Sensory food issues are common causes for eating problems among neurodivergent children.  Sensory processing differences can lead to extreme reactions to food based on taste, texture, temperature, smell, or appearance.  Too much or too little sensory input from the environment also affects children’s ability to eat well.  It’s important for parents to understand that kids with sensory differences aren’t just picky eaters. These kids need extra support and understanding as they learn to eat new foods.  In this article, we’ll explore symptoms of sensory food issues, the different types of sensory processing difficulties, causes of sensory food aversions, the impact of sensory food issues, and how to make sure children with sensory processing issues are fed well and nourished.   

What are signs of Sensory Food Issues?

A child that seems to be a picky eater may have sensory food issues if he/she:

  • Avoids or only eats certain textures or consistencies of foods
  • Avoids or only eats foods that are a particular color or shape
  • Has intense reactions when food gets on his hands
  • Gagging or vomiting at the sight or smell of certain foods
  • Experiences frequent meltdowns and dysregulation around mealtime
  • Is unable to tolerate sounds of crunching, chewing, or heavy breathing

What are sensory processing differences?

Our brains are constantly scanning the environment and taking in information from the world around us. This happens whether we’re aware of it or not.  Individuals with sensory processing differences read and processes information differently.  This can lead to unexpected and sometimes challenging behaviors.  Normal sounds, smells, food textures, flavors, and other sensory input can make them feel frightened and confused because of the way their brain interprets the information.  Flavors can be really intense. Textures can feel painful. Smells can be intolerable. Although certain foods are generally considered safe for children, they don’t always feel safe for kids with sensory problems.  

different types of sensory processing difficulties

Sensory Modulation Disorder, Sensory Motor Disorder, and Sensory Discrimination Disorder are different subtypes of Sensory Processing Disorders that affect how the brain processes sensory input. A child can be affected by a combination of different subtypes, sometimes presenting as both sensory seeking and sensory avoidant. These differences impact the way the person reacts to information from any of the eight different sensory systems including:

  • Taste
  • Touch
  • Smell
  • Sound
  • Sight
  • Proprioceptive (movement and motor skills)
  • Vestibular (balance and orientation)
  • Interoceptive (internal feelings)
Three subtypes of sensory processing disorder

Sensory Modulation Disorder 

Children with Sensory Modulation Disorder have a hard time processing and responding to different sensory input.  The taste, textures, or smells of food, the way food looks on the plate, the feeling of food on their hands, sounds and lights in the room where they’re eating can be really difficult for them to tolerate. Sensory avoidant individuals tend to have big reactions to sensory input. Children who are sensory seeking may need increased sensory input, and can have more delayed or decreased response to sensory input. A child who is sensory craving is usually constantly seeking more sensory input.  Being extra sensitive or less sensitive in any of these areas makes eating and mealtime more challenging.

Sensory Motor Disorder

Children with Sensory Motor Disorder have a hard time with balance and coordinating movement. Dyspraxia refers to the difficulty coordinating the muscles in the mouth, lips, and tongue. This often impacts oral-motor skills and makes chewing and swallowing more challenging.  It can also affect their ability to feed themselves using all the muscles and movement involved in bringing food from the plate to the mouth. Postural disorders effect balance and make sitting up at the table to eat more difficult.   

Sensory Discrimination Disorder

Sensory Discrimination Disorder affects the brains ability to distinguish between different sensory input.  For example, a child might have a difficult time distinguishing between the feelings of hunger and fullness, or differentiating between tastes that are a little sweet or very sweet. Children with sensory discrimination disorder have a hard time noticing differences and similarities in any of the eight sensory systems. 

causes of sensory food aversions

Sensory food issues occur in children with sensory processing differences. The causes of sensory processing disorders are not completely understood. It it likely linked to a combination of genetic and environmental factors.  Many children with Autism Spectrum Disorder (ASD) or ADHD can have sensory processing differences.  Often these differences lead to food aversions, or in more extreme cases Avoidant Restrictive Food Intake Disorder (ARFID).  

Impact of sensory food Issues

Sensory food issues can lead to feeding disorders, such as Avoidant Restrictive Food Intake Disorder (ARFID). They contribute to a child’s inability to eat in a number of ways.  Children who are more sensitive to tastes, smells, or textures might have a limited food preferences that put them at risk for poor intake and nutrient deficiencies.  Children who may be described as extreme picky eaters, or highly selective eaters, are at higher risk for iron deficiency, poor bone health, decreased immunity and poor growth.  

boy with sensory food issues uses headphones to help him eat

It’s important to understand that children with sensory food aversions aren’t just being picky or manipulative about food. Sensory food aversions can impact the relationships within the family and outside of the home.  It can be hard for others to understand the intense reactions to foods. Mealtime stress can be challenging for the child and for parents. Children with sensory food issues often feel left out of social activities due to their anxiety around eating. Parents also develop anxiety about their inability to feed the child balanced meals. All of this can lead to more disconnection and negative feelings associated with eating. 

Nourishing a Child With Sensory Food Aversions

Children need three things in order to eat and grow well: appropriate feeding skills, safe food and eating environment, and a positive relationship with their caregiver.  Particular foods and environmental factors, normally considered safe for neurotypical children, can be triggering for kids with sensory aversions.  General feeding advice doesn’t always work, as these children often prefer to go hungry rather than to force themselves eat something they can’t handle.

Forcing a child with sensory food aversions to eat is usually more harmful than helpful. It can be traumatic for some children. Well meaning parents often resort to forcing or pressuring their kids to eat because they want their child to be well nourished and healthy.  A responsive way to address these concerns is to understand how their unique sensory sensitivities are relate to selective eating, and find ways to accommodate for their preferences.  

A child’s refusal to eat meat and vegetables is concerning for many parents. With some observation and understanding, parents might discover that their child has a hard time with certain textures, flavors or smells.  They can adjust or accommodate to meet their child’s needs.  Some helpful solutions would be to meet their nutritional needs with other types of food that are more tolerable for the child. Supplements and vitamins are also be helpful for some children. Many parents find it worthwhile to work with a dietitian as they explore different ways to meet their child’s nutritional needs.

Support for Children with Sensory Food Issues

Children with sensory food aversions can participate in feeding therapy to develop the confidence they need to learn how to eat better. Occupational therapists (OT) provide therapy for children who have difficulty with motor skills involved in feeding. This includes actions like bringing food to the mouth, or sitting up to eat.  They can also work with families to create a plan to provide the amount of sensory input that child needs throughout the day.  Appropriate sensory input can help calm a child’s nervous system, making mealtime less triggering for the child.

Speech therapists (ST) work with children to develop oral motor skills involved in chewing and swallowing, and transitioning to more complex textures of food.  ST can also help children with oral aversions to decrease anxiety around food and eating.  A pediatric dietitian can monitor the child’s growth and nutritional status, and work with the family to find appropriate solutions to a limited diet as the child learns to eat different types of foods.  

It’s important to find a feeding therapist that fits your family and your child’s needs. Different approaches to feeding therapy might focus more on behavioral outcomes or on creating positive experiences with food. In either case, addressing the underlying issues that contribute to extreme picky eating is important.  

Conclusion

Sensory Processing Differences (SPD) are common reasons for food selectivity in neurodivergent children. Sensory food aversions often lead to major problems with feeding. Restrictive eating habits can negatively impact a child’s nutritional status. Finding ways to accommodate for the child’s differences is one way to avoid nutrient deficiencies and growth delays.  Helpful support fosters positive experiences around meals, and aids in improved processing of sensory information. Appropriate intervention will help to decrease the child’s anxiety around food and build their self confidence in eating. Contact us to see if working with a Registered Dietitian would be helpful for your child.

Sources:
  1. Pediatric TLC. (n.d.). Sensory-based motor disorder. Retrieved March 31, 2023, from https://pediatrictlc.com/sensory-based-motor-disorder/
  2. Sensational Kids OT. (n.d.). Sensory processing. Retrieved March 31, 2023, from http://sensationalkidsot.com.au/home/sensory-processing/
  3. Miller, L. J., Coll, J. R., & Schoen, S. A. (2012). A randomized controlled pilot study of the effectiveness of occupational therapy for children with sensory modulation disorder. Journal of Occupational Therapy, Schools, & Early Intervention, 5(3-4), 97-117. https://doi.org/10.1080/19411243.2012.745265
  4. STAR Institute for Sensory Processing Disorder. (n.d.). Subtypes of SPD. Retrieved March 31, 2023, from https://sensoryhealth.org/basic/subtypes-of-spd/