Sensory Problems Usually Are the Problem with Difficult Eaters
Dear Sensory Smarts,
My five-year-old is such a picky eater! There are only a few foods she’ll eat: pasta, pizza, and ice cream. She wants to eat macaroni n’ cheese almost every meal, but it has to be one particular brand. If the store is out, she will not eat another brand. My parents and in-laws think it’s because I spoil her. They all say I should serve her what everyone else is having and if she doesn’t eat, then tough. I did try it once and she simply did not eat. Help!From,Mac n’ Cheese Maven’s Mom
Dear Maven’s Mom,
Kids with oral sensory issues and food aversions will not eat foods they find repulsive and may wind up with nutritional deficiencies. Your child did not become an extremely selective eater because of something you did. It may help to consider the underlying factors that may be impacting your child’s inability to tolerate a wider variety of foods.
Oral Sensory ProblemsKids with sensory challenges, especially those on the autism spectrum, often have sensory issues in and around the mouth. Remember that the lips, tongue, inside cheeks, and throat are lined with skin. A child may be exquisitely sensitive to textures, and unable to tolerate foods that are lumpy, slippery, chewy, crunchy, or a combination of textures, like yogurt with granola. Some kids are particular about flavors, and may only eat foods that are bland, sweet, or even highly spiced. Some kids are particular about temperatures and insist on or refuse foods that are cold, hot, or lukewarm. Some kids stuff their mouths to feel there’s something in there. Other kids object to the way food looks or when items touch each other on a plate.Some problem feeders have oral-motor weakness, and lack strength and stability in the lips, tongue, and jaw for nursing and later for eating solid foods. Jaw weakness makes chewing difficult while tongue weakness makes it hard to form a bolus (round food mass) to swallow. High or low muscle tone in the mouth can also be an issue. A child may have a hyperactive gag reflex and avoids eating and gagging. At its most extreme, a child may throw up when an offending food is tasted, smelled, or simply mentioned.
Most kids on the spectrum crave predictability. Your daughter may insist on exactly the same brand of mac n’ cheese cooked exactly the same way as a form of control in a world that sometimes feels out of control. If she has successfully eaten that one type of mac n’ cheese in the past, it’s got to be the very same kind in the future.It sounds like your daughter sticks to “the white diet,” consisting of carbs and cheese, a common diet among kids with sensory issues. These foods are relatively soft and have an easy “mouth feel.” Unfortunately, these foods consist of gluten and dairy, which many kids with autism do not tolerate well.
Gluten is the main protein in wheat and other grains and casein is a protein in cheese and other dairy products. The theory is that these proteins trigger immune responses in some kids, resulting in a pleasurable, druglike response. Gluten and casein sensitivities are worth exploring with a nutritionist or allergist.
When a child has a significantly limited food repertoire, do not withhold the few foods that are acceptable. If you take away that one brand of mac n’ cheese, you’re taking away one of the few sources of nutrition for your child, even if it is a poor one. Pizza can be healthy if you buy or make it with high-quality ingredients.I start by identifying one food the parent would like to add to a child’s diet, typically a fruit or vegetable. If possible, the child selects the particular fruit or vegetable.
Find more on eating difficulties and other sensory challenges in Raising a Sensory Smart Child and at sensorysmarts.com. You may also want to check out these books: Just Take a Bite (by Lori Ernsperger, available in bookstores and online) and Happy Mealtimes with Happy Kids (by Melanie Potock, available at MyMunchBug.com).
Got a question? I’d love to hear from you. Please email questions to Lindsey@sensorysmarts.com.
Autism Asperger’s Digest March-April 2011 issueColumn: Sensory Smarts www.autismdigest.com
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Sensory Problems Usually Are the Problem with Difficult EatersDear Sensory Smarts,My five-year-old is such a picky eater! There are only a few foods she’ll eat: pasta, pizza, and ice cream. She wants to eat macaroni n’ cheese almost every meal, but it has to be one particular brand. If the store is out, she will not eat another brand. My parents and in-laws think it’s because I spoil her. They all say I should serve her what everyone else is having and if she doesn’t eat, then tough. I did try it once and she simply did not eat. Help!From,Mac n’ Cheese Maven’s MomDear Maven’s Mom,Kids with oral sensory issues and food aversions will not eat foods they find repulsive and may wind up with nutritional deficiencies. Your child did not become an extremely selective eater because of something you did. It may help to consider the underlying factors that may be impacting your child’s inability to tolerate a wider variety of foods.Oral Sensory ProblemsKids with sensory challenges, especially those on the autism spectrum, often have sensory issues in and around the mouth. Remember that the lips, tongue, inside cheeks, and throat are lined with skin. A child may be exquisitely sensitive to textures, and unable to tolerate foods that are lumpy, slippery, chewy, crunchy, or a combination of textures, like yogurt with granola. Some kids are particular about flavors, and may only eat foods that are bland, sweet, or even highly spiced. Some kids are particular about temperatures and insist on or refuse foods that are cold, hot, or lukewarm. Some kids stuff their mouths to feel there’s something in there. Other kids object to the way food looks or when items touch each other on a plate.Some problem feeders have oral-motor weakness, and lack strength and stability in the lips, tongue, and jaw for nursing and later for eating solid foods. Jaw weakness makes chewing difficult while tongue weakness makes it hard to form a bolus (round food mass) to swallow. High or low muscle tone in the mouth can also be an issue. A child may have a hyperactive gag reflex and avoids eating and gagging. At its most extreme, a child may throw up when an offending food is tasted, smelled, or simply mentioned.
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Comments (2)
My whole family has dietary sensory issues. My son and I are both diagnosed on the autism spectrum, my husband with ADHD and OCD, and my daughter with ADHD.
We each have our own list of "not if I was starving to death" foods, as well as "it better be available" foods. For example... for me, uncooked cottage cheese falls in the "I'll die of starvation first" category. For my husband, any fish does (therefore, no being shipwrecked on a small island....).
Then there's the "if I have to" foods, that can be tolerated but aren't desired, that can be incorporated subtly into dishes to increase nutrition balance.
The way I helped the kids expand their dietary repertoire, was to insist on "no thank you" portions of each component of a healthy diet before access to the preferred food item (occasionally... items). This means one good-sized bite (or a whole bunch of little nibbles with "yech" face attached) of foods from each food group that are not already on the "not if I was starving to death" list. Once texture and color issues were identified, I focused on preparing these foods with preferred textures and colors whenever possible.
When they were very little, it was one "no thank you" bite. Now that the kids are teenagers, it is one from each of the food groups first.
After the "no thank you" portions, individual choice is given and each family member fills up on their favorite, routine items... unless someone discovers a no thank you that turned into a new additional favorite. Now my kids are teenagers, and the payoff of doing this from the time they were little is immense. There is a wide variety of vegetables, proteins, etc. that are on their tolerated menu, and much more on their love-it menu than you might expect for highly picky eaters.
By doing this, the kids (and hubby), have discovered foods they now like but which they might have otherwise always turned their noses up at, and we have a good picture of the texture/flavor profile is for each person. I've been able to use that to incorporate diced, purreed, etc. forms of dislikes into sauces, etc. for the nutrition value, very successfully.
Most importantly... one night of no food never killed anybody. It just gives parents a bad case of overtired and cranky. You MUST stick to your rule for no thank you portions, or it doesn't work. Trust that the combination of desire for the preferred foods (which the kiddos know will happen as soon as those yucky bites are done), and hunger, will overcome stubbornness in the child if you are more stubborn. ONE BITE, to start, of ONE item before accessing preferred foods. Then after several months two... then three... Grin!
MIchelle Sarabia, MA
Special ed teacher and Mom of a wonderfully different family
"i tried it once." the kid wont die without dinner once.