Practical Autonomy-Based Tools for Families Stuck in Food Struggles - Restrictive Eating and Pathological Demand Avoidance Part 3| Ep. 160

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.