or fullness level is before dishing out a second portion.
Hungry vs. Full. One good way to determine whether your child truly wants a second portion is to have them create a unique scale that allows them to express their hunger or fullness. Keep in mind that even adults may have difficulty determining the difference between hungry and full based on biological factors. A deficiency or resistance to the hormone leptin, for example, can impede on the ability to determine fullness. More research is needed to identify whether this holds true for children too, and if so, what the exact trigger is [1].
Create your scale. Try designing a child-friendly chart that ranges from 0 to 10—0 meaning starving and 10 being extremely full.
Let your child think up their own descriptions for the numbers 0, 3, 5, 7, and 10, but begin by asking them to describe what 0 and 10, or starving and stuffed—the most extreme sensations—feel like first, as these are most obvious. What does “extreme hunger,” or a 0, feel like? Is it dizzy? Is it crying? Is it sleepy? Is it a meltdown? Does your belly hurt? Are you nauseous or queasy? Then ask them to identify the opposite extreme. This would be overfull or stuffed and equal to a 10 on the scale. Does this mean belly pain? Belly sticking out? Nauseous? Want mommy to rub belly? Pants may be uncomfortable around their tummy? Not interested in eating more food? Can’t sit at table any longer? Can’t eat your favorite food if offered?
Each of these descriptions will differ slightly from one child to the next, but ultimately, it will help to jump-start this identification process, allowing them to both feel and recognize internal satiation cues. If it’s difficult for your child to verbalize their feelings, try using faces (happy, sad, etc.), stickers or pictures of children who appear happy, sad, angry, etc. to allow them to relate to the emotion.
Once extreme feelings are identified, then narrow it down by establishing what it means to be neutral, or not hungry and not full. This would be a 5 on their scale.
If your child is at a 5, but claims to still be hungry, then it’s appropriate to serve enough food to get them to a 7 on the scale. At that point, you probably wouldn’t need to serve an entire portion. (Of course, the amount will differ for each child, and individual parents can estimate and then let their child determine the rest.)
If your child responds that they are at a 7, explain to them that their body received all of the nutrition it needs for now, and they can have something to eat at the next meal or snack when their body is hungry again. (Remember, this all depends on your child’s personal scale. This may be a 3 for them.)
If your child asks for food in between meals or snacks, explain that food is only necessary when they are truly hungry, which may be when they feel like a 3 or higher (again, this may vary). The point is to teach them the difference between hunger and fullness, and while they should trust that you’ll serve them more when they are truly hungry, the scale will also allow them to identify whether they need more or not on their own.
Example of a H/F scale
10 = Belly Pain
7 = Comfortable fullness
5 = Neutral, can eat a little more
3 = Stomach growling, stomach empty, need to eat
0 = Starving
Institute a reward system. You can also consider offering a reward for positive behavior, for example, when your child sits nicely at the dinner table. The reward should be age specific, and consistency is key. This reward should not be food. The reward is not for eating but for sitting at the table. Never reward for eating or use food as a reward.
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One way to facilitate a reward system is to utilize tangible measurements of time, such as an hourglass. This can be placed before your child so they can monitor their behavior too. Start small, and work up to greater accomplishments. For the first week, if your child sits at the kitchen table for more than 10 minutes, regardless of what they did or did not eat, they would get a reward. At week 2, if the child sits at the table for 12 minutes, regardless of what they eat or how much, they would get a reward. Helpful Hint: The sand timer from Lakeshore Learning Center offers different time ranges from one minute to ten minutes.
Of course, all children—not just those with ADD or ADHD—have limited attention spans when it comes to sitting at the table. These strategic tactics are simply inspired by behavioral techniques utilized for children with special needs, though the goal is a common one: to ensure that your children get the nutrition they need.
- Aronne, LJ, Bowman A. The Skinny: On Losing Weight Without Being Hungry-The Ultimate Guide to Weight Loss Success. New York, NY: Crown Publishing Group; 2009.
