Sensory processing challenges affect how the nervous systems receives, interprets and responds to sensory information from our environment. This includes touch, taste, smell, sight, sound and movement. Children who have sensory issues may have an aversion to loud environments, bright lights, smells or different textures. The intensity of their reaction can exist on a spectrum.

There is a lot of sensory information that comes with eating, so children with sensory processing difficulties may feel overloaded and experience anxiety or physical discomfort during mealtimes. The challenges of communicating about sensory experiences, and the fact that the signs of sensory overload are often misinterpreted as ‘stubborn’ or ‘defiant’ behaviours, can make it difficult for parents or caregivers to recognize these issues and respond accordingly.

Although food-related sensory issues can be challenging, with empathy, patience and creativity, mealtime can become more welcoming for everyone. Here’s more on the signs to watch out for, why sensory sensitivities occur and strategies to deal with challenging feeding behaviours to create more positive eating experiences for your child.

Signs of Food Related Sensory Challenges

Sensory challenges related to food can appear and be demonstrated in various ways and every child’s experience will be different. Here are some of the common signs to look for:

• Extreme reactions to new food experiences (e.g. vomiting, gagging, explosive temper tantrums)
• Limited diet and few accepted foods
• Avoiding entire food groups (e.g. no fruit, vegetables or protein)
• Only accepting certain textures or temperatures (e.g. crunchy or hot food)
• Refusing food if there are small changes made to the presentation
• Insisting that different foods on the plate do not touch each other
• Eating very slowly or taking a long time to chew and swallow
• Displaying anxiety or behavioural issues around mealtimes
• Avoiding other messy activities (e.g. digging in sand, crafting)
• Losing weight

Although some of these signs and behaviours can occur occasionally with all children and some children may be ‘picky’ with food preferences that are unrelated to sensory sensitivities, if you are concerned about your child’s eating habits, reach out to their primary care provider. Other physical issues that require treatment, such as reflux, digestive issues, underdeveloped motor skills or chronic nasal congestion, can also create sensory difficulties or stressful associations with mealtimes.

Risk Factors

Many people associate sensory processing challenges with autism spectrum disorder (ASD). While people on the autism spectrum are likely to experience sensory issues, there are other factors and disorders that may increase a child’s risk of sensory symptoms. These can include:

• ADD/ADHD (Attention-Deficit/Hyperactivity Disorder)
• Learning differences
• Premature birth
• Genetic conditions (e.g. down syndrome)
• Neurological disorders (e.g. cerebral palsy)
• Environmental factors (e.g. lack of sensory experiences in early childhood, force-feeding or restrictive diets)

Understanding the signs and risk factors can help with early identification and intervention to improve your child’s food experiences.

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Strategies to Cope with Food Related Sensory Input

Serious feeding difficulties and eating problems require support from a health professional. If you have connected with your doctor and ruled out other possible causes, many children with sensory food aversions can be helped by introducing new foods in a supportive and gradual way. Through learning successful strategies to cope with sensory input and increasing the number of positive experiences with food, your child can be more successful. Here are some approaches to help your child and reduce everyone’s stress around mealtimes:

Avoid Pressure

Refrain from using rewards, bribes or punishments related to eating and celebrate effort over results. Do not insist that your child eat a certain amount or try a food that they are uncomfortable with. And do your best to avoid showing your disappointment or frustration. Pressuring children with sensory challenges usually creates more negative associations with food. Use phrases like, “Would you like to try this?” or, “It’s okay if you don’t like it,” and don’t push for anything else than what you’ve agreed on. This will show your child that you understand that this is hard and will continue to build their trust and confidence.

Go Slowly

It typically takes many exposures for a child to accept a new food and this is even more likely for children with sensory aversions. Gradually expose your child to a new food in stages. For example, they could start with just looking at the food, then touching it, smelling it, and finally tasting it. Stay consistent by continuing to expose them to the food to decrease their fear and discomfort over time. You may consider having a non-food related reward in place if they do eventually eat a new or feared food successfully.

Limit Distractions

Try your best to make mealtimes predictable by eating at around the same time and in the same place every day. Limit distractions to reduce sensory overload by dimming the lights, turning off the television or any screens and eliminating strong meal smells before serving. Keep mealtimes short, avoid discussing their eating habits at the table and focus on enjoying the meal together.

Change Presentation

There are so many ways to present food to make it more appealing and to spark your child’s interest. Arrange food into patterns or shapes or use cookie cutters or skewers to create fun designs. Divided plates or bento boxes with multiple compartments are an easy way to keep different foods separate if that is helpful for your child. Mini-versions of favourite foods like sandwiches, burgers or pizzas and themed meal nights can add excitement. To keep things simple, smaller plates with less food and little utensils can create more manageable and less intimidating portion sizes.

Adjust Texture

If your child is sensitive to a specific texture, modify it. Depending on their preference, puree fruits, vegetables or meats, soak crackers or bread in milk, offer frozen fruit or crunchy, raw vegetables. If you’re working on introducing a specific food and haven’t been successful, think about all the different ways it can be served. Instead of a fresh banana, try crunchy banana chips or blend it in a smoothie.

Offer Choice and Control

Provide your child with more autonomy by offering as many choices as possible. Involve them in setting the table so they can decide where to sit, what plates or utensils to use and the napkins to set out. Let them select if they want their sandwich cut into triangles or squares or their cheese in sticks or cubes. Set up a snack station with healthy options your child can access independently so they can choose what and when to eat. Meals that require customization—like pizzas, salads or tacos—will also let your child build their own meal. Placing food in the centre of the table and having your child serve themselves is another strategy to increase their independence. Try to include a preferred or familiar food and encourage them to choose a protein and a vegetable.

Get Messy

Add more sensory-based activities outside of mealtime to help desensitize your child to sensory input. Sensory bins with cooked beans, rice, pasta and oats can present textured food in a positive and inviting way. Kinetic sand, water beads or slime can also be used to simulate the wet or sticky foods your child may be uncomfortable with. During mealtimes try to stop focusing on manners. Let your child touch and play with their food and don’t ask them to clean up until the meal is over. If they put something in their mouth that is making them uncomfortable, tell them that it’s okay to spit it out.

Cook Together

Involve your child in meal planning to find new foods or fun recipes they may want to try. Take them grocery shopping and let them pick out foods that look interesting to them. Encouraging your child to participate in cooking and preparing meals will increase their interest and comfort around the food being served—even if they’re not yet ready to taste it. Having fun together in the kitchen will create more positive associations with food and provide yet another opportunity for your child to explore comfortably.

Every child’s sensory needs are unique so it will require some trial-and-error to find the right strategies for your family. Working with an occupational therapist (OT) or dietitian who specializes in children can help you find the most successful approach for your child. This is particularly important if sensory food aversions are impacting their quality of life or ability to maintain a balanced diet.

For more information on how an OT or dietitian can help, call VHA’s Enterprise Health Solutions team at (416) 489-2500 ext. 4649 or email ehs@vha.ca

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If you found this article helpful, you may also want to read:

• Navigating Sensory Processing Challenges with Children
• Recognizing Mental Illness in Children and Youth