Feeding Therapy

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8 Secret Strategies for Sensory Issues with Food

Adapted from: Your Kids Table by Alisha Grogan MOT, OTR/L

Why do children have sensory food aversions? And, how can you help them overcome sensory issues with food? Get the answers and 8 simple strategies…

Why Do Kids Have Sensory Issues with Food?

To understand food related sensory issues, we’ve first got to talk about sensory processing, which is our ability to interpret smells, tastes, sounds, touches, sights, and movement from our environment.

Although most of us process this information in similar ways, it is completely unique to every individual, to every child. We are bombarded all day long with various sensory input, and eating, which many of us do 5 or 6 times a day, is a huge sensory experience that most of us take for granted.

As adults, we have been quite desensitized to the textures, flavors, and smells of food, but many of our kids have not. In the first few years of life, mealtimes are all about processing the sensory input they are receiving from various foods.

Often, when kids display picky eating, especially those with food aversions/extreme picky eating, the touch, taste, or smell of a food is being processed in their brain as dis-pleasurable in some way.

And, by dis-pleasurable, I mean down-right uncomfortable. Think of something that makes you shudder… nails on chalkboard or touching a slug? That feeling that you have may be just as extreme for your child when they touch an orange.

Their brain is processing it all in different ways than yours does.

This of course can start your child down the slippery slope of a limited diet, narrow lists of favorite foods, and specific foods they won’t dare come near during mealtimes.

How your child responds to foods, may at least in part, be simply neurological. While a sensory overload can seem exaggerated, it is a real experience to your child.  I hope that this information helps you as the parent depersonalize the refused dinners, at least at little, anyways!

Here’s the good news, children’s brains are extremely plastic. Meaning they are able to easily learn new things. When a child learns something new or experiences something differently, a new connection is made in their brain.

The more they have that same experience, the stronger that connection gets, and then they are able to react differently than they had previously because their brain is using a new connection to process the information.

This is WHY THERAPY WORKS!

Are you following me here? Let me say it another way by telling you about my son who has a long history of sensory food aversions. Isaac gags and shudders every time he touches chicken, but one day he helps me make chicken in a different way. 

We cut it into small pieces and serve it with a fun dip in a cool little ramekin. I pretend the chicken is little baby dinosaurs jumping into a pond of ketchup. 

Then, Isaac is really motivated and relaxed (because he isn’t being pressured), so he picks up his “little baby dinosaurs” and sends them soaring into his dip without a hint of a shudder or gag.

Guess what? His brain just made a new connection, and then I had a starting point to build from! I promise there is hope for your child who only dreams of eating chicken nuggets.

While I’ve mostly been providing examples of a child who is sensitive to textures because the brain is over processing the input, it is also entirely possible that your child may be under sensitive to sensory input. 

Think of sensory processing as a spectrum with being sensitive or defensive to input (food texture, smell, etc.) at one end and seeking input at the other end with a whole lot of variability in the middle.

Not processing input well can also cause picky eating because children may not feel certain soft textures in their mouth well (as if the sensation is dulled), and thus avoid them. 

These kids, in particular, will often prefer crunchy foods, seemingly spit out soft foods, or over-stuff their mouths to try and “feel” the food.

Does My Child Have a Sensory Food Aversion, Sensory Feeding Disorder, or Restrictive Food Intake Disorder?

While there is no specific diagnosis for a “sensory eating disorder” or a sensory food aversion, these terms might be used when your child eats a very limited amount of foods because they have difficulty with how foods smell, taste, feel, or even how they look.

Kids that fall into one of these groups and are picky eaters, often have sensory based food aversions:

• • Sensory Processing Disorder (Note that many health care providers acknowledge this diagnosis, but it is not in the current version of the DSM, which means some insurances providers will not accept this as a reason to justify therapy but children OFTEN have other diagnosis such as Developmental Delays, Muscle Weakness, Coordination Delays that we can bill medical insurance for).

  • ADD/ADHD

  •  Children Born Prematurely (The sensory system is one of the last to develop in utero, which is why sensory processing difficulties are common. However, this is not a rule. Many preemies display no difficulties in this area.)

  • Autism Spectrum Disorder

  • Down Syndrome

  • Children Adopted from Orphanages in Eastern European Countries or Russia

It’s also important to note that kids with significant sensory difficulties with food, whether they have one of the above diagnoses or not, could receive a diagnosis of Pediatric Feeding Disorder (PFD), which applies to kids through age 18. 

Red Flags for Sensory Issues with Food

If you child has most or all of the behaviors here, it is possible that sensory issues with food may be part of the underlying reason your child is selective about what they eat.

You will notice some opposite extremes in the list below, which are indicating different ends of the sensory processing spectrum as I discussed earlier. As you’re reading, make a mental checklist of any that you see your child doing regularly:

• • Gags at the sight, smell, touch, or taste of foods. Gagging while trying to eat is a different cause that has to do with the mechanics of eating. A Hyperactive Gag Reflex can be a sign of high anxiety, stress, and digestion issues.

Gagging can also be a learned behavior that may have started from either a sensitivity to sensory input or difficulty chewing or swallowing food at some point.   It usually has to be addressed in a positive feeding therapy treatment protocol to decrease.  

• • Eats only specific types of textures. Most of the time, the preference is crunchy foods, but sometimes soft foods are the preferred. This preference can even be carried over to highly specific requests of certain brands, colors, and flavors of food, feeding therapists call this a food jag.

• • Avoids or dislikes their hands getting messy, and I’m not just talking about at meals. You will often see your child get uncomfortable with crafts or digging in dirt/sand, etc. (This is an important point, learn more about it with an OT evaluation)

• • Over stuffs or pockets food excessively and/or frequently. Pocketing food can also be the cause of poor coordination and/or difficulty chewing.

• • Never went through an oral stage as a baby/toddler where they mouthed and chewed on toys and other objects to desensitize the mouth.

• • Excessively mouths and chews on various toys past the age of 18 months. (This is often a sign of anxiety, high stress, digestion issues, or nutritional deficiencies).

Even if sensory processing is the major player, learned behaviors can play a huge role so ABA can help when it becomes behavior based.

ABA and OT co treat together at our Autism clinic for best results in changing behaviors around foods!

Medical related hidden reasons could be at play too including most children who are picky eaters have food digestion and sensitivity issues to dairy (cows milk/casein protein) and wheat (gluten) digestion issues. Or they may be deficient in magnesium, pre and probiotics, and/or omega 3/DHA.

Julie Mathews at Nourishing Hope has GREAT resources for help. http://www.nourishinghope.com

8 Strategies for a Sensory Food Aversion

With that said, these few tools can be very powerful when used consistently over a period of at least 4-6 weeks because they help to desensitize the sensory system. Come back to these strategies as needed.

1.Play in a variety of sensory bins at least 5-6 times per week.  This is often the first thing I suggest to sensory kids and picky eaters because it helps to break down the overall sensitivity at the brain level. Put the bins inside a small plastic kiddie pool for EASY clean up!

Ideas: Rice bins, Rice and beans, colored spaghetti noodle play, non toxic edible water beads, shaving cream, syrup play, pudding and other food play, sand play, etc.

• • 2. Use a vibrating toothbrush two times a day. My kids use these all the time, but for smaller toddler mouths or those that are really sensitive, this brush is a great option.

When brushing teeth, encourage your child to allow you to help, and brush the sides of the tongue top of the tongue and inside the cheeks as well. Use vibration, oral massagers, and oral exploration toys VERY often to desensitize the mouth.

• • Follow your OT Sensory Diet plan that is established at the EVAL and adapted as treatment sessions progress, making sure they are staying in green or blue levels of calm, relaxed, engaged state.

• • 3. Build off of textures that your child is preferring. Think about making small changes to the foods they already like by changing up the brand, flavor, etc. This will help build a bridge to new foods in a way that is comfortable.

  • For example, if they eat regular potato chips then make it similar but healthier with veggie chips and straws, then introduce Snapea Crisps.

  • If they eat cheezits, then try cauliflower crackers (same color, texture)

  • If they eat applesauce, then add Sea Moss (no flavor, extremely healthy sea veggies, and no change in texture) to their applesauce or yogurt.

  • Try dried crunchy veggies first if they like crunchy potato chips- then try Terro Chips, Sweet potato chips, Snapeas, dried crunchy green beans, etc.

  • Crunchy salty chickpeas are very healthy

  • Protein chips- crackers with high protein and healthy

• • 4. Encourage them to interact with the food in some way. Take baby steps. They may need to spend some time just touching the food to get used to the texture, for example.

  • Allow a washable plastic TRY dinosaur or car or baby doll in food play. There are over 25 STEPS to eating a new food and it takes the brain almost 30 POSITIVE interactions and repetitions to make a permanent brain connection- so be patient, and keep trying!

  • Make it FUN!!!!!! NO STRESS allowed at all!!!!!!!!!!!!!!!!!!!!!!!!!!!

• • 5. Cook together. This is a no-pressure time that allows kids to explore new foods. They will often feel brave enough to try something new in the fun and relaxed nature of the moment. Again, the key here is breaking down some of that sensitivity through the exploration of food.

• • 6. If your child falls into the over-stuffing/seeking texture category, you will want to alternate crunchy bites of food with soft food. You can also give the cheeks a firm, but gentle squeeze if the stuffing or spitting out starts, or briskly stroke from the ears to the mouth a few times. This is not meant as a punishment, but to give input to help them process the sensation of the food better.

  •  

Cut up TINY pieces of new foods and hard to chew foods, so that their brain does not “FREAK OUT” and gag or spit it out because it feels like it cannot handle the hard to chew texture.

One tsp presented per year of age- very SMALL amounts presented to prevent the brain from fight, flight reaction.

• • 7. The family that eats HEALTHY sit down meals together- have children who eat HEALTHIER foods. Don’t bring to therapy spinach if the family never eats spinach. Bring the greens and healthy proteins that the child has been exposed to at least 30 times at family meal times and that will be included in FUTURE meals.

• • 8. Often foods that have a uniform shape and even texture are more likely to be eaten.  And, it’s very common for kids with oral aversions to have a strong preference for a specific type of texture.

Use that to your advantage!  For instance, I would serve a small cube of cheese instead of a slice of cheese that I had randomly torn into pieces. Or, if a child preferred crunchy foods I’d serve meats that veggies that had a crunchy texture. 

Adapted from Alisha Grogan is a licensed occupational therapist and founder of Your Kid’s Table www.yourkidstable.com

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