Children with sensory based feeding difficulties frequently have restricted diets and can demonstrate aversive feeding behaviours like food refusal, gagging, or textural aversions to specific kinds of food.  While the main purpose of eating is to achieve an adequate intake of food in order to sustain growth, the process of eating is not just one of sustaining life: in human societies it is a social event. (Reilly 1993 in RCSLT 2006).It is recognised that any difficulty during mealtimes impact ‘not only on the physical but also the emotional and well being of the individual’ (Arvedson & Brodsky, 1993). Adequate nutrition comes from eating a wide variety of foods and the focus should be on expanding dietary choices rather than on increasing the amount a food your child eats.

Suzanne Evans Morris, a Speech-Language Pathologist from New Visions, highlighted a few very important principles when planning to expand your child’s diet.

(i)    Comfort and safety are the most important aspects of the mealtime. Children need to learn about new foods in an unthreatened way. They need a great deal of exposure to a food before they will consider tasting or eating it.

(ii)    Rule out any underlying gastrointestinal discomfort like reflux.

(iii)    Build on what your child knows and accepts: make a list of the foods and liquids that your child likes and accepts. Suzanne Evans Morris recommends organising these foods and liquids by sensory qualities such as taste, texture, colour and smell. Example: does your child eat mostly foods that are crunchy or crisp? Foods that are bland? Foods that are smooth and soft? Foods with similar colour? Make a list of other foods in the same categories. Example: a child who eats soft smooth foods such as mashed bananas may accept another soft white fruit such as pureed apple sauce, mashed tinned pears or pineapple mixed with banana more easily than broccoli.

(iv)    Create new combinations: a child who likes popcorn, crisps and cheese may accept popcorn with melted cheese or Nachos.

(v)    Make very tiny changes in the new food that you offer. Example: yellow cheese could be changed to mild cheddar, medium cheddar, mature cheddar. Apples come in sweet and tart variation. A child who eats yellow apples may have an easier time moving to yellow pears than to strawberries.

(vi)    Give your child an opportunity to play with food. Through playing with food (smearing it on the highchair, stirring it, pouring it or making designs with it) your child learns to become comfortable handling the food and learns how the consistency and texture of the food feels. Gradually your child will develop the confidence to explore the food with the mouth through licking or tasting.

(vii)    Make a separate time for food play so that your child knows he/she is not expected to eat the food. Once your child has become familiar with the food through play, introduce it as part of the meal.

(viii)    Help your child to feel safe with textured foods. Children need to know that they can get pieces of food out of their mouths if they need to. Teach your child how to use their fingers to remove a piece of food, or bite and spit food out. As this becomes more comfortable, they may progress to holding the food longer in the mouth or moving it around before spitting it out.

(ix)    Get your child involved with mealtime preparation: show them how to scoop the food into a bowl, how to mix, pour or spread.

(x)    Offer food with high nutritional value. For children who prefer sweet foods, begin with a vegetable like carrots or sweet potato with added maple syrup. Some children like fizzy drinks, but instead you can give them fruit juices mixed with carbonated mineral water. If your child has a tendency to hold food in his/her mouth, try dipping their foods in spicy condiments, example barbecue sauce, sweet & sour or salsa. It is very important to consult a qualified dietician if you have concerns about your child’s nutritional intake.

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