Sensory Food Aversions, sensory issues highly Sensitive child eating

Does your child have challenges with textures, taste or smell of particular foods?  Do they prefer crunchy over soft? Do they gag  or vomit when eating certain foods?  If so, they may have a sensory food aversion.  In this post, I will be sharing information about sensory food aversions and our family’s journey with this.  I will discuss the mistakes we made and and what strategies we are implementing currently.

Disclaimer: I am not a doctor or health professional.  This is my child’s unique experience. I am writing this to give you insight into our plan to help our son. He was evaluated by both an occupational therapist and speech pathologist and below is the treatment provided that is specific to his unique challenges. There are many different reasons that children have aversions to foods.   I recommend getting your child professionally evaluated before starting any treatment plan.  This post may contain affiliate links. See my disclosure page for more details

What is Sensory Food Aversion?

Eating is an intense sensory experience that includes several sensory inputs from the visual appearance of the food, to the smell, texture and taste it produces.   The amount of sensory input involved may go unnoticed by those without sensory challenges, but those who struggle with this can find meal times very difficult.

Sensory food aversions occur when a person consistently refuses to eat foods that are of a specific texture, taste, smell or appearance.

Picky vs. Problem Eater

While a lot of people would probably describe their child with food aversions as picky, there is a difference between being picky and being a problem eater.  A picky eater is someone who is very selective about what they eat; however a problem eater in my opinion is someone who’s diet is extremely limited to a few foods and/or has physical symptoms when eating that prevents them from getting the nutrition they need.  

picky eater food aversion

Oral Motor or Sensory Aversion?

Not every child’s eating challenges are the same.

A child’s refusal to eat certain foods could be due to a lack of oral motor development, whereby they do not have the proper oral motor skills to effectively manage the food in their mouth.

A child with sensory food aversions usually has a hyper-awareness or sensitivity to taste, textures, and smells of food that can lead to resistance, gagging and meltdowns related to eating.  This may or may not be related to Sensory Processing Disorder.

An evaluation by a speech pathologist is necessary to determine whether eating difficulties are due to sensory issues or an oral motor one.

sensory food aversion oral motor

Our Family’s Journey with Sensory Food Aversion

We started noticing from age one that my youngest son, Mr. 5, would gag when seeing certain foods.  At first we thought it was a weird thing he would outgrow. I distinctly remember him gagging in his high chair anytime he saw us eating spaghetti or grilled cheese.  He had no problem eating macaroni shaped pasta or cubed cheese, so I just wrote it off as a weird thing that he’d outgrow.

Over time, Mr. 5 grew to eat a variety of food including fruits, vegetables, beans, certain meats, nuts and every snack made available to him 🙂  It was pretty easy to accommodate his needs. He was fine as long as I didn’t serve him spaghetti or anything with melted cheese.

We had early intervention out to evaluate him just to be safe, but even they were not concerned since his nutritional needs were being met.  

However, as Mr. 5 grew into a toddler and then preschooler, he started having aversions to more and more foods.  He began labeling them as “stringy” foods and refused to eat anything that didn’t have a perfectly smooth edge and texture.  In addition to grilled cheese he was now avoiding and gagging on chicken, fish, eggs, lunch meat, and bread that wasn’t toasted.

A Second Evaluation

Meals were full of meltdowns and so we decided at age 4 to have him re-evaluated by an occupational therapist (OT).  His situation wasn’t serious enough to enter into an intensive feeding therapy program at the hospital.  His nutritional needs were still being met, but the pediatrician and I agreed that working with an OT might be a good first step.  

Unfortunately the OT had little experience with sensory challenges. After 6 weeks we decided that the therapist was not a good fit for us and we stopped therapy.  It was definitely becoming inconvenient to try and accommodate my son’s increasing demands for food prepared in a certain way, but I figured it was just something I had to deal with.

Something Needed to Change

Fast forward to age 5 and the start of kindergarten, things got worse instead of better.  The thought of stringy foods being “bad” was  now so ingrained in his head that he began gagging at the sight of other people eating “stringy” foods.  He was gagging and throwing up food at restaurants and getting very upset at meal times. He also now had the added challenge of full day school, which meant eating a packed lunch at a table with other children and their lunches.  It quickly became a quality of life issue and I strongly believed something had to change.  Someone had to be able to help us.

I trusted my gut and went back to talk to my son’s pediatrician to advocate for him.  We were referred to another outpatient treatment center a half an hour away from us that offered services including OT, speech and feeding therapy.  

What was different about this place was that they offered an integrative approach, which is exactly what had been missing before.  

After an OT evaluation, it was determined that occupational therapy alone would not solve our son’s sensory food aversion issues.  It was a determined that a combination of OT and feeding therapy with a speech pathologist (SP) would produce the most effective results.  

Starting Therapy

For 8 weeks (the duration allotted by our insurance) Mr. 5 would get feeding therapy with a SP two days a week and occupational therapy with an OT one day per week.  The SP would work with Mr. 5 specifically on his anxiety and texture aversion to certain foods. The OT would work on his tactile avoidance with “stringy” things by doing a lot of messy play with stringy textures like slime, putty, shaving cream etc.  She would also be incorporating a lot of proprioceptive work to calm his body.  He is definitely a sensory seeker when he is nervous and so the plan was to create a sensory diet that could be implemented to help with meal times.  

At the time of writing this post, we have been in therapy for 4 weeks and I have already learned so many strategies to help our son. While these tips are specific to our situation, my hope is that you may find a tip or two that can help your child as well.

 

Top 4 Mistakes we made with our Son’s Sensory Food Aversions

1. Wasting time with treatment professionals who were not a good fit.

We wasted a lot of time with professionals who either were not the right fit or who did not fully understand our son’s sensory challenges. Not all professionals are created equal. You know your child best, so be sure that you are happy with the approach they are taking with your child.

2. Avoiding interaction with non-preferred foods as much as possible

The first thing that the speech pathologist asked me during our initial meeting was “How do you handle Mr. 5’s food aversions to non-preferred food.”

Honestly, we avoided them when we could. It just wasn’t worth the meltdown. When I tried putting a non-preferred food on his plate he would typically get very upset and start pushing it off violently.

The SP informed me that the food did not need to be directly on his plate, but it was very important for Mr. 5 to be offerred the non-preferred food when it was served to the family. He suggested putting it in a separate bowl near his plate. This way it wouldn’t touch any of his preferred foods, but he could still see it and explore it without the pressure to eat it.

He explained that children need to be offered and exposed to a new food 10-15 times before they will consider eating it.

3. Pressuring and bribing to try non-preferred foods

In suggesting that we needed to frequently food aversions sensory picky eaterexpose our son to the non-preferred food, the SP was very adamant that we never force him to eat these non-preferred foods.

If a child has a true aversion or fear of a food doing this can cause severe distress and anxiety at meals which is the exact opposite of helpful.

I have to admit that we had pressured and bribed Mr. 5 several times in the past with no success. We would often ask that he have “X” number of bites of a non-preferred food before getting dessert. 

4. Focusing on food struggles only at meal times

Typically parents try to get their child to eat non-preferred foods only during mealtimes. This make sense, because this is when you are typically sitting down with your child to eat. However, meal times are not the ideal time to work on food struggles.  This is typically the time when your child is most hungry and least flexible.

Sensory Food Aversions Strategies 

In addition to learning how to fix our mistakes, we also learned some great strategies to help Mr. 5 with his sensory food aversion to textures.

1. Offer a preferred food with a non-preferred food.

During therapy, Mr. 5 gets to pick a preferred food to snack on and a drink of his choice when exploring a non-preferred food.  This provides Mr. 5 with some feelings of safety and control over the process, which leads me to my next tip…..

2. Give more control with choices when possible

food aversions sensory issuesAs I have stated before, sensitive children like to feel in control of their situation.  Before sitting down to work with a non-preferred food, we were instructed on a few ways that we could give our son more control.

Allow the child to choose which non-preferred food he or she would like to work with that day.

Then, have the child choose which preferred food he or she would like to have as a snack in between exploring the non-preferred food.

Ask the child how he or she would like it cut and how many pieces they’d like it cut into

Provide a no thank you bowl for them to put pieces in that really bother them as they explore the food.  

 3. Exploring food with other senses first

I think most parents expect children to jump right from refusing a food one week to being happy eating it another, but there are several essential steps that need to happen in between before progress can be made.

During therapy, the SP does not talk about eating the non-preferred food until about 15-20 minutes into the session.  First, they explore the food completely. Then they talk a lot about how it looks. The SP and Mr. 5 touch the food. They smell it .  Sometimes they even dissect it. During this, they also discuss what parts Mr. 5 likes and doesn’t like about the non-preferred food.

Before any progress can be made with sensory food aversions, a child first has to become comfortable around a non-preferred food.

For example, pizza is one of Mr. 5’s non-preferred foods, so they talk about the crust, then the sauce, then the melted cheese.  They smell it and pull the cheese off. Then the SP talks to Mr. 5 about what he does not like about pizza. Since he likes the crunchy crust, they started with taking bites of that first.

It is all about breaking down the scariness of the food and sensory aversion with slow, intentional steps.  The first step is breaking down the belief that has become ingrained in the mind.

They frequently use this plate as well, which my son has really been receptive too.  It’s fun and it helps take the focus off of eating a certain amount of food.  He likes seeing what word or picture is under each food and trying to make it to the end to see what’s in the box!

Our typical one hour session 2x/week with the speech pathologist goes as follows:

  •  Before entering the room, the SP takes Mr. 5 to the kitchen and lets him pick out a preferred food and drink, as well as two non-preferred foods to explore that day
  • They also pick out a toy from the toy closet, because he gets rewarded with a few minutes of play time every 15 minutes for exploring, NOT eating the non-preferred food.  
  • When possible, the SP gives Mr. 5 more control by asking how many pieces he would like the non-preferred food cut into.  
  •  They explore the food with their hands first, then eventually touch it to their mouth.  If Mr. 5 can do this, then the SP asks if he can give it a kiss. If successful, then he asks him to hold it between his teeth, hold up his hands and say “Ta-da!”  like a magic trick. Mr. 5 loves this!
  •  If all this is accomplished during the session, he will then ask Mr. 5 if he thinks he can take a bite.  Again giving Mr. 5 control over the situation with a choice. He is clear to tell him that he will never force him to try it.  

Depending on how long he has been working with the food, sometimes he tries it and sometimes he refuses.  When he tries it they rate it on a scale.

 In between exploring non-preferred food Mr. 5 gets opportunities to take bites of his preferred food.

Slow, But Steady Progress

I have been amazed at the progress Mr. 5 is making with these techniques.  The SP has been able to get him to voluntarily take small bites of grilled cheese, pizza, eggs, and chicken so far without gagging.

We are also assigned homework to do at home. Of course, he does much better with a professional in an office setting than at home with me where he feels safe expressing his frustration, but we are making progress.  This past weekend he ate 7 tiny bites of a cheese sandwich at home, which had never happened before!

I hope that sharing our journey with food aversions offers you some insight.  While this treatment is specific to my son’s challenges, many of these basic tips can be applied to any child struggling with sensory food aversions.  Patience, persistence and the correct treatment professionals can make all the difference in your child’s success with sensory food aversions.

Have a question or a tip that has worked for your child?  Be sure to leave a comment below!

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