For many children with sensory issues, eating can be overwhelming, scary or even make them physically sick.
Source Kids recently published a fascinating Q&A with speech pathologist and feeding therapist, Renee Cansdale from Let’s Talk Let’s Eat. Renee explores causes of feeding difficulties, challenging textures and useful strategies to overcome eating difficulties.
Today we’re sharing an edited extract of the story, with thanks to Renee and our friends at Source Kids.
What causes feeding difficulties and why do they seem to go hand in hand with autism and other neurodevelopmental conditions?
Feeding is one of the most outrageously sensory things you can do! You take substances of different shapes, sizes, colours, textures, temperatures and flavours, then you are expected to experience those sensory properties inside your body and change them by chewing and then swallowing. Children are particularly perceptive to their sensory world, so it stands to reason that eating is much more difficult for many.
[Image description: A mother and daughter are preparing food together in their kitchen]
What are some of the physiological reasons kids can struggle to eat?
Other than sensory challenges, children can have high or narrow palates, dental differences, tongue and lip ties, oro-motor coordination difficulties, food intolerances, allergies or gastric motility issues. Oral apraxia which is difficulty coordinating and initiating movement of the jaw, lips, tongue and soft palate can also contribute to feeding difficulties.
Often autistic children have a combination of these difficulties and may be diagnosed with Avoidant/restrictive food intake disorder (ARFID).
How can parents encourage their child to eat enough of the foods they need?
Unfortunately, we cannot make our children eat. Thus our job becomes giving our children the best opportunities to explore and become familiar with foods, and help them regulate their sensory world whilst accessing as many essential nutrients as possible.
This is where an experienced dietician can help. Once you are doing all that you can, it’s important to acknowledge that and embrace an unconventional diet.
You can also focus on building your child’s confidence, courage and flexibility – both generally and with food. In 90 per cent of cases, if you force foods that your child is not comfortable with, they will go in the other direction.
Why do some kids prefer crunchy foods and others prefer soft textures?
Crunchy foods are often highly processed and therefore consistent and predictable in their presentation and the experience of eating. This predictability likely makes them more appealing than soft foods which can be a variety of temperatures, with differences in taste, texture and smell.
Crunchy foods are also often easier to process from an oro-motor perspective. It’s why chicken nuggets are so popular – they’re crunchy, beige, not too smelly and predictable.
Some children might prefer soft foods or purees when the food is familiar or predictable. These can often be delivered to the mouth quickly via spoon or pouch and don’t need much skill or processing time in the oral cavity.
Some kids seem to hate when food touches or is mixed. What can I do to help this?
Some kids definitely don’t like food touching, perhaps because one food can taint the taste of another. Things like divided plates can be helpful and also bento boxes or zip lock bags. Tongues, forks, spoons, toothpicks and corn cob holders can be helpful for reducing the sensory input of touching a food with their fingers.
Pouches are also helpful because they cannot see the food and it is delivered straight to the back of the mouth. See what your child responds to best and work from there.
Spilling foods or drink can also sometimes de-rail a great food interaction, so try to keep things contained at first.
Many neurotypical and neurodiverse children find mixed textures like casseroles and spaghetti bolognaise really challenging. Involving children in the preparation and exploration of these foods can help demystify mixed textures.
What can I do to help my child start to learn about new foods?
Remember that actually swallowing the food is the last of a series of steps. Each step they reach along the way is an achievement.
When trying a new food, it can be important to get familiar and comfortable with a food’s many sensory properties before tasting.
This can be a long process but don’t lose heart or give in to the temptation to pressure or bribe. When children are having fun, they will learn and explore, but it will be on their own terms according to their own comfort levels.
We can’t expect children to put things into their bodies that they don’t feel comfortable with however we can support them to manage the sensory properties of foods and be flexible to explore new things.
Thank you to Source Kids for allowing us to share this story which appeared in the Source Kids Autumn 2022 Issue. Renee Cansdale is director of Let’s Talk Let’s Eat which specialises in Feeding Therapy. She follows many of the strategies from the SOS approach to feeding.
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