By: Maureen Karwowski, OT
In my house growing up, meals were serious business. My parents had rules around “dawdling”, and playing with food was an absolute “no no”. Now, in my work as a pediatric occupational therapist, I advise the families that I work with to break these rules (and for good reasons).
Many of the children that I work with have sensory processing difficulties. Sensory processing challenges occur when a child has difficulty interpreting and responding to the sensory experiences in daily life. It is estimated that 1 of 20 children are impacted by a sensory processing deficit (Ahn, Miller, Milberger, McIntosh, 2004).
For some children with sensory processing difficulties, they have heightened sensitivity to textures, smells and tastes. These sensory over-reactions negatively impact a child’s ability to tolerate diets with a wide variety of textures, looks, smells and tastes. I have clients who eat foods that are similar in color, for instance all shades of white (crackers and chips). Other children eat foods that are munchable in texture, so graham crackers, chicken nuggets, and macaroni and cheese. One little boy that I worked with could not even be in the kitchen while his mother was cooking because the smells were so offensive to him. I remember clearly that he told me “food is not fun for me like it is for you”. That was a profound statement from a child of 5 years of age.
The good news is that I have seen great results in helping a child to expand their diet with work in therapy, and with the parents’ work at home. Many children do well with an individual while others do their best in a group with other children. I always start with a thorough occupational therapy evaluation, and assess the child’s sensory processing skills, motor coordination and fine motor skills. I work closely with speech therapists and a dietitian who specialize in working with children with feeding challenges. I want to rule out any oral motor and medical concerns before starting any kind of therapy with feeding.
The goal of my therapy sessions is to explore foods in a fun and low pressure manner. So dawdling and playing with food are an integral part of the work with my clients. Picture making towers of cucumber slices, while my client knocks them over repeatedly. Picture using those cucumber slices as goggles to look through. How about blowing peas off the table and into a bowl? I love making shapes and letters with cooked spaghetti noodles. These types of games provide my clients with the sensory experience of the food, but in a way that is very low pressure. The goal is not to eat the food initially, but to explore the foods in any way that the child can tolerate it. As the child is more comfortable with the touch, smell, look and taste of a food, the more likely they would be to eat the food.
For parents at home, I do suggest a time where the parent and child are having fun with exploring food, in any way that they can. I encourage families to have the child help with carrying food to the table, or pick out the vegetables at the market. Can the child mash potatoes? How about toss a salad? A child is much more likely to explore a food if they know that their parent is not expecting them to taste it.
Consult your child’s therapist to determine if your child would benefit from a sensory approach to feeding or contact Easter Seals DuPage & Fox Valley for information about our summer feeding groups.
If you are interested in learning more about sensory feeding work, join us for our upcoming continuing education course on September 12-15, 2019. When Children Won’t Eat: Using the SOS Approach to Feeding