Sunday, May 30, 2010

The Sensory Impact on Eating

Sensory issues are common amongst children on the autistic spectrum and one of the most obvious places is in the mouth. Some children need extra sensation there while others have a very low tolerance.

Either way, it causes problems.

The Need for Extra Sensation
My youngest son was always putting objects into his mouth as a baby. In fact, it's something that he still does most of the time now, aged six. It wasn't just food that interested him, it was wallpaper - which he ate at night from the walls nearest his cot. It was toys and stones and bits of fluff too. My wife used to have to watch him closely all the time becuase he'd often start choking and have to be rescued. The sensory needs were so overwhelming though that no sooner had he spat out the object he was choking on then he would start eating it all over again.

On the first Christmas we had after he could sit up, we had to unplug the lights on the Christmas tree because he kept trying to mouth them. Later on, after I discovered a christmas light bulb in his nappy (yes, it had made it all the way through) we moved the tree entirely out of reach.

Our pediatrician wasn't much help either. He first suggested that children with low iron sometimes suck rocks and other objects to get the vitamins and minerals they need. We tested our son but his iron levels were fine. When we complained to the pediatrician about our son eating lead pencils, he simply said smiling, "he probably just wanted to put lead in his pencil". I think that was when we realised that we needed to change pediatricians.

These days, we recognize it as a sensory need and tolerate it accordingly. I say tolerate instead of "approve" because he still does a huge amount of damage to clothing and furniture with those teeth. There are sensory tools that you can get for kids to chew on but somehow we always figured that he'd prefer to seek out his own sensations.

One thing's for sure, the need for extra sensation is at least partially to blame for my son's huge appetite.

Too Much Sensation
Then there's the other side of the coin. Over-sensitive mouth tissue. This has always been a problem that I have, and it seems that my eldest son suffers from it as well.

Just the sensation of my tongue on the top of my mouth can sometimes have me itching or trying to calm down my mouth for hours. When I'm sick, an inflamed throat or an ulcer feels gigantic and has great impact because I can't stand for it to come in contact with other parts of my mouth.

The biggest impact however is in the region of food. I do have some taste issues; for example, I can't handle carrots too well and I seriously can't even look at sultanas. The thing is, that I think these issues didn't start out as taste problems. I think they started life as sensory issues.

These days, I'm grown up and I can eat carrots provided that none (or at least minimal) chewing is done. It's not so much that chewing releases the flavour but rather that it brings my mouth in contact with the texture of carrot. I can also clearly remember that my first issues with sultanas began as texture issues.

When my eldest son was just a baby, it was quite common for the feeder (usually my wife) to be covered in muck (spat out food). She used to get quite mad about it and feel that my son was mocking her. Of course, back then we didn't know about autism and we had no idea that it was texture issues.

Today, my son still eats very little. I'm not worried. I was nicknamed "sparrow" by my best friend's mother because I ate almost nothing. I survived. There were always things I could eat, eventually.

Again, there are things you can do to get around the problem, one of the most obvious being to change the texture. Try orange juice instead of oranges. Try teaching your child to use a knife to cut corn kernels from a cob instead of biting them off (I have texture issues with the cob but not with the corn). Try using a blender to puree foods, try freezing them. Try anything and everything...

...but don't panic.

As far as I know, no child has ever starved themselves to death - or even into a state of illness, for texture reasons when food was readily available. As I used to say to my wife when our son wouldn't eat. It takes about 25 days for a child to starve themselves to death - call me on day 20 if he still hasn't eaten anything.


Anonymous said...

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Foursons said...

Jakob has serious texture issues. I can hardly get him to eat anything and he has been that way since birth. The cereal I fed him as a baby was discontinued and we were in a heap of trouble when we couldn't find another one he would eat. He never ate Level 3 baby foods. (Those are the ones with chunks of food in them.) And at 8 years old he eats oatmeal, mac and cheese, pizza, and meat without seasoning. No breads, no condiments, no desserts, no veggies or fruits...just the few things. I have found vitamins that he will take but it is only one kind. People look at me like I am insane when I tell them what he eats, but thankfully since the diagnosis and new understanding I no longer feel like that bad parent.

The Rambling Taoist said...

Ah yes, texture issues. I know them all too well!

I can't drink soda pop because of the fizz. When it hits my tongue, it is immediately spit out. For this same reason, I can't drink beer or champagne.

I also can't touch corduroy (or velvet) -- it makes me feel as if I just stuck my finger in a light socket! I've decided that my aversion to beverages that fizz is related to my aversion to corduroy. It engenders the same reaction. The only difference is that one involves the sense of touch with the skin, while the other involves the sense of touch with the tongue.

Bonnie said...

Love this post. My son use to chew on everything too, but has grown out of it. Regarding food and textures we did Food chaining which over time was very helpful.

Best of Luck!

Stacey,momof 2 said...

I was going to suggest also try the tempature of the food-- My son will eat about 3/4 of a cup of frozen peas-- but then if you give him cooked peas he will only eat about 1/3 of a cup!
I was also going to mention that when the kids are young-- under two years, they need to be re-introduced to food more than once. :)

Leslie said...

Gavin, I seem to have both sides of the coin with my own mouth. As far as I can remember, I wasn't in the habit of chewing non-food things.

I need my food to be very flavorful and have lots of different textures. One of my very favorite things is Inglehoffer Original Stone Ground Mustard. It is full of whole mustard seeds that I love to crunch. I love the way they pop!

I can't eat most potato chips or crackers and have a hard time with hard, crusty breads. They scratch the inside of my mouth and it hurts for hours.

Right now I am eating brown & wild rice and green peas with pork that my husband cooked with curry sauce. I love mixing all my food together and getting all the flavors and textures in each bite.

Thank you for this post; I had never heard of Aspies/Auties craving more oral sensation, only being overwhelmed by too much.

In Real Life said...

My daughter has sensory issues with food as well. She is quite rigid with her foods. Although, there has been quite a drastic improvement since she has been going to occupational therapy, they have worked wonders with her and she is now going through a phase where she is not only willing to try new things, but she thinks it's fun! It is so exciting!
It may seem like baby steps to some, but the fact that she will eat a different shaped noodle is cause for celebration in our house.

Leslie said...

Taoist, that reminds me, I can't stand fizzy/foamy stuff either. When I was in the habit of drinking soda, I would wait until it was flat and drink it watered down and room temperature; very odd for a Southern Girl!

The foam issues make brushing my teeth a problem; I have to try to think of other things because if I start really noticing the foamy toothpaste, I start gagging.

I don't let it keep me from having good dental hygiene, though. I have found a toothpaste that is less foamy than most commercial brands and I make sure to put the minimal amount on my toothbrush. Then I use watered-down mouthwash...I can't tolerate it full-strength.

Do any of you have toothpaste issues?

The Rambling Taoist said...

Not any more! I became a full-time denture wearer in February.

StatMama said...

Informative post! My son has struggled with over-sensitivity since we began moving him to solid foods from the bottle. Paste baby food with no solid chunks were fine, but as soon as we introduced texture, he showed us just how sensitive he was to it. Foods were instantly rejected, with a whole lot of shuddering, face-making, and mouth wiping. What a mess. But it was clear it was not just a matter of preference - he was really struggling.

As of now, at 4 1/2 years, he eats no meat at all and it is nearly impossible to get him to try new foods. However, he LOVES raw fruits and vegetables and will eat them by the ton.

Alysia said...

Textures have always been the issue here too, along with temperature. My son never went past stage 2 food for baby foods, and has a very limited amount of food he'll eat. His slow weight gain shows that too. My husband said that if he would only eat ice cream, he'd feed it to him 3 meals a day!

Caitlin Wray said...

This post brought back some sad memories for me... Simon has huge oral seeking tendencies, and major texture aversions. He'll eat just about anything crunchy, and just about nothing mushy.

Last year he was in a home daycare that was 99% of the time really awesome. I was PAINSTAKINGLY CAREFUL about interviewing/getting references for a home daycare and this lady was really great. She was an early childhood educator, not a babysitter. But... she's also human. And she made some mistakes, mainly in situations where she felt Simon was being naughty or defiant (he was of course responding to sensory overload).

The one that your post reminded me of was (before his diagnosis) she prepared scrambled eggs for him. There are a lot of NT people who don't really care for the texture of scrambled eggs, so it's not hard to see how Simon would be repulsed by them. Well, after much encouragement, he worked himself up to trying them - and the texture made him throw up. I have since read this is faily common with ASD kids.

But his caregiver not only scolded him for vomiting, she also made him get down and clean it up in front of everyone.

I was not impressed, and I was also sad for Simon, because it was a humiliating moment for him, in front of his friends.

Just another reason we need to always assume our kids are doing the best they can in the moment. Fix the moment, not the child.


Anonymous said...


Definitely gonna recommend this post to a few friends

Penelope Trunk said...

I know I'm late to this post, but I wanted to say that if the sensory issues are severe, the child will start starving. My son became failure to thrive because he was sensory defensive. We had to do force-feeding to avoid intubating him.

And, his father, who also has Asperger's, had to have an operation to have his tonsils out in order to keep him from starving himself.

I think I am sounding like a crazy person. I don't mean to. I just mean to say that there are two cases in our family where the kid was starving and it still didn't make him want to eat.


Shannon Shipp said...

My daughter is 6yrs old with aspbergers. the biggest problem with her eating for her is the smell or look of the food, or even the packaging it is in. It is very mental with her, all she has to do is look at or smell something she doesn't eat, and here comes the gagging and vomitting. A noodle on the floor, someone dipping something, or the thought of trying something new, definitely gag time. Packaging is a big deal, she can only drink blue 2% label milk, if that label is new including any pictures like cookies or anything else on it. She will not even attempt to drink it. Bread is eaten if it comes in a bag, I could not bake bread and cut it for her, she would gag at the thought of it. I am struggling because I don't know how to get her past the thought of it. We have tried many different therapies with our O.T. None have proven successful. She is in a general ed classroom, and at lunch she sits near only cold lunch students, but has been in view of hot lunch and actually thrown up at the lunch table because she saw someone dipping something she thought was gross. It is a daily struggle.

olive pip said...

gosh I brush my teeth with total focus on trying not gag, toothpaste foam is my hygiene nemesis.

Anonymous said...

It is the sodium lauryl sulfate in the toothpaste that makes it foam. Look for a sulfate-free toothpaste product. The paste has the same texture but without the foam.

Anonymous said...

Try a sulfate free toothpaste. It is the ingredient sodium lauryl sulfate that causes the foaming. The sulfate free toothpaste has the same texture as regular toothpaste but without the foam.

Miguel Palacio said...

Ah, I can touch courduroy or velvet for hours. I really enjoy the texture. But you won't catch me dead wearing wool! It's one of the most horrible sensations.

My parents just thought I was being obstinate. Before I could fully talk I would call it "pica-pica", which, I guess, loosely translates to "scratchy-scratchy" in baby-talk.