Gustatory: Over Responsive
1. Student may be underweight and deficient in nutrients
If you are concerned that the student is underweight and/or deficient in nutrients, referral to a medical professional is essential. The student’s parent/guardian can arrange an appointment with the GP for medical assessment.
Point to remember
- Advise parent to seek advice from GP if there are concerns regarding the student’s weight and health
2. Student eats limited range of food and refuses to try new food
Some students eat a very restricted diet of only a few food items. These students often eat the same meals every day and refuse to deviate from this routine and refuse to try new food items. Presenting them with new food items may lead to high levels of anxiety and extreme behavioural responses e.g. throwing food across the room, running from dining hall.
If the student’s weight is within a healthy range and the student has been assessed to not be deficient in any nutrients, it may not be essential to introduce new food items. There may be other priorities to focus on instead. However, if the student is not eating a sufficient range of food to maintain health, broadening the diet will be essential. The student and parents may also have identified it as a priority goal for social and emotional reasons.
There are a number of reasons to explain food refusal and restricted diet:
- Overresponsivness to the taste of food i.e. refusal of strongly flavoured food or specific flavours
- Overresponsiveness to the texture of food e.g. refusal of soft textures, or refusal of dry/crunchy textures
- Overresponsiveness to the smell of food e.g. dislike of strongly smelling food
- Rigidity about the colour of food e.g. only eating white food items; refusing to eat green food
- Rigidity about the brand of food e.g. only eating one type of bread
- Unable to tolerate different food touching on the plate
Other factors may also include mental health disorders, emotional difficulties and behavioural difficulties.
This resource focuses on sensory processing and therefore the suggested strategies are recommended for a student who is refusing to try new food due to sensory overresponsiveness. If your concerns are related to any other factors, please seek advice from a relevant professional e.g. GP, psychologist.
Before introducing new food, a medical assessment is recommended to check child’s weight, health and any food allergies. Introducing new food should be a shared intervention programme between home and school so that consistent strategies are being used.
- Involve the student in food shopping and food preparation. This introduces the student to the texture and smell of food items without the pressure of eating them. Sensory based play can also be used to introduce different smells and textures.
- Keep mealtimes calm:
- Allow preferred food items at mealtimes. This will encourage the student to eat at mealtimes and establish an eating pattern. New food should be introduced outside mealtimes.
- Ensure student is eating in a calm environment to reduce anxiety. If the student feels overwhelmed in a noisy dining hall, he is less likely to eat. It may be appropriate to allow the student to eat in a quiet classroom where there are less noises, smells etc.
- Do not persuade or coerce the student to eat new food as this is likely to increase stress and food refusal.
- Use a desensitisation process to introduce new food:
- Select a consistent time each day to introduce new food and include this on the student’s schedule or timetable. This may be called ‘Trying time’.
- Select an appropriate place to try new food each day. It should be a quiet place with minimal sensory distractions. This will reduce feelings of sensory overload.
- Select a new food which is similar to food items which the student does eat. Use the texture of food which the student prefers e.g. mashed/pureed texture or dry, crunchy texture. Do not introduce a new texture as it is sufficiently challenging for the student to try a new taste. Simultaneously introducing a new taste and texture will be too overwhelming. For example, if the student likes crunchy textures, introduce raw vegetables rather than mashed vegetables.
- Allow the student to gradually progress through the steps of desensitisation e.g.:
- Tolerating the new food on a plate in front of him
- Smelling the food item
- Touching the food item
- Holding the food item to his lips
- Touching the food item with his tongue
- Licking the food item
- Eventually biting and swallowing the food item
Each step in this process make take several days before progressing to the next step. It is important not to rush or coerce the student as this increases anxiety. Allow the student to control when he/she is ready for each step in the process.
- When the new food item is tolerated by the student, it can be moved to mealtimes and the quantity gradually increased.
- Transition the student to a calming activity after ‘Trying time’ each day as he is likely to be feeling anxious. Select an activity which is calming for the student e.g. deep pressure input, time on the iPad/computer, listening to music, reading a book.
- Some students eat better in the company of adults or peers – the student may be more willing to try new foods if they see other people trying the same food and enjoying it.
Point to remember
- Use a desensitisation programme to introduce new food items; do not coerce the student to eat new food items. Parents and teachers should work in partnership if introducing new food to student.