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Feeding: Picky Eaters and Sensory Processing. Presented by Jan Van Horn, School Psychologist Kat Hyatt, Occupational Therapist. The Fundamentals. Sensory Processing Posture Motor Planning. Problems: what do we see. Overstuffing/Overeating Gastrointestinal/Digestive problems

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Feeding picky eaters and sensory processing

Feeding:Picky Eaters and Sensory Processing

Presented by

Jan Van Horn, School Psychologist

Kat Hyatt, Occupational Therapist

The fundamentals
The Fundamentals

  • Sensory Processing

  • Posture

  • Motor Planning

Problems what do we see
Problems: what do we see

  • Overstuffing/Overeating

  • Gastrointestinal/Digestive problems

  • Selective (refusal and aversions)

    • Type of food

    • Texture of food

    • Presentation/meal ritual

Factors to consider
Factors to Consider

  • Overeating

    • Sensory seeking

    • Not registering

    • Emotional factors

  • Selectivity:

    • Hyperresponsive (texture, taste, smell, temperature, vision, mixture)

    • Motor deficits

    • Ritualistic

  • Digestive:

    • Pediatrician input

Causes for hypersensitivity
Causes for Hypersensitivity

  • Early noxious experiences

  • Lack of exposure

  • Neurological impairment

  • Combined factors

  • Hyposensitivity

Assessing the problem
Assessing the Problem

  • Food records: what, when, where, and how

  • Questionnaires

  • Interviews

  • Observation

  • Review the fundamentals

Now what
Now What

  • Social Stories

  • Social Factors

  • Behavioral

    • routine and structure for meal times

  • Elements you can control

    • Bite size, food type, texture, flavor, color, shape, auditory/visual distractions

The motor component
The Motor Component

  • Work within endurance abilities

  • Special seating: upright posture without working too hard to eat

  • Movement breaks

  • Weighted utensils/cups

  • Non-slip plate/bowl surface

The sensory component
The Sensory Component

  • Guidelines to Approach:

    • Rapport

    • give control/offer choices

  • Desensitize

  • Progressive presentation

    • Introduce non-preferred items to one sense at a time

    • Gradual mixing


  • Child explores mouth with own hands

  • Use of rubber/hard toys

  • Brush and massage: NUK, toothbrush, warm washcloth, ice cube/ice pop

  • Blow toys (bubbles, whistles)

  • Start dipping in variety of pureed foods/juices to introduce flavors/textures. Between meals or during snack time can be a good time to work on desensitizing, as nutritional intake is less important at those times than during full meal times

  • If a desensitizing routine is established, use a fast version “warm up” prior to meal times to prepare to eat the meal

Interventions for hyposensitivity
Interventions for Hyposensitivity

  • Typically it is more difficult to train the body to feel something that it is not registering

    • Try “warm up” activities with sucking, blowing to “wake up” oral area

  • Compensatory strategies

    • Mirror

    • Hygiene

    • Meal planning


Case-Smith, J. (2001) Occupational Therapy for Children St. Louis, Missouri: Mosby.

Therapy West, Inc./pLAy Studio class: Hands-On Sensory Integration Treatment for the Child with Autism: An Interdisciplinary Approach. October 8-9, 2010. Contributers: Erna Blanche, PhD, OTR/L, FAOTA; Janet Gunter, MA, OTR/L; Juliana Gutierrez, MA, OTR/L, SWC; Christy Skura, PT, DPT, PCS; Shelby Surfas, OTD, OTR/L

Yack, E., Aquila, P., Sutton, S. (1998) Building Bridges Through Sensory Integration. Las Vegas, Nevada: Sensory Resources.