Sensory Picky Eaters & Problem Feeders

Picky eating can be a common challenge that many parents experience with their children. While it may seem like a phase that will pass, for some children, picky eating can be a serious problem that can affect their child's overall health. 

This type of eating is often associated with sensory issues and known as sensory processing disorder. It can make it difficult for children to have a balanced diet. 

In some cases, picky eating can even lead to a condition called Avoidant/Restrictive Food Intake Disorder (AFRID). Children have such a restricted diet that it impacts their growth and development.

Picky eating is used to describe children who have a limited or selective diet because children refuse to try new foods or different food groups. This can be a frustrating and challenging for parents because they struggle to provide their child with a nutritious diet. It's not just a matter of being stubborn or difficult but because of their child's sensory processing disorder. 

When a child has sensory processing challenges they may have an over or under-sensitive response to sensory input. This can result in sensitivities to different tastes, textures, or smells.  A child with sensory issues may find different textures like mushy or crunchy foods overwhelming and not appealing. 

Child who have sensory differences can be overly sensitive to strong smells or tastes. This can make it challenging for parents to introduce new or unfamiliar foods into their child's diet. These children may become labeled as picky eaters but in fact they are struggling with sensory difficulties.

It is very important to understand that picky eating is not just a phase that will pass. Sensory issues can be a real challenge for children and it's very important to acknowledge and address them. Seeking help from a pediatrician can provide parents with a better understanding of their child's sensory difficulties and how it affects their eating.

When trying to introduce new foods to picky eaters with sensory issues. Forcing or pressuring a child to eat a particular food can often have the opposite effect and cause more significant resistance and anxiety towards that food. Instead, parents can try introducing new foods gradually in small portions in a supportive way.

Parents can work with their child's therapist or doctor to create a food plan. This can involve gradually introducing new foods, incorporating preferred foods into meals and making meal times a positive experience. 

Children with sensory processing disorder are not just being difficult or stubborn. They will need a lot of love, support and understanding to work through their food challenges. 

Signs or Symptoms of Sensory Based Food Intolerance:

Texture - Child may avoid touch to hands or mouth smooth, moist, creamy; but may crave crunchy, sour, spicy

Visual - Many children are 'yellow food' eaters; French fries, pasta chicken nuggets        

Oral Motor - Low oral muscle tone, weak lip, cheek, or jaw muscles

Smell -  Some food smells

Temperature - Avoidance or preference for hot, warm, room temperature, cold

Regulation - Difficulty accepting new food based on taste, texture, what it looks like, rigid temperament; children that find what they like and it works for them so they figure why change it  

 Behavioral - Some children who are sensory defensive in other aspects of their lives learn secondary behaviors in order to cope.  They are control seekers so they can manage their environments and not have to be faced with unexpected challenges.  This behavior may carry over to meal time.

Maintain firm rules around mealtime and at the dinner table. Eliminate talk about what the child doesn't like and won't eat.  

Rules of the house can be that everyone helps prepare meal, sets table, and sits for a minimum of 10 minutes.  This has nothing to do with eating the meal.  

Do not hold a grudge if your child won't try something new.  They should feel good about their participation in the meal time event.   Once you are working with your child to try new foods you won't also be working at mealtime rules and behaviors.

Prepare by desensitizing with a damp wash cloth to lips with firm pressure, a tooth brush or other tool firmly rubbing inner cheeks and tongue, and jaw compressions by applying pressure to top and low molars.

Use a plate divided into 3 sections.  Put 2 foods that your child loves and is really motivated to eat:   pieces of cheese, pieces of apple, or pieces of mini M&Ms.  In the 3rd compartment put a new food.  He needs to go around the plate taking a bite of each item before moving onto next item.  New food can be touching it to lips a few times.  Don't forget to praise.  Then proceed to touching tongue with new food item before moving to next item.  After tongue, have him hold it in his mouth; do not allow spitting it out.  Instruct him to remove it and put back in plate or napkin if he has to.  It may take a few meals before ready to chew or swallow.  Respect that he gave the old college try and truly does not like the food item.  Move onto another food item next time and have him tell you what he would like to try.  Make a list together.   I can't emphasize enough the importance of not getting mad or carrying a grudge.  Praise your child for his efforts.  In addition to the reward of moving onto the food he likes, you can also use a token board, sticker chart, or marble jar to reward as you go; good table manners, following rules for 3 sectioned plate, smelling it, licking it, etc.

These strategies and others are not easy to implement alone.  A pediatric occupational therapist or pediatric speech-language pathologist specializing in sensory processing and feeding disorders would be the professional(s) to get help from.

Lori Frommer, OTR/L
Home Therapy Solutions, LLC
Occupational Therapy and Parenting Foundations

If your child only eats certain foods and often refuses to try new types of food, you may be wondering if your child is a picky eater or has a feeding problem. Here are a few ways to know the difference. Typically, the majority of children who are picky eaters and do not have a more serious feeding problem demonstrate a normal growth pattern. Normal growth and development as well as the absence of physical symptoms (e.g. trouble swallowing) are factors that healthcare professionals often look for when determining whether a child is a demonstrating picky eating or problem feeding.

Common signs of picky eating include 

Eating a limited amount and type of foods

Refusing certain foods, especially fruits and vegetables

An unwillingness to try new foods

A strong preference for specific foods

Preferring to drink milk or juice instead of eating

Snacking instead of eating proper meals

Preferring fatty foods and sweets

Feeding problems, on the other hand, may be due to an underlying medical problem and it may also be linked to malnutrition. Signs of a feeding problem include:

Difficulty swallowing

Painful swallowing

Choking or coughing while swallowing

Complaining of pain while eating

Diarrhea and/or vomiting

Food allergies or sensitivities

Failure to thrive

Certain disorders (e.g. autism)

DISCLAIMER: I am not an Occupational Therapist. I am an adult who has Sensory Processing Disorder, a sensory parent and a Grandma. The information on this website is not medical advice and does not replace the information that your child's therapists gives you. These are just ideas and information that I have learned myself over the years of being a parent and an adult living with SPD. If you are concerned for your child, please always seek medical attention through a family doctor, pediatrician or therapist. This website is for suggestions and informational purposes only. Each child is different and what works for one child may not for another because all children have different needs. Please always consult with a professional.

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