On several occasions recently, I've posted comments that referred to the practice of limiting children's food for purposes of discipline or unconventional psychotherapies. I think I've made it plain enough that I disapprove of this practice in anything beyond the common "no dessert!" form. It would be hard to argue that it is or is not effective, as there is no evidence that is relevant. The people who advise or use this method are not inclined to do empirical research.
Still, we can ask the question: what makes people think it would be useful to withhold food or limit a child's diet, other than for reasons related to physical health? It's unlikely that anyone would choose to do this by accident or simply because they are told to do it. They are likely to believe they have good reasons for their choice. What could such reasons be? Some can be drawn from material written by unconventional therapists or parenting coaches, but there may be other reasons too.
1. Some people believe that limiting food is a way of establishing adult authority.
Some unconventional therapists or "coaches" propose that children's good development depends on having their "will broken" and coming to be completely submissive to adult authority. Otherwise, they predict, the child will not develop a conscience and will be prone to wrong or immoral behavior in a variety of ways, possibly even physically attacking the parent. Such advisors sometimes stress their belief that emotional attachment can only occur when a child is convinced of the power and authority of an adult. Certainly, a child who depends for food on the arbitrary decision of an adult will acknowledge that person's authority, though he or she may also hate or fear the person and escape if possible.
Some years ago, one of the "Babywise" books, part of a highly authoritarian child-rearing program, recommended that very young infants should be nursed or bottle-fed only every four hours, as a way of establishing "good habits" regarding adult schedules and convenience. This is not sufficiently frequent for most babies in the first couple of months, and malnutrition was the result in some cases.
2. Some people are convinced that diet is a major determinant of behavior.
It's certainly common for people to believe that sugar causes hyperactive behavior, in spite of years of research indicating that the two things have nothing to do with each other. Other food components have also been accused of triggering aggressive or unco-operative behavior in children, and while this idea has not been tested adequately, it's possible that some individuals have food sensitivities that are associated with behavior. Parents or others who believe that food components cause behavior problems are likely to want to exclude those items from their children's diets. However, if food is the only factor they pay attention to, they may exclude more and more components until the child's diet is not adequate either in calories or in nutrients. This would be a problem particularly when behavior problems are actually not associated with food, and no matter how many foods are excluded, the behavior remains the same.
Parents sometimes feel that they have demonstrated to their own satisfaction that a food has a bad effect, by removing it from the child's diet for a while. If the child's behavior seems to improve, the parent feels vindicated. However, parents and others need to remember the old "General Electric effect", the name used to describe the fact that people tend to do better when they know someone has done something for them. They should also consider that behavior and health vary by themselves; if a parent chooses to remove apple juice (or whatever) from the diet when the child is in bad shape, improvement would be expected in the natural course of events, whether the apple juice was responsible or not. In any case, when foods are excluded, the remaining diet needs to be assessed to make sure it's adequate.
3. Some people believe that withholding food is a logical consequence of certain behaviors and therefore is an appropriate punishment.
Although punishment is known not to be an effective way of changing behavior, it's hard for parents to give up using it in some form. Some unconventional therapists and "coaches" recommend punishment in a form they describe as "consequences". They have even made this into a verb, so that a child is said to be "consequenced" rather than punished. Members of this school of thought believe that "consequences" are more effective when they have a logical relationship to the misbehavior. An obvious example would be sending a child away from the table in the middle of a meal if his table manners are too revolting for the rest of the family to watch. A more subtle connection would be depriving a child of the food his mother cooked, as a "consequence" of his being disrespectful to her on some unrelated issue.
Whether withholding food as a " consequence" would lead to poor nutrition and weight loss would depend on the frequency of the problems for which a family chose to use this method. Unfortunately, when a punishment is not effective, parents all too often feel that their only recourse is to intensify what they have been doing-- in this case, possibly leading to severe food deprivation.
4. Some therapists and parents use food as part of a behavior modification plan to treat serious emotional disturbance.
Behavior modification methods, which are part of some conventional treatments for disorders like autism, depend on the use of reinforcers (roughly speaking, rewards) to encourage a child to do things like talk. Food reinforcers are among the easiest to use, but of course they will not be effective for a person who is not hungry. When training animals with food reinforcers, behavioral researchers usually deprive the animal of all but a small amount of food until it has been reduced to 75% or 80% of its normal weight. This would be an enormous loss of weight for a child, especially when we consider that growth in weight should be happening, so that method is not used with humans undergoing behavior modification treatments.
However, it is true that the child must be hungry (as she would be before a meal) in order for the food reinforcer to be effective , and families who hear about this may decide that more intense hunger would work better. I doubt that anyone working with a trained behavior therapist would make such a mistake, but it is possible that an adult who hears about behavior modification could misunderstand, or could even think that behavior modification practices give a general rationale for depriving children of food.
It's easy to be angry at adults who harm children by limiting their diets, however beneficent their intentions may have been. Rather than being ineffectively angry, though, we would do better to be aware of food-withholding practices and be ready to "say something if we see something". Teachers and neighbors have been responsible in a number of cases for helping rescue children whom they saw eating from garbage cans.
