An inexhaustible topic is the discussion of the relationship between eating and the sensory profile. An important element of working with parents is to map the child's sensory profile, especially in terms of the characteristics of the foods he or she likes and accepts. The types of foods he or she likes are an important starting point for treatment and changes. For children with restricted diets, it is unlikely that there will be a major, sudden change. A slow, gradual process of trying new foods and introducing them into the diet can be envisaged, with information on what foods the child is currently eating being essential. What are the so-called safe foods? From this, we can make small adjustments as we go along.
Stimuli are processed in the nervous system continuously, and generally speaking, if all goes well, it is not conscious. We know that it is working well because the child is able to keep himself and his behaviour emotionally regulated by using different strategies. That said, if he or she is sensory sensitive or has a different sensory profile from the average, he or she is constantly "working" to avoid becoming uncontrolled. For such a child, even a normal, ordinary day at nursery or school, where he or she has to adapt to the daily routine, can be a huge effort.
Sensory sensitivity or sensory processing disorder only becomes apparent when something causes self-regulation to fail.
And this is where the process of self-regulation is linked to eating. Based on research on ARFID, we know that sensory sensitivities are always part of the pathogenesis of the disease. Without it, extreme selective eating does not develop. So if your child has ARFID, you can be sure that there is some sensory sensitivity associated with it.
A child who is in nursery or school all day is exposed to a lot of stimuli over which they have no 'control'. For example, he cannot control how loud the others are, how much he is pushed during play, whether the neon in the classroom is too bright, or whether he can barely maintain his attention when he is drowsy from the silence. Each of us has different sensory preferences or sensitivities. Not to mention that our current state of mind (fatigue level, hunger, etc.) also has a major impact on our tolerance. Meals are one part of your day that you can have an impact on. It is possible that the child's desire for self-regulation may be involved in not eating. It is an area of his life that he can control, as we as parents can see quite clearly. What a child eats is ultimately out of our control. It is his choice what goes into his mouth.
If we look at it from this perspective, it may be easier to understand why children with extremely restricted diets are limited to such a narrow repertoire. Considering that as children we have control over very few things, and eating is one of them, it is not surprising that children with a sensory sensitivity or different profile from the average child actually use meals to help them self-regulate. In other words, food should be supportive of their sensory profile. They also .unconsciously use this opportunity to create the most pleasant, comforting, predictable "environment" for themselves with safe food. From this perspective, it is a logical and adaptive response.
How do we know what will help them or how we should think about making a change?
It is rather simple, but requires some detective work to find out what characteristics of a food are important to a child. The first step is to make a list of safe foods. This includes all foods that the child currently accepts. In addition, it is useful to list foods that the child has eaten occasionally or has eaten in the past but no longer eats. Finally, it is important to identify foods that he or she dislikes or finds repulsive. Once you have a list of foods, try to look for patterns and commonalities.
This will reveal which characteristics the child prefers and which he does not. For example, are sounds important to him? Does he prefer foods that make a relatively large noise when eaten? Crunchy crisps or chewy raw vegetables? Perhaps mouth-watering candys? Or the opposite may be true: he is disturbed by sounds and prefers foods that can be eaten without making any sound.
Does he like foods that require a lot of chewing? If so, he may need proprioceptive (from the body) input. Does he like complex flavours? Or, on the contrary, does he prefer separate, distinct flavours? Does he dislike sauce being poured on his pasta? Or what about textures? Does he eat things with mixed textures? Or does he eat it by just picking the same texture out of the food? Does he like strong smelling foods? Is it important for him to have his sense of smell "on" when he eats? Or does he specifically avoid foods with intense smells?
And we could go on and on, with variations in taste, smell, sight, temperature, touch/texture, homogeneity.
Thinking about this, and even working with them, together, to find out what are the most important qualities for them in each food, is very helpful in terms of how to expand their diet. You can find posts on food-chaining (https://www.arfid.demetrovics.hu/post/étel-kapcsolás-egy-hatékony-módszer-az-étrend-bőv%C3%ADtéséhez-arfid-os-gyerekek-esetén) and planned tasting (https://www.arfid.demetrovics.hu/post/tervezett-kóstolás-tervezett-nyugalom) for the principles of change, but this is square one to get started. You can also get important information about what is difficult for them, whether at school or elsewhere, and often just talking about it can help and find an understanding audience.
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