Help! I have a Picky Eater!

Dealing with a picky eater can be stressful and frustrating, but we’re here to help! Diesje Hiltmann, one of our incredible occupational therapists, specializes in feeding difficulties and has some helpful tips.

Have you ever thought: “Why can you just not eat what we all eat!” or “I’m tired of making different meals for everyone!!

Guess what: You’re So Not Alone

The likelihood of having a picky eater in your house is high. Statistics show that 40% of typically developing children and 80% of children with disabilities have some form of feeding difficulty ranging from being a mild picky eater to more severe feeding difficulties resulting in malnutrition. This isn’t due to poor parenting, although parents often have the tendency to feel like failures.  Rest assured that you’re not failing to take care of your child’s nutritional needs, but there’s a chance that your child may have some underlying sensory-motor difficulties that prevent them from managing certain foods.

Check out this great website I found that does a great job at answering a lot of questions we’ve all had about our kids and their eating habits…and if you still have any questions or concerns, give us a call at Canoe and ask to speak with your favorite feeding expert, Diesje.  Yep, that’s me!!

If you are interested in occupational therapy for your child or any of our other services, please don’t hesitate to contact our Burlington therapy center. 

Strategies for Transitions

We’re always excited to share posts from members of our pediatric therapy team. This post comes from Haley Payne, our very talented Behaviour Consultant and head of our Behaviour Therapy team.

Any parent can agree that at one point or another their child has had difficulty transitioning between activities, routines or events. Often, children can struggle with transitions whether they are small daily events (e.g. from a preferred activity to a less preferred activity) or larger transitions (moving, changing schools etc.) Often, children on the spectrum or those with other developmental disabilities have an especially difficult time with what can appear to be the smallest transition. This may  be a reflection of a need for predictability (Flannery & Horner,1994), or due to difficulty in comprehending what is happening next (Mesibov, Shea, & Schopler, 2005). Fortunately, there are many techniques and tools that can be used to help children transition more appropriately, independently and consistently.

Explanations and Language

  • Use concrete language and simple sentences to explain what is going to happen next. Try not to add more language or details than necessary.
  • Prime your child before the transition, using language they will understand.

Count Downs and Transitional Cues

  • Giving warnings can help children anticipate transitions before they occur. Giving warnings about how many minutes are left for an activity and using a 5 second countdown can help children anticipate the end of an activity.
  • Each child will differ in the number of warnings they will need but these warnings can usually be reduced as the child experiences successful transitions.


  • Timers can be a useful tool for helping children transition, especially visual timers which allow children to see how much more time they have before an activity will end.
  • Kitchen timers, digital timers and Time Timers are all suitable options for helping children understand when a transition will occur.

Schedules, visual

  • Visual schedules are an important tool for many children on the autism spectrum, however children who are not on the spectrum can also benefit from schedules which use pictures of activities to indicate what will happen next.
  • Visual schedules are especially helpful for children who like to know exactly what events will occur each day and they have been shown to reduce transition times and negative behaviours associated with transitions  (Schmit, Alper, Raschke & Ryndak, 2000).
  • Visual schedules can help children predict daily activities (e.g. mealtime, social groups or sport activities, school and T.V time) and larger events on a monthly calendar (e.g. trips to the doctor or vacations).
  • Knowing what information is important to your child will help determine how much detail your visual schedule needs.

Consistency and Follow Through

  • No matter what tools and techniques you use to help support your child’s transitions, being consistent and following through are two of the most important things to remember for facilitating transitions.
  • Giving an instruction multiple times or allowing a child to barter for more time with an activity can send mixed signals about the expectation involved in transition routines.
  • As a rule of thumb, repeat your instruction no more than one time and if needed prompt the child to transition appropriately (e.g. clean up toys and come to the table for lunch).
  • Prompts should only be as intrusive as necessary to complete the job and should be faded over time (e.g. using a full physical hand over hand prompt should eventually be faded to a gestural prompt).

Use Praise

  • Praising a child for transitioning independently or without negative behaviours can increase the probability they will transition well again in the future.
  • It is important to remember to praise closer and closer approximations to the desired behaviour (Cooper, Heron & Heward, 2007). For this reason sometimes it is necessary for parents to look for the things the child is doing right and focus on praising these elements of the transition routine.

Each child is different and some techniques will work better for some than others. Knowing your child and their learning strengths and deficits can help you choose suitable tools and techniques to teach them to transition more independently and appropriately over time.



Cooper, J.O., Heron, T. E., Heward, W. L. (2007). Applied Behavior Analysis (2nd ed.). Upper           Saddle River, NJ: Pearson Prentice Hall.


Flannery, K. & Horner, R. (1994). The relationship between predictability and problem behavior for students with severe disabilities. Journal of Behavioral Education, 4, 157-176. –


Mesibov, G., Shea, V., & Schopler, E. (2005). The TEACCH℠ approach to autism spectrum disorders. New York, NY: Plenum Publishers. – See more at:

Schmit, J., Alper, S., Raschke, D., & Ryndak, D. (2000). Effects of using a photographic cueing package during routine school transitions with a child who has autism. Mental Retardation, 38, 131-137


If you have any questions about behaviour therapy or helping your child with transitions, contact our Burlington therapy center at 905-633-9222. We’re always happy to help!

Encouraging Self-Esteem in Your Child


It is heartbreaking for parents to see their child feel that they don’t measure up to their peers. Understandably, parents worry of the emotional impact on their child. Indeed, it has been found that low self-esteem in adolescence predicts depression up to two decades later (Steiger, Allemand, Robins, & Fend, 2014).

So, how can one help increase their child or teenager’s self-esteem? The easy answer would be to praise them heavily, right? After all, getting compliments should make them feel better, no? It turns out that recent research published in Psychological Science has revealed that this strategy may actually backfire on parents (Brummelman, Thomaes, Orobio de Castro, Overbeek & Bushman, 2014). Indeed, not only does it convey to children that they should continue to try to meet very high standards, but it also leads children to avoid important learning experiences.

What is a parent to do then?  While receiving inflated praise may make a child feel loved and appreciated (although they may notice it is phony), one important problem is that it does not help them develop their sense of competence, which directly feeds in their self-esteem. Developing self-competence, then, would be a great way to promote self-esteem.

Here are a few ways to encourage self-competence and self-esteem in your kids and teenagers:

  1.  Let them take healthy risks. Do not constantly try to avoid experiences of failure for your child. These will happen at some point, and your child needs to know how to deal with these feelings too.
  2. Let your child make age-appropriate choices. This is a great way to make them feel that they have some power over their life.
  3. Help your child set realistic goals. For example, if your child is struggling in her piano lessons and can’t get this new piece, why not go back to easier and fun pieces? Your child will get to the more difficult ones when she’s ready, and will continue to love playing piano rather than despising it.
  4. Do offer some praise. However, make sure it is focuses on the effort rather than the outcome, and is offered with a genuine tone.

At Canoe Therapy, we’re committed to providing a comprehensive range of therapies for kids of all ages in the greater Toronto area. Our areas of expertise include behavioural, occupational & speech therapy, as well as physiotherapy and psychology. If you’re interested in beginning your journey with Canoe, contact our Burlington or Etobicoke therapy center today.

Anxiety and Children

We’re thrilled to share a blog post written by our Clinical Child Psychologist, Marie-Eve Dubois. Dr. Dubois is bilingual, helping children and families in both English and French at our Burlington therapy center. This post will also be featured on our blog in French!

As a psychologist working only with children, adolescents and their families, one of the most frequent concerns parents seek my help for their child is anxiety.

According to Statistics Canada, 6.4% of children under the age of 15 suffer from an anxiety disorder, making anxiety the most common mental health problem in children and adolescents. Anxiety can take many forms: specific phobias (e.g. dogs, dentist, etc.), separation anxiety (i. e. Becoming extremely anxious when separation from the parent occurs, such as when leaving the child at daycare), panic attacks, social phobia, selective mutism and generalized anxiety disorder.

Exposure Treatment

One of the most important aspects in the treatment of anxiety disorders is what we call ‘exposure’. This gradual process helps the child experience anxiety-provoking situations once he or she has learned coping strategies. This helps work around avoidance, which only serves to increase anxiety in the long term. For example, let’s think about a child who is afraid of dogs after having been bit. Parents stop visiting friends and family members who have dogs in order to avoid having to deal with a meltdown. When taking a walk in their neighbourhood, they change sidewalks when seeing a dog approaching. Soon enough, the child has learned that dogs must be REALLY dangerous if mom and dad make sure I don’t ever encounter one. In this case, exposure would consist of possibly looking at pictures of dogs, then petting a stuffed animal representing a dog, to slowly approaching dogs more and more. The key here is to remain in the situation until the child has calmed down and not to remove the child from the situation (that would be avoidance again).

Despite this being the most effective treatment for anxiety, a recent study published in Canadian Psychology has showed that this technique is underutilized in the Ontario public system, given the low numbers of practitioners with an expertise in providing this type of treatment. When seeking treatment for your child, here are some of the key things you should look for:

  • The professional you are working with should do a thorough interview to better understand the situation.
  • This will typically lead to what we call psychoeducation, or teaching you and your child about anxiety and how we can best help you.
  • Treatment will then consist of relaxation and other coping strategies, followed by exposure, either at home or in clinic.

It is also recommended that parents be involved in the treatment of their child to learn techniques and support their child so that they can benefit most from treatment and make anxiety a thing of the past! At Canoe, we’re committed to working with both children and their parents, creating a complete therapy treatment plan that works at the clinic and at home.

Speech Therapy & Literacy

This post was written by Nancianne Chin.

Most of us are familiar with Speech-Language Pathologists (S-LP’s) as professionals who teach children how to pronounce that ‘r’ sound, or help late talkers begin talking. Did you know that S-LPs help children with reading skills too?

S-LPs have received extensive training in sound awareness, which means they can help children learn to rhyme, count beats in words, blend sounds, and connect letters with the sounds those letters make. They also help support story comprehension, retelling of stories, coming up with language to describe pictures, and identifying the main components of a story. The tools and methods used by SL-Ps are in line with research from the National Institute for Child Health and Human Development, which determined the best way to teach children to read.

Summer is the perfect time for your child to work on their literacy skills to ensure that they are ready for the new school year. The S-LPs at Canoe Therapy are excited to offer intensive 1-week groups this summer for kids in JK-grade 1 where they’ll practice and improve their reading comprehension skills in a fun, exciting environment! Groups are 2 hours per day for 5 days and run Monday-Friday over select weeks this coming July and August.

Contact Us

If you are interested in signing up for or have any questions about our summer programs or any of our other therapies, please contact our Burlington clinic. Our team of speech pathologists is dedicated and passionate about helping children grow and succeed. Our comprehensive approach ensures that your child will receive the best treatment possible.