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Eating difficulties

There are several reasons why children with and without sensory processing have challenges with eating.

• Previous experiences (e.g. tube fed, reflux, vomiting, choking, etc)
• Modelled behaviour
• Learnt behaviour
• Stress
• Sensory difficulties
• Coordination difficulties

This website page will specifically focus on children who have eating difficulties as a result of sensory challenges.

Mealtimes and sensory processing

There are several reasons why children with sensory processing difficulties have challenges with eating. Eating requires postural stability to maintain sitting, whilst having the motor co-ordination and sensory processing to manipulate and eat the food put into the mouth. (Humber)

Children with sensory processing challenges are often processing sensory input at a much higher rate than others which results in them experiencing sensory overwhelm. Many children can experience this during mealtimes which can result in mealtimes becoming a routine with negative associations.

We rely on interoception (Interoception is our sensory system that provides information about the internal condition of our body—how our body is feeling on the inside – Humber) to sense when we are hungry and to identify when we are full. Eating is a learnt behaviour and it is important to understand a child’s feeding history in order to support eating difficulties.

A child may have had reflux, a surgery or an unpleasant experience when starting solid foods that may now be impacting on their association with food and pain or unpleasant feelings and emotions.

Taste, smell and texture

Taste and smell are closely associated.

If a child is over-responsive to smell this can affect their taste.

Most taste perception is dependent on the perception and interpretation of smell sensations which go right from the nose to the part of the brain involved with emotions and motivation.

Explains why eating can be such an emotional roller coaster.

Sensory sensitivities can also affect the child’s ability to cope with different food textures and tastes.

Seating for eating

Correct sitting posture during meal times provides increased stability and support for the child to access and engage with the meal. The child should be seated with the following during meal times (as shown in picture);

• Feet flat on the floor
• Lower back is at the back of the chair
• Hips and knees are bent at 90°
• Table placed between hips and underarms

A booster seat, footrest/stool or side supports may be required to provide the child with maximum stability during mealtimes.

 Source: Your Kids Table

Coming to mealtimes regulated

If your child feels any sense of anxiety around mealtimes they are potentially going to come to the table dysregulated. In order for a child to learn and engage at mealtimes they need to be in a calm and alert state.

Encourage active play and movement activities before sitting at the table for a meal, to assist with regulation. Your child may benefit from engaging in activity that they enjoy or find calming e.g drawing or playing lego before transitioning to the table.

A regulated child = more success and learning during mealtimes.

Ideas to support engagement and learning at mealtimes

• Set up good pre and post mealtime routines e.g. setting the table, washing hands, five minute warning and a clean-up routine involving scraping scraps into the bin.
• Eat together at the dinner table. This encourages social interactions, social modelling and exposure to different foods. Children are more likely to eat a new food if an adult is eating the same food versus just present and eating a different food.
• Use a plain placemat to define the child’s food space. This is then a portable cue that can be transferred to anywhere you go.   If playing and eating in the same place – have one placemat for eating and one for play.
• If needed, allow your child movement breaks during mealtimes or allow them to sit on an air cushion e.g. move-n-sit, disc-o-sit cushion or ball chair.
• Use a non-slip mat under their plate to hold it still.
• Offer ‘family meals’ with a buffet style set up on the table for everyone to serve themselves.
• Involve the child in meal preparations to increase their exposure to foods.
• Find other times to play with food outside of mealtimes in a different spot to where the child normally eats. e.g. puddings or jelly.
• Ensure the child has a face cloth during mealtimes to wipe their hands and face straight away if they are over sensitive to touch.
• Minimise visual and auditory distractions during meal times.
• Use a taster tray at school (ideal for infant ages) so that they line up with others make a choice and their packed lunch is put on the same tray.
• Give your child permission to change their minds, don’t make choices for them (teach them to say “no thanks”), don’t set the boundaries