Woman's Hour - Extreme fussy eating, Pay, Off the Rails

Episode Date: September 4, 2019

As BBC journalist Carrie Gracie prepares to release her new book, Equal, about her yearlong battle for equal pay, we discuss the impact this case has had on equal pay for all. Have these high-profile cases inspired employees, employers and policymakers to take action? Sam Smethers from the Fawcett Society, Charles Cotton from the CIPD and Paula Lee from Leigh Day Solicitors join Jenni. Now for the final part in our series Off The Rails. We’ve been following the work of South London youth worker Nequela whose personal experience of getting into trouble and prison helps her reach troubled teens. Jo Morris met her one Thursday afternoon when she was getting things ready for the evening's senior youth club.Experts are warning about the risks of extreme fussy eating after a teenager developed permanent sight loss after living on a diet of chips and crisps. When does fussy eating become a danger to health? And how can parents distinguish between regular fussy eating in children, and the psychological condition of Avoidant Restrictive Food Intake Disorder – ARFID? Jenni speaks to Dr Victoria Aldridge, Senior Lecturer in Psychology who conducts research into ARFID, Dr Lucy Serpell, Clinical Lead for Eating Disorders at North East London NHS Foundation Trust and associate professor of Psychology of Eating Disorders at UCL and Clare Thornton-Wood, dietician and spokesperson of the British Dietetic Association. Presenter: Jenni MurrayInterviewed guests: Sam Smethers, Chief Executive, Fawcett Society Charles Cotton, Senior Reward and Performance advisor, CIPD Paula Lee, Associate Solicitor, Leigh Day Jo Morris, reporter Nequela, youth worker Dr Victoria Aldridge, Senior Lecturer in Psychology, De Montford University Dr Lucy Serpell, Clinical Lead for Eating Disorders at North East London NHS Foundation Trust and associate professor of Psychology of Eating Disorders at UCL Clare Thornton-Wood, dietician and spokesperson of the British Dietetic Association

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BBC Sounds. Music, radio, podcasts. Hello, Jenny Murray welcoming you to the podcast for Women's Hour for Wednesday the 4th of September. In today's programme, as a teenage boy loses his sight because he lived on chips and crisps, how dangerous is what we might describe as fussy eating? And how do parents distinguish what's a threat to health and what isn't? In the last of our series, Off the Rails, the youth worker, Nikila, with a checkered past of her own, and the help she can give to young people who might be following the path she took. Now, I'm sure you remember the case of Carrie Gracey, the BBC's former China editor, and the way her case highlighted a bit of a problem with men, women and equal pay within the corporation

when the results of the pay audit were revealed. Tomorrow, Carrie will publish a book, Equal, a story of women, men and money. Here's what she said on the 29th June last year when her settlement with the BBC was agreed. I love the BBC. It's been my work family for more than 30 years and I want it to be the best. Sometimes families feel the need to shout at each other but it's always a relief when you can stop shouting. I'm grateful to the Director General for helping me resolve this. I do feel that he has led from the front today. In acknowledging

the value of my work as China editor, the BBC has awarded me several years of backdated pay. But for me this was always about the principle and not about the money. So I'm giving all of that money away to help women who need it more than I do. After all, today at the BBC, I can say I am equal. And I would like women in workplaces up and down this country to be able to say the same. Carrie Gracey, well what impact have gender pay gap reports, the revelation of inequalities and high profile cases such as Carrie's had on women's fight for equal remuneration in the workplace? Charles Cotton is a Senior Reward and Performance Advisor at the Chartered Institute of Personnel and Development.

Paula Lee is a solicitor at Lee Day and is representing Tesco workers in a case of equal pay for work of equal value. And Sam Smethers is Chief Executive of the Fawcett Society. Sam, why was the Fawcett Society keen to support Carrie in her claim? Well, I think the key thing and it comes through really clearly from the quote you just played actually for Carrie was that it was all about the principle of equality and that's certainly what Fawcett's all about that's what we're fighting for for women and you know she epitomized that with the way she conducted herself

throughout that fight the way she has so generously donated her entire back pay to Fawcett and to Yes Law so we could launch our equal pay advice service and that's because she knew and it became very clear to her through all the women who contacted her at the time that her case was one amongst many and there are many other women at the BBC who've been fighting for equal pay and there are many other women up and down the country who don't have carriage resources, who don't have the advantage of being able to go in to see the Director General to negotiate her pay, who were really in the same position and battling it. So how was her claim actually carried out?

Well, she never had to go to court. She never had to go as far as a tribunal. She saved that battle because she was able to negotiate her backpaying and get a deal with the BBC. But that's a very unusual circumstance. The service we've launched with Yes Law is all about helping women negotiate a settlement and avoiding that legal battle because the law as it stands is actually quite dysfunctional for women. Now Charles as someone who works in

human resources what impact did a case like this and other cases that we're familiar with have on employers? Well i think it's encouraging some employers to look at how they reward people to say well actually is it fair and can we justify what we're doing and that actually can help them stand out in the labour market if they're able to show well we are paying people fairly people want to come and work for them another driver is to try and ensure you don't get into difficulties and that you aren't open to legal challenge and the money that you are spending on paying benefits actually is reflecting people's efforts rather than perhaps prejudice and bias but are employers content to be going this way or are they having to be dragged screaming towards it?

I think, to be fair, if the government hadn't legislated we probably wouldn't have seen as much activity that we are seeing now. I think one of the problems is that organisations, when they look at how they're rewarding people, there aren't justifications that are correct or apply now. They may have made sense perhaps 10, 15, 20 years ago when the job evaluation scheme, which is a way of kind of valuing jobs, was brought in, or when line managers are making decisions about how much to offer somebody to join an organisation or to promote.

But when you look at it now, those explanations don't hold water. What sort of explanations? I mean, was it just, why are there women that don't need the money? Well, it may have been that it was the labour market at that time. It was a seller's market or a buyer's market that could influence starting salaries, or it could be linked to experience. And often people use experience as a kind of a catch-out as marketing that can influence starting salaries or it could be linked to experience and often

people use experience as a kind of a catch-out without really thinking about are we talking about skills or are we talking about knowledge and if so how long are those skills and knowledge going to be relevant for that position and it's always easy to offer people more money it's harder to take it away from them. Paula what effect do you reckon these kind of high-profile cases have had on employees who might have thought, oh, I might have a case? I can think of three things immediately. The first thing about Carrie's case, which has impressed me hugely and I think is a potential North Star,

is that she has raised the possibility that a woman can bring an equal pay issue to her employer and keep her job. The received wisdom out there is as soon as you put your head above the parapet you are going to be shown the door under the terms of a settlement agreement. So huge thanks for Carrie for showing it is possible to bring that issue to an employer and retain your job. The second thing the high-profile cases do, such as we do at the day, the group claims, as Sam pointed out, Sam described equal pay law as dysfunctional.

I think it's unfriendly to women. What the big cases do, each part of the litigation is hard fought. And so what that means in reality is that the cases go up to the Employment Appeal Tribunal, they go up to the Court of Appeal, they go up to the Supreme Court. And in the case of the Tesco case, we've now made a reference to Europe. So what that does is that that creates a settled feeling. Points of dispute are settled. We get settled law. Settled law is important. What the law, rule of law requires is certainty so the more certain more certainty we get the

easier one hopes it will become for women to bring um these claims the third thing just to come is that when the large group claims as well is that you get safety in numbers the high profile cases they attract women women want to join every time one of these cases is in the press there's a surge in increase in inquiries to lead day to the website. People interact with the blogs on social media and they're interested in joining and they want that safety that's provided. Now, Carrie mentions in her book what an emotional toll the whole dispute created. How do you manage to help your clients through it when it can go on for years? It's extraordinary. The emotional toll is extraordinary. What happens in my experience is you'll get a high profile case will hit the press.

A woman will contact you and say, I've been nudging this issue for a few years now. Things are starting to coalesce. I'm starting to feel the balance tip in that I'm ready to launch. So actually, by the time a woman presses the trigger, a lot of the emotional feeling has been gone through that they seem to be more angry when they're ready to go. When they're ready to press the trigger, what we find with equal pay claims is that they are historic, you're looking back to see if there is an issue there. And once you've made that decision to put your head above the parapet, unlike other employment claims, they can be less emotional because no one is saying you're bad at your job. It is a contractual issue around pay, but they are hugely emotional. But a lot of the emotion is gone through actually believing that your employer has paid you less.

And that's where you get huge emotion. And Sam, how with the money that Carrie donated to you, the back pay that she donated, how can you deal with this kind of thing? I mean, Carrie says quite clearly in the book, the emotional toll was terrible. Absolutely. And one of the things that's coming through with the individual women who are coming through the service and who have come to us is that I think there needs to be a bit more peer support. We need to do more to put these women in touch with each other. And some of the other cases that have been fought recently I know those women like Sam Walker for example whose cases was against the co-op you know she's going out there

and helping other women and that is really powerful I think the other thing that we want to change is this issue about having any kind of remedy for injury to feelings now in equal pay cases there is no currently no entitlement to injury to feelings now in equal pay cases there is no currently no entitlement to injury to feelings compensation but in other discrimination cases there is and clearly from Carrie's book it's really obvious that this is a massive emotional journey for her to realise that she was so significantly undervalued by her employer. Charles how are you working with employers to encourage the implementation of equal pay policy? Well, we are ensuring that we kind of show the advantages.

I mean, not only is it the law and there's a moral argument, there's also a business argument. If you have fair pay policies, people will be more motivated by those. They'll be more likely to join an organisation if they can demonstrate that their policies are fair. The challenge is how do you become open and transparent about your pay systems, especially if you're dealing with legacy issues.

Your organisation may have grown by acquiring other companies and the pay practices in there may not have been fair or even if they are, there's no kind of justification now for why people are being paid what they're being paid. So you need to kind of look at it on a regular basis, think about why are we paying what we're paying, are we spending the money in the right places and for the right things. And how much are employers fearing that they could go

bust as a result of this kind of thing? I think for many it's probably around reputational risk. If your investors or your clients and consumers start to question why are you treating people that you employ poorly then that is going to have an impact with the danger of going to court it's a case well there are more legal challenges for the individual to go through so they're perhaps less fearful about that though that's not right they're perhaps less fearful about that than compared to what investors and public opinion may think. Sam, how have policymakers reacted to these kind of cases? Well, there's more interest in doing something about the gender pay gap and equal pay than there has ever been.

You know, when we were talking about these issues 10 years ago, we didn't get the traction we get now. We think, you know, with 50 years of the Equal Pay Act next year, it's high time that we reform the law. So one of the other ways in which we're using Kerry's money is to do some work on changing the Equal Pay Act. We're going to come up with some new legislation in the next session. And that is really about addressing some of the shortcomings that we currently have. So giving women access to the information they need to bring a challenge, you know, making sure that we address these gaps in remedies that I've been talking about, including pension contributions, which are really important for women, particularly low-paid women, and trying to streamline the process a bit more.

And then also doing something about moving us on from just reporting gender pay gap figures into actually having action plans in place. We need employers to be required to have an action plan in place that we can hold into account. Paula, what would you say is most important for policymakers to be required to have an action plan in place that we can hold into account. Paula, what would you say is most important for policymakers to be looking at? If I was legislating today, the first we have, the sex equality clause is what underpins all equal pay legislation.

And it's an invisible clause, which is in everybody's contract of employment. And I would put that in bold writing. So every contract says you have a right to be paid equal work for equal pay and I think if it was highlighted in that contract women would feel it would they'd feel more bold to put their head above the parapet it's invisible at the moment and I think if it was made express and human resources people pay decision people were sending out offer letters

to multiple people at the same time of different sexes on the same job they would notice those rates of pay more. So I would bring that right up. It is there. It's invisible. It needs to be bold. Now, Carrie mentions in her book how important male colleagues and allies can be. What, Paula, should men in the workplace be doing? Should they be saying, oh, I earn this.

Oh, I earn more than you do. We should do something about this. 110%. The first equal value case was the Camelhead shipyard case, Julie Haywood, and she was massively supported by all the men at the Camelhead shipyard. And she had huge union support. That was in Birkenhead, wasn't it?

Yeah, in Birkenhead. Massive male support. Men don't need to fear this. shipyard and she's she had huge union support and she had huge yeah in birkenhead massive male support um men don't need to fear this the remedies that sam are talking about the equal pay provisions of the equality act they work by leveling up pay no one is saying that men should be paid less no one is saying that men have to take a hit in their salary all the women are saying is oh can you give me a hand up to level you're at because i think i'm entitled to that too there's nothing to fear here. And equality, also as Carrie says, this is not a female issue.

This is a community issue. It's a society issue and it benefits everyone. There's nothing to fear. Charles, what do you think men should be doing? Well, if they want to have fairness in the workplace and ensuring that their female colleagues are paid fairly is important and many men you know are married to women they've got mums they've got daughters so if they want their female friends and family to be treated fairly in the workplace then they should

be supporting the female colleagues that they have in their own workplace as well. And Sam finally who's doing this well whether it's countries or particular employers who's good at it? Well we have had some good practice cases of employers that we've had speak at conferences and so on so you know we've had people like Arup and Sodexo the Mayor of London's office is actually going beyond the requirements of gender pay gap reporting but that you know I would say good practice is sometimes hard to find, if I'm really honest. So I think we could all do a lot better at really getting employers to be open and transparent

about what they are doing. And definitely talk about pay. The first step is breaking the taboo, talking about pay. And men can do a lot to help with that. Sam Smethers, Paula Lee, Charles Cotton, thank you all very much indeed for being with us. And of course, we would like to hear from you. If you think you've got an equal pay claim, we'd love to hear from you.

So you can email us or, of course, you can send us a text. And thank you all very much for being with us. Now, still to come in today's programme, as a boy becomes blind after a diet of chips and crisps, when does being a fussy eater become a danger to health? And how can parents tell the difference? And the serial, episode three, of How Does That Make You Feel? Now, earlier in the week, you may have missed Emma Barnett and Nimco Ali,

who discussed sex and periods. And yesterday, Jenny Brister talked about what it's like to be the parent in a lesbian couple who didn't give birth to the child. You can always catch up by downloading the BBC Sounds app. Just search for Woman's Hour and you'll find all of our episodes. Now, for the final part in our series, Off the Rails, we've been following the work of a South London youth worker, Nakila. She was in trouble in her teens and served a prison sentence. Her experience helps her reach other youngsters

who are at risk of going the same way. Jo Morris met her one Thursday afternoon when she was getting things ready for the evening's Senior Youth Club. So this is our little view, our little rooftop. Sometimes we come out and do barbecues in the summer and we have little competitions out here as well. It's a nice sort of space, especially in the summer, to just chill out here with the girls.

There's not enough of a support system for young females, so for me, that's where I channel a lot of my energy, making a difference with the young females. There for me, that's where I channel a lot of my energy, making a difference with the young females. There's not enough support. Why is that? Why isn't there the support for women? Oof! I don't have a clue. The focus seems to be so widely on males.

The focus is boys in gangs, males in gangs, because no-one looks on it in light that girls are as bad as boys. We are planning on doing a discussion with the younger group to see what their views are about boys, understanding about social media, the safeties, the risks, and we first thought we would only have to focus it at our older girls. No. A lot of the younger girls are talking to guys.

We've got eight-year-olds talking to males. Just got to make a call if you don't mind. Who are you calling? A parent I've been working with, her and her young person, her and her daughter for the last year and a half. And I have started to support mum in light of the young person doesn't really want the help at the minute. I've been working with her daughter for a year and a half continuously.

And we went through a stage where there was great change. And at the moment, we feel like we've lost her to the streets. So at the moment, I'm working very closely with mum and supporting mum because mum is... Mum's in despair. She's broken. What do you mean you think you've lost her to the streets? We've lost her to the streets, the lifestyle What's she doing?

Hanging around with gangs, coming in late Not wanting to abide by the household rules All types of things you don't want your 16 year old daughter to be doing She's involved with But familiar areas to you? Very familiar areas to me, to you very familiar areas to me yeah very familiar areas to me but the difference was i wasn't disrespecting my mum so you're helping mum yeah i've been helping mum i'm i'm like part of the family i am i'm a part of the family in light of

mum's a lot of people stop giving up with mum. Why? Due to a daughter. So, building that relationship with mum, I go to meetings, I represent at court, I attend school meetings, college meetings. Hiya, afternoon, how are you? Oh, I'm good, thank you. You sound a lot more chirpy today. These uncles could go for, like, two, three hours.

Honestly. You're so patient. Thank you. Thank you. It's from being in prison, sitting down and watching time. So I had to learn how to have patience and resilience being in a system like that. You know this life, Nikila. You understand these young people. What advice would you give to parents resilience being in a system like that. You know this life, Nikila, you understand

these young people. What advice would you give to parents whose kids are at risk of getting into trouble? Parents need to kind of take more responsibility, more ownership of their young person, have a more of an active role. So checking young people's phones, finding out who their friends are, know where they're going when they are going out. Be involved. Get engaged. Take them out. Understand. Have a moment with your children. Sit down because a lot of these young people, that's all they want. That time with their parent as opposed to mum going out with boyfriend or going out shopping. Have that time where you may go out with your young person shopping.

Ask questions. If you don't ask ask questions you're never going to know and give that child and that young person the space to talk a safe space to talk because all the time as adults we have the expectation of young people when the young person talks it's you're being rude you're having an attitude I don't like the way you're talking to me, but what's their development? If we're constantly saying to them, the way you're talking, it's about, let's address how you approach, the way you come across. Let's find other ways for you to speak to me instead of shouting and raising your voice. Maybe you might need to count to five or check your attitude for a minute as opposed to don't speak to me and it's just it's a competitive thing between the parent and the child and it flares it flares egos and a lot of young people have egos due to the approach of the parents sometimes because they get to that stage where

they have an opinion and a voice too parents don't always like it do they no they don't what are the key signs you're looking for when young people are at risk of offending behavior or getting into trouble key signs are young people who are not in school, young people who are gang-affiliated, young girls who have potentially been pregnant, girls who have been exploited, girls who are taking trips out of London, drug commuting, drug runners. So those are the type of factors I'm looking for when mentoring young people.

And what do parents need to be looking out for? Same type of things. Difference within their behaviour. Staying out late. Young people getting designer stuff, coming in with money. Parents recognising that these things, they haven't provided their young people with it. Attitude changing.

Maybe carrying things or holding things in households. Just being aware, checking young people's rooms, checking social media. Not all young people need to be out to be involved in it. Some of these things are happening at home. As we know, most young people, most of the world at the moment is glued to their phones, so imagine how it is for a young person. I have a clear knowledge of the world that they're from

as opposed to some of our parents. They don't understand what it's like being out here when you leave your door. Some parents don't walk through the estates. They walk on the main roads, so they don't see what's happening within the estates. They don't even know the names of their young people's friends, so for me it's about tapping in and showing them, I'm interested in your world.

What can you offer them that their parents can't? What are you doing differently that their parents can't do? I'm not badgering. You're not badgering? I'm not badgering and I'm not telling. I'm suggesting. I'm giving solutions. I'm asking. I'm listening. I'm understanding. If we show no interest they're going to feel like, who's there for them, who's on? No-one's interested in me. A lot of the young people feel like they're at home in a room full of people but they're still alone. How is that?

So it's about making everybody feel welcomed. Hi, how's your day? What have you been up to this week? And it's something I make a point of duty to make sure I say hello how are you what you been up to may not be the longest conversation but I've seen you they have more trust in someone who's gone through it these young people will have more trust in me than they will have in someone who's just done the degree because they see me as nicks from the roads when they're not around positive influences when they may not have no money they're tempted to do other things it can go that wrong so quickly so it's about just being able to have that support network that safety net

this information isn't going anywhere unless they're going to harm themselves or somebody else this is when the information gets shared between the services or child protection but other than that these young people know I'm not the police I'm not the social services I'm a normal person in the community just like them. Nikila was talking to Jo Morris and we would like to hear from you if you have experience of dealing with teenagers in trouble you might have been through it in the past and have some tips to share or if you're in the middle of it now we'd like to hear from you you can contact us through the website and you don't have to give us your name now it's not unusual to hear parents worry that their child is a fussy eater who won't

touch fish or broccoli or any number of green vegetables but it came as a shock to find what impact in its most extreme form it can have on a child's health. A young man of 19 has become blind because throughout his teenage from the age of 10 or 11 he has eaten nothing but chips and crisps with the occasional sausage or piece of ham. Well, how common is such a dangerous eating disorder? Why would a child restrict their diet in such a way? And how can a parent distinguish fussy eating, which won't damage the health, from something so serious? Well, Claire Thornton-Wood is a dietitian who speaks for the British Dietetic Association. Dr Victoria Aldridge is a senior lecturer in psychology at the

Montfort University in Leicester and joins us from there. And Dr Lucy Serpel is an associate professor of the psychology of eating disorders at University College London. Lucy, how common is an eating disorder as severe as this one? Well, we know that eating disorders occur in probably one or two percent of young people, but an eating disorder as severe as this one? Well, we know that eating disorders occur in probably one or two percent of young people, but an eating disorder as severe as this is really incredibly rare. And ARFID, which is the specific eating disorder that this young person... That's avoidant restrictive food intake disorder. Yes, is a very newly described eating disorder. And so we don't really know how common it is. But I would say that, you know,

a situation like the one described in this article is extremely rare. Claire, why would eating such a diet, I mean, incredibly restrictive diet, but why would it make you blind? It would make you blind primarily because you're not getting enough vitamin A. That's the main nutrient that's linked to eye health.

Victoria, I know you've done a lot of work on this avoidant restrictive food intake disorder. Do we know what might be causing it? Not entirely. I think avoidant restrictive food intake disorder is such a, it's a broad term even now. And so it can describe a whole range of kind of behaviours and characteristics in a child or an individual at any age. And I think there are lots of factors that can feed into that, particularly in sort of younger children as they're developing their sort of dietary breadth. There are lots of factors that can be implicated in that.

What sort of factors? I guess experience. So we expect that eating is a fairly simple behaviour, but actually it's quite complex. It involves interactions of psychology, biology, kind of social integration and experience. And if anything goes wrong at those stages, so if children aren't exposed to a range of foods

or they have a temperament that makes it particularly difficult for kind of cohesive meal times, or sensory sensitivity is particularly common in children with ARFID or picky eating at that sort of slightly more extreme end of the spectrum. Then that can make eating and exposing new foods very, very difficult because of the experience of eating. We actually require that you gain experience in touching foods and putting them in your mouth, getting them around your face. And if a child or an individual is very sensory sensitive then that's going to be a really unpleasant experience for them. Claire, what kind of personality do you

think in a child might lead them down this road? I mean I think it could be any type of personality really but I suppose that the child is perhaps likely to be more anxious because the the whole situation is really a fear of food and only wanting to eat those foods that are very very familiar to them what's the root of a fear of food you hear that expression a lot these days because these children it seems to me from having read about the work that you've done it's not about worrying about getting too fat or being too thin there's something else going on here it's all it's all really linked to sensory behavior so children might have a feeling that foods that they regard as safe are those foods that are dry that are crunchy so perhaps they'll

only eat crisps and crackers and dry breakfast cereal or they might only want sweet foods that they regard as safe are those foods that are dry, that are crunchy. So perhaps they'll only eat crisps and crackers and dry breakfast cereal, or they might only want sweet foods that are beige. So again, that might be crackers and it might be bread. They can be really particular about the types of bread that they eat. So for instance, you might do a piece of toast, but the toast has to be cooked in a particular way. It has to be brown all over. It has to be a certain level of brownness or they won't they won't eat it other times that we have problems are for instance around Christmas time some manufacturers will change their packaging so they might have some biscuits that I mean exactly the same exactly the same biscuit as they were previously but they've got a Christmas wrapping on and the child will perceive that as something completely different and won't want to um won't

want to eat that because it's not one of their safe preferred foods lucy how might a worried parent differentiate between the fussy eater who's not at risk which is so common won't touch broccoli won't touch fish and one who is in danger like this boy was. I think that's a really really important point because we all know children who are fussy eaters and I would say that fussy eating is a kind of normal childhood stage. Most kids with fussy eating are healthy, they're not underweight and they're not malnourished and they can eat you know a fairly restricted range of foods and still thrive so if your child's thriving but they don't like broccoli I don't think you've got anything to worry about and we would be very concerned if you know the message

from this single case this rare case would be that you know everyone who's got a child who doesn't eat vegetables and fruit should take them to the GP but if your child certainly if your child's failing to grow or failing to gain weight in the way that children should be doing, and if you're worried about your child, you know, really lacking in energy, eating a very extremely restricted range of foods, and you're worried they might be malnourished, then I think it is worth talking to your GP about it. But I think that, you know, the other thing is if things are getting worse, if it looks like the picture is getting worse, most children as they get older, they become teenagers. They want to kind of fit in with their friends, eat a wider range of foods, and they might be encouraged to do that.

If your child seems to be eating fewer and fewer foods as time goes on and becoming more restrictive, then I think that's a bit of a danger sign. What happens if a parent tries to force a normal eating pattern on a child who is going in this direction? I mean, I would never recommend that parents force their children to eat. We do come across this, that parents are obviously really, really desperate and they'll do things like try and spoon-feed their child. But as you know, if somebody sat you down in front of a plate of food and tried to force you to eat it, that's a really unpleasant mealtime experience.

And we'd encourage parents to make the mealtime experience and we'd encourage you know parents to make the mealtime experiences as pleasant as possible and as pleasure as pleasurable as possible and not to force children but perhaps rewarding children for eating a broader range of foods would be you know more useful approach. Victoria we had an email from a woman who has a son who's six and a high functioning autistic and eats peanut butter sandwiches and chipsticks no meat no veg and some fruit how common is that in autism it's it's extremely common yes a very high prevalence of arford type behaviors in children with autistic spectrum disorders and other similar sort of developmental disorders.

It sort of almost comes with the territory. And we would hope that parents who are already receiving support for the ASD would have a team involved to be looking at the feeding. And obviously these children have highly restrictive tendencies anyway. And so the patterns that we would see in ARFID are the sorts of patterns that you might also see with ASD. And probably just the approach will be that little bit slower, that little bit more delicate in terms of trying to help that child.

If you did want to try and expand their dietary intake, it's going to be a slow process, but there is room for improvement in diets of all children but you do have to be uh kind of manage expectations it it will be slow it will be gradual i think in in her email she said that one of her problems was with his fondness for peanut butter the peanut butter jar changed and this problem that claire was about, where just a change in packaging can be really difficult. What do you do in that sort of case? Do you just keep the old packet or the old pot and put the new stuff into the same pot?

I mean, we hear lots of imaginative stories from parents about what you do. And I guess that's where the anxiety comes in for parents and for the child or the individual with ASD or with ARFID, is that if you're already eating a very restricted number of foods and then package changes or ingredients list changes, to that child that's a new food. It's something they don't consider safe because it's not familiar. There is no kind of right or wrong answer. Some parents will keep old packaging if possible. I've even heard of people contacting the food company to ask them to kind of revert the ingredients.

But I guess that's why you'd hope to be working with a kind of multidisciplinary team to work on increasing the number of foods that child will accept over time. But again, very, very gradually so that you don't end up left in a situation where the child's only eating fewer and fewer foods, as Lucy already alluded to. Claire, how easy is it to get vitamin and mineral supplements into a child with these kind of problems? It's actually generally can be quite difficult because the vitamin and mineral supplements, they come in various forms. You can get powders, chewy ones, drops, liquids, but obviously they've all got a taste and a texture. So it can sometimes be quite difficult to do that.

So, I mean, we would sometimes look at trying to add them to foods, but you do have a problem with that because these children have very very heightened sense of taste so if you then put something into the food change the taste they then will potentially reject that that food as no longer one of their one of their safe foods. Lucy I can I can just hear friends people saying oh come on know, this is the fault of the parents. They're not feeding their children properly. How much stigma attaches to this whole question? Yeah, I mean, I really hate hearing people blame parents who I think, you know, in almost all cases

are doing their absolute best. And I think we shouldn't underestimate the impact of having a very, very extremely picky child or a child with any kind of eating disorder on families, you know, and these are very, very stressed families. So I think, you know, in the work that I do, I would always try and encourage people to be sympathetic and supportive towards families rather than criticising them. This isn't bad parenting. And, you know, anyone who has children will know that if you have more than one child, they have different temperaments and different attitudes towards food. so this isn't something that's caused by parents but parents are obviously incredibly important in supporting their child to recover from these kinds of eating disorders. And you mentioned how it can affect relationships with other children earlier what

sort of impact does that actually have on a child's social life? If you can't go to your friend's party because you can't eat one of the buns that might be provided at tea time. Yes, I mean, I think that's really, really distressing for children. But it is also something that can be used to help children to become a bit more adventurous. And we know when children get to middle childhood, they're more influenced by their peers than they are by parents. So it might be that parents have been spending years trying to get a child to eat i don't know a vegetable and then they go to a party with friends and everybody's eating something and they try it in that kind of situation where everyone's doing the same so i think peer influences can be really helpful glad to what extent in your experience do children grow out of this? I think in my experience they don't tend to grow out of it completely,

but there are certain techniques that we can use to widen the range of the diet. And exactly as Lucy is saying, sometimes when they do get into their sort of early teens, they are more motivated to see if they can work with us to try and overcome. So they might want to go to they can work with us to try and overcome so they might want to go to a party and be able to eat pizza because that is a food that all of their all of their peers eat um i mean the the work that we do is looking at um you know how can we get the diet um as good as we possibly can we probably aren't going to get them to eat the same as the rest of the family necessarily, but it will be a diet that would be adequate for them.

I was talking to Claire Thornton-Wood, Dr Victoria Aldridge and Dr Lucy Serple. And thank you for all your emails and tweets. On the topic of fussy eaters, Jane Stammers tweeted, I used to do cookery sessions with my daughter's class in a speech and language unit. Lots of the children had difficulty with touch and texture and were fussy eaters. The sessions helped to normalise food and foodstuffs.

And Aidan emailed, Please, please, please stop calling it fussy eating. It gives children a complex going into adulthood. But Liz tweeted, Very concerned the professionals on the programme totally dismissed parents' role in a child's eating patterns. Not all families are emotionally healthy and a child might use food as the only power or control they have

if they're in a bullying or abusive environment. Lisa emailed, without judging parents who are faced with what is an extremely stressful situation, I wonder why this seems to be much less of a problem outside the Anglophone world. Having lived in France, Germany and Italy, it is much rarer. And having lived in an Asian country for five years with different families, mostly not well off at all, I never saw a single picky eater. I don't have any answers, just questions. And Linda wrote to us about her experience. She emailed, I'm so glad this piece touched on the issues for children with autism. My autistic son has a fairly restricted diet and

can be hypersensitive to tastes, textures and smells. In fact, he can tell which sausages he will eat just by sniffing them. He also won't eat foods which are touching each other. On the question of equal pay, someone who didn't want to be named emailed, Thanks so much for raising the issue of equal pay. It is heartening to hear that these issues can be resolved amicably. I'm currently on maternity leave and my employer decided to mark down my bonus payment for the year, despite us agreeing on a performance level before I went away. Their justification? Because I hadn't been there to perform. They have delayed conversations to appeal this until I return in a few weeks' time.

But listening to the piece, I'm hopeful that this can be resolved positively and provide some education to colleagues that people on maternity leave are still employees of our company. And Roland said he was impressed by the youth worker, Nikila. He tweeted, she speaks with great articulacy about the problems of parents and children on estate. She has a remarkable understanding of what's going wrong. And Cathy agreed.

Nikila is speaking so much good sense. I'll play this for my teenage girls on iPlayer tonight and hope it sticks for the years ahead. Peerless and invaluable advice. Thank you. Now do join me for tomorrow's programme when I'll be talking to the Macca, Scotland's national poet Jackie Kay,

about a revival of her 1986 play, Kieraskuro. And also the best-selling author Tracy Chevalier will be with me here. I'll be talking to her about her tenth novel. It's called A Single Thread and is set primarily in Winchester and the Cathedral. Join me tomorrow. Bye-bye. I'm Sarah Treleaven and for over a year I've been working on one of the most complex stories I've ever covered. Bye-bye. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby.

It's a long story, settle in. Available now.