Sensory regulation and food selectivity in children: what to do in such a case?

10-year-old Dana, accompanied by her mother, entered the clinic on the recommendation of the family doctor. The worried mother described Dana as picky about food. The mother’s concern is about her daughter’s nutritional status, and the possible harm to growth and development. Dana, on the other hand, does not understand what the fuss is about, for her she eats everything except foods she “does not like”.

In such a situation one has to clarify the reasons for the girl or boy giving up this or that food. Dana had a reluctance to eat foods with a texture like that of chickpeas or cheese. She does not eat eggs because of the smell, and peaches out of bounds because of the texture that chills her. Breakfast cereal is not an option because of the noise of the “crackling” texture in the mouth, which bounces it off.

And if that’s not enough, the mother adds that preparing meals is a big challenge. Dana needs a special adjustment at home, and even more so when eating outside the house – spending time with family and friends, trips and restaurants because Dana is reluctant to accept new foods that are not known.

Eating selectivity
Eating selectivity is a phenomenon that bothers quite a few parents, in two different aspects: in the impact on the nutritional status and the consequences on growth and physical development, and in another aspect in everything related to the conduct and organization of food and meals. The reasons for eating pickiness are varied and varied: they can be the result of anxiety that has existed in the past around eating events. Other reasons are the child’s rigid and picky nature which is expressed in the food as well as in other areas of life, games of control in front of the parents when the food is a “bargaining tool”. The child may be in the category of “super tasters”, these are sometimes called gourmets and are hypersensitive to tastes. There may also be difficulty in sensory regulation.

Sensory Integration
From the descriptions and explanations of Dana, who avoids many foods, it can be recognized that the background is a difficulty in sensory regulation. Sensory regulation is the ability to regulate and organize information from the various sensory systems and respond in accordance with accepted demands and expectations of the environment. The five senses are taste, smell, sight, hearing and touch. To them are added the system of balance and movement (vestibular), and the system of deep sensation (proprioceptive) – which transmits the information about body posture and body sensation in space.

While for many an experience that involves all the senses is a powerful and enjoyable experience, for children with difficulty in sensory regulation, the brain has difficulty processing the whole of the senses, and the child feels distressed. From child to child the symptoms vary and so does the intensity. There are several common signs in children:
Reluctance to dirt. Therefore, for example, they will prefer not to paint in gouache or play in the mud. Sensitivity to the touch of certain fabrics or garment tags on the skin of the body, and it is necessary to cut them before use. Sensitivity to odors and / or sounds. Frenzy and difficulty sitting for long periods of time. Reluctance to human touch, such as hugs or kisses. Reluctance to touch grass or sea sand. Clumsy body movements that are not adjusted. And also – eating pickiness.

10-year-old Dana, accompanied by her mother, entered the clinic on the recommendation of the family doctor. The worried mother described Dana as picky about food. The mother’s concern is about her daughter’s nutritional status, and the possible harm to growth and development. Dana, on the other hand, does not understand what the fuss is about, for her she eats everything except the foods she “does not like”.

In such a situation one has to clarify the reasons for the girl or boy giving up this or that food. Dana had a reluctance to eat foods with a texture like that of chickpeas or cheese. She does not eat eggs because of the smell, and peaches out of bounds because of the texture that chills her. Breakfast cereal is not an option because of the noise of the “crackling” texture in the mouth, which bounces it off.

It is not surprising that a child with difficulty in sensory regulation will be picky about eating. The act of eating uses all our senses. The sense we think of in the context of eating is the sense of taste, but in fact all the senses are involved in the act of eating. The appearance of the food on the plate, the colors, the manner of serving, the smell, the texture and the noises that accompany the act of eating: biting into food, sucking, chewing and swallowing.

so what are we doing?
First it is important to know that in most children the choice of eating passes or decreases as they get older. For example, a toddler who avoids contact with sea sand, will usually get used to this contact over the years following re-exposure and positive experiences around family recreation at sea. In the context of eating it is worth finding the right balance: exposing the child to varied food, but not forcing them to eat, criticize or put pressure around eating. You should continue to serve the food to the table, allow it to smell, touch and look at the food, watch others eat the same food, even if not eat it.

Encourage experimentation with small portions gradually (sometimes even tiny ones like a grain of peas) over time. And when successful, continue this exposure until it can be put on the menu. To the extent that the refusal is persistent and absolute, it is advisable to let the subject go for a while and try at another time. Exposure to new food consistently 15 – 10 times and even more may help.

A study done among eating picky eaters found that displaying pictures of vegetables over a period of time led to a greater number of picky eaters agreeing to try the foods. In addition, and in case there is a concern about the lack of nutrients due to the reduction of many foods from the menu, it is recommended to go to a dietitian for a diagnosis – and if necessary start treatment.

Desire to move forward
Let’s go back to Dana. During the session we discussed the main food groups required in a balanced menu. In each group we located the variety of foods that Dana eats. It was noticeable that the protein group has almost no representation on the menu, and together we thought about how and what can be included – even if gradually – in the menu.

When we explained to Dana the need for treatment and the treatment plan, she expressed a desire to move forward and cooperate, and it was suggested that later in the treatment we would each time add a different food of her choice and according to the need required in the menu. We advised her to taste (as opposed to “eat”) new foods at first.

It was explained to the parents that there would be no dramatic changes but slow and moderate progress. Many foods will still deter Dana, but the goal is to reach a full and nutritionally balanced menu. With Dana’s maturation, make sure that there is no harm in conducting yourself outside the home – on traffic trips or hanging out with friends in restaurants, for example.

In cases where there is ongoing nutritional or social impairment in eating, as in other areas of life, it is advisable to consult professionals at the same time. In cases where there is impairment in growth and development a dietitian should be consulted regarding the appropriate treatment. In extreme cases it is necessary to involve caregivers from the field of eating disorders.

By Editor

Leave a Reply