How to tell if your child has sensory food aversions

Not all picky eating is simple. Some children have sensory food aversions which is a strong reaction to certain sensory properties of a food making it a thoroughly unpleasant experience.

When picky eating goes on beyond the typical toddler years or you have adjusted mealtimes significantly and they’re still struggling, it’s worth investigating whether sensory food aversions are part of whats going on.

What is a sensory food aversion?

Sensory Food Aversions refer to when children exhibit a strong reluctance or refusal to eat certain foods and its rooted in their sensory processing of the food’s appearance, smell, texture or taste, which can trigger a negative response.

For example, a child might reject foods that are too crunchy, too smooth, or have a strong smell, finding these sensory inputs overwhelming or unpleasant.

This is often seen in children with sensory processing differences, including those on the Autism Spectrum (ASD).

These children process sensory information differently, and because they interpret them as unpleasant, it can lead to a limited diet.

However children with sensory food aversions can be helped with feeding therapy involving a gradually introduction of new foods in a supportive and non-pressurised way.

A mother and son sharing a meal, demonstrating a gentle approach to parents controlling food portions

How children learn to eat

Eating is one of the most complex tasks that human beings master throughout their entire lives.

It can take a typically developing child 2-3 years to learn how to eat. If your little one has difficulties along the way, this time extends significantly. 

Learning to eat is a whopping 32 step process(1) for each food they encounter that involves the sensory system. 

In addition to the sensory side of things children also learn to eat (or not eat) through cues in their environment and how we as parents interact around food in front of them.

How the sensory system is involved

Eating involves using all 8 (not 5) senses at the same time. These are:

  • Visual (sight)
  • Tactile (touch) 
  • gustatory (taste) 
  • olfactory (smell) 
  • auditory (hearing)  
  • proprioception (positioning or sense of self in space)
  • vestibular (balance)
  • interoception (how your body feels inside)

Eating is the only thing that children do that engages all of their senses at exactly the same time.

Children who struggle with eating may actually have difficulty processing what their senses are telling them.

What is sensory processing? 

Sensory processing is how your child interprets the world around them through their experiences. The sensory information is processed by their brain and they respond accordingly. 

Children with sensory processing differences can fall in to one of or a combination of the following 3 types:

A boy eats chips from a bag, highlighting the importance of balanced snacking within a framework of parental guidance

Avoiding or over responsive

This is where there is a heightened awareness meaning they experience things more deeply than others.

These children may try to avoid as many sensory experiences as possible to protect themselves, they can be hypersensitive and overwhelmed easily.

They often have difficulty with wearing certain types of clothes, playing in sand, walking on the grass with shoes off, they don’t like social events, crowds, rough play or sports.

When it comes to food, they dislike wet or sticky textures, strong smells, lots of different food on the table, noisy dining halls.

Low registration

This is the opposite of avoiding.

These children do not notice sensations such as the colour, shape or smell of food, or even where that food is in their mouth. They therefore come across as disinterested in food, meals and eating.

They may not notice hunger, thirst and what feeling ‘full’ feels like so it can seem like they have no appetite.

Children with low sensory registration can appear tired, passive, quiet and prefer to sit around.

Seeking

This is where they can’t get enough!

Often sensory seeking children are labelled often as wild or hyperactive.

They crave sensory input and are constantly ‘on the go’ stimulating their vestibular and proprioceptive sensory systems. These children won’t sit still and just can’t stay at the table.

They like strong flavours, crunchy foods, very hot or very cold foods and often make a big mess when eating.

Could your child have autism if they have sensory food aversions?

Many autistic children also have sensory processing differences and also have extreme picky eating or anxiety associated with food and eating(2)

However many children with sensory food aversions do not have autism and having autism doesn’t automatically mean that a child will have sensory food aversions.

What are the consequences of sensory food aversions?

Many parents ask us for advice when their GP can’t help because their child is growing and gaining weight as expected. NHS services unfortunately only have capacity for unwell children or those whose growth is faltering which means that many don’t get help.

Reduced range of foods

A big worry with sensory food aversions is that children won’t eat a variety different kinds of foods. They often end up eating fewer veggies, fruits and meat, and prefer more snacks and foods made from refined carbohydrates like white versions of carbs or sugar.

Nutritional deficiencies

When your child wont eat an entire food group or eats a limited range of foods, they’ll likely not be getting all the nutrients that they to be healthy and well.

However it’s not just as simple as giving them an ‘off the shelf’ multivitamin, your need to identify which nutrients their diets are falling short of and replace those as there is ‘too much of a good thing’ which is the risk of using a generic multivitamin.

A dietitian can assess and advise appropriately.

Family stress

I don’t need to tell you how stressful it is, because you’re living with the struggle every day. I want you to know that I understand how it feels, I’m a parent with a child with sensory food aversions too. Here’s what we’ve experienced:

  • The over reaction to new or different food.
  • The daily power struggles at the meal table.
  • The juggle of cooking different meals.
  • Or trying to find one that everyone enjoys.
  • The constant worry about nutrition!

When I did my feeding therapist training, the psychologist teaching explained that the stress levels parents feel when trying to feed a child with sensory food aversions was only second to the stress they’d be under if they’d been diagnosed with cancer.

It’s huge.

Social Isolation

Sensory food aversions can also make some children feel left out. They might not want to go to their friend’s house to play, to birthday parties or eat out in restaurants because they’re worried about having to eat certain foods they don’t like.

A fussy eater refusing his dinner

What are the 32 steps to eating and how does this fit in?

Each of the 32 steps represents a level of tolerance for 5 of the 8 senses. They are grouped into 6 sensory milestones:

  • Tolerates the food
  • Interacts with the food
  • Smells the food
  • Touches the food
  • Tastes the food
  • Eats the food

Children can jump through the 32 steps quickly for some foods but get stuck on a single step for weeks, months or years. 

Because eating is a multi-sensory task children must be able to manage all of their sensory experiences at the same time before a food is eaten. 

Here are the 6 sensory milestones one by one.

Tolerates (Steps 1-5)

Just seeing your food is part of learning to like it. And that’s what this first milestone is all about, being able to visually tolerate the food.

Some visually sensitive children automatically avoid looking at the food as soon as they are in the same room as certain foods, they literally may not even be able to look at it. 

Until a child can visually tolerate a food, they won’t be able to progress up the steps towards smelling or tasting the food.

Interacts with (steps 6-9)

Interacting with food isn’t the same as touching the food; that comes later.

In the interacting steps, your child is using objects or containers to interact with the food. If they are capable they could be helping prepare a meal in the kitchen, or helping serving themselves or others.

Younger children can play dump and fill games with food or stirring the (cool) pot, washing fruits and veggies etc.

Smells (steps 10-13)

In this step your child will be working towards tolerating a stronger smell at each step. From simply being in the same room to leaning in close to take a sniff.

Touch (14-24)

This stage has the most steps as texture is one of the most complex senses to master. We’re working on tolerating touching with one fingertip and gradually getting closer to their mouth. 

Taste (25-30)

This is the first time food is going to the mouth and it’s step no 25 of 32! 

They’re starting with just a tip of the tongue, taste or a brush of the lips, without expectation to bite, chew or swallow. Spitting food out at this stage is just fine.

Eating (31-32)

This is the final 2 steps where 32 is actually biting, chewing and swallowing normal mouthfuls of food. 

When you are working with a feeding therapist, you will be continuously referring to the 32 steps and supporting your child to move up the steps in a supportive and non-pressurised way.

A child with sensory food aversions has in his chair chair crying over a bowl of scrambled eggs

How children learn to ‘not’ eat

Children eat multiple times a day and if their sensory systems are telling them it’s unpleasant, eating is quickly learned to be a negative experience.

When negative sensory experiences happen the body’s natural reaction is a stress response to escape the situation by either: 

  • fight – tantrums, kicking, hitting, arguments, throwing food, causing drama at the table 
  • flight – fidgeting, running away, avoiding going to school or friends houses for tea
  • freeze – breath holding, child closes down, won’t talk.

On top of this they may have learned additional reasons for not-eating, read on for a mini psychology lesson on how children learn.

Classical conditioning or learning through association

Classical conditioning is also known as learning through association and was made famous by the scientist Pavlov and his dog back in 1897.

Pavlov observed his dog salivating at the sight of food, recognising it as a cue for something tasty. By repeatedly ringing a bell when presenting food, he found the dog would salivate just at the bell’s sound, even without food. This showed the dog had learned to link the bell with food.

We see this in real life all the time now, from the desire to eat popcorn at the cinema (we’ve classically conditioned ourselves to associate eating with the big screen) to your child wanting an ice cream whenever you go to the park. 

However, classical conditioning also plays a huge role in ‘not’ eating. 

If your child has had a negative experience with food, for example they are a sensory avoider of sound (hearing) and they are being asked to eat their lunch in a noisy dining hall at school. It’s going to be really unpleasant for them and they are not going to be able to eat. 

Now the lunch hall has been classically conditioned towards not eating.

Operant conditioning or learning through consequence

This is learning through habit.

We know that positive reinforcements often encourage more desired behaviour in children. For instance, rewarding a child with a sticker for trying new food can lead to more of that behaviour.

However, offering an iPad to distract a child from not eating inadvertently encourages more refusal to eat.

Is it ARFID? (Avoidant Restrictive Food Intake Disorder)

Children with sensory aversions to food are sometimes referred to as having a paediatric feeding disorder(3), ARFID(4) or misdiagnosed as having an eating disorder.

ARFID is classified as an eating disorder although there is involvement of body image or a desire for thinness.

Children appear to have a lack of interest in food or eating and so just don’t eat.

Many however also have sensory aversions including visual, taste, temperature, smell, sound or texture of particular foods and often can’t eat in the same room as other people or food. 

Often children with ARFID are fearful about things like choking or having an allergic reaction to food and expect pain or discomfort when eating. 

Paediatric Feeding Disorder(3) on the other hand is diagnosed when a child is unable to meet their nutritional requirements through eating when compared to other children of the same age and developmental stage. 

It can be caused by medical issues, nutritional problems, a lack of feeding skills, sensory-motor skills or psychosocial issues and is often a combination of several of these.

Many children with ARFID or PFD will go on to require tube feeding or rely on nutritional supplements as a means for survival.

These children do not grow out of it, they need specialist feeding therapy and often with a multidisciplinary team of healthcare professionals in order to get better.

A happy girl holding a ham and lettuce sandwich

Does my child need a diagnosis to get support with sensory food aversions?

If you want to access the NHS or have private medical insurance then yes. However a diagnosis can be hard to obtain due to limited services, and priority given to children with medical issues.

However not having a diagnosis doesn’t mean that you can’t access help.

We run our Fussy Eating Fixed programme for children with suspected or confirmed sensory food aversions.

How can I help them?

Now you understand that their eating behaviour is not them being naughty, difficult or fussy. Avoiding food comes from a place of avoiding something thoroughly unpleasant.

There are some foundational steps that you can have in place at home that centre around making the mealtime environment more comfortable:

  • Strategically planning meals and snacks for nutritional balance.
  • Implementing a structured routine for meals and snacks to encourage appetite.
  • Creating a pleasant mealtime atmosphere and mood.
  • Teaching basic table manners by example.
  • Refraining from pressuring, rewarding, or bribing your child to eat.
  • Setting family rules, such as asking permission before taking food.
  • Avoiding the provision of ‘rescue meals’ or on-demand snacks if initial offerings are not eaten.
  • Enforcing the rule: “You don’t have to eat it, but you do have to join us” at meals unless there is a severe sensory aversion where children can not be in the same room as food
  • Keep mealtimes free from distractions like TV, iPads, or toys.
  • Offering guided choices within food groups, like choosing between chicken or ham for a sandwich.
  • Observing your child’s eating habits and adjusting weekly meal plans to address nutritional needs.
  • Role modelling positive eating behaviours by eating together, showing enthusiasm, appreciating the cook, and expressing enjoyment of the meal.

Once these are in place comes feeding therapy. You can access a self help version of feeding therapy via our program Fussy Eating Fixed.

a young girl chipping vegetables with her dad's help

How long does it take to overcome sensory food aversions?

If only I could tell you! All children are different and the degree of their sensory food aversion will be different too. What I can tell you is that often feeding therapy is a long journey, sometimes it’s months and it can even be years to see the progress that you want.

I understand, I have a child with sensory food aversions too. It’s incredibly stressful when you just want your child to eat well and grow normally.

The best thing I can advise you is to get started, because the sooner you do the sooner you can start helping your child and lift some of that burden from you too.

Sarah Almond Bushell Registered Dietitian and Children's Nutritionist
Sarah Almond Bushell MPhil, BSc (Hons) RD MBDA – Registered Dietitian & Feeding Therapist

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meet Sarah

I’m Sarah, a Registered Dietitian, Children’s Nutritionist and mummy from East Sussex. My blog is to guide & inspire you with information about weaning, nutrition, food and toddler feeding. Learn more about me here.

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