Feeding Difficulties

Sensory Feeding Problems- What Are They?

These are problems where something about the way food looks, tastes, smells, or feels is overwhelming or uncomfortable to a child.

Children with sensory problems commonly have difficulty transitioning from one food texture to another. They may remain “stuck” on liquids or “stuck” on pureed or baby foods and refuse foods with more texture. Sometimes children with sensory problems have uncontrollable gagging or vomiting reactions to foods.

Behavioral Feeding Problems- What Are They?

These include all other problem behaviors that occur around meals. Examples include but are not limited to: refusal to sit at the table for meals, refusal to self feed (when able to do so), and disruptive mealtime behaviors such as throwing food, stealing food from others, crying screaming, vomiting to get out of the meal, and others.

Distinguishing Sensory and Behavioral Feeding Problems from Other Kinds of Feeding Problems

While some behaviors are clearly behavioral in nature (sneaking food, for example) others may not be as clear. Food refusal, for example, can be a behavioral problem, but it can also be caused by oral-motor, digestive or sensory problems. Therefore, before treating behavioral feeding problems, oral-motor and digestive problems must be ruled out or addressed first. Next, sensory problems and behavioral problems may need to be distinguished from one another, as sensory problems will probably require some form of sensory stimulation or de-sensitization, while behavioral problems may require other kinds of strategies.

Food Selectivity- A Sensory or A Behavioral Feeding Problem?

Food selectivity means being very selective about the foods one eats. Food selectivity differs from “pickiness” in degree. Picky eaters usually eat at least one food from all of the food groups. Children with food selectivity, however, often avoid one or more food group entirely. They may eat no fruits or vegetables and/or no meats. They may eat no red foods, or no green foods, or no smooth or wet foods. They may eat only one brand of a particular food and refuse to eat any other brand. They may drink only water and refuse all other beverages. They may eat no more than 3-5 different foods altogether.

Food selectivity is seen in children with a variety of different diagnoses, but it is most commonly seen in children on the autism spectrum. Not every child on the autism spectrum has food selectivity, but a significant sub population of children with autism do have food selectivity.

Is food selectivity a sensory feeding problem or a behavioral feeding problem? Unfortunately, there is no one answer. Each child is different, including children on the autism sprectrum. Some children clearly have sensory reactions to food and need de-sensitization strategies. Other children have more behaviorally based problems and require other kinds of strategies.

– Information from West Virginia University