This reader's Q&A first appeared in EmphaSIze - the SI newsletter - August 2019:
Q: Should I recommend allowing a child with ASD and sensory integration difficulties (7-year-old) to go hungry to encourage them to eat healthier meals?
A: Motivating children to eat healthier is certainly a challenge and, whilst allowing a child to go hungry might be heard of, and maybe even tried in our own homes, the results are inconsistent and the literature to support this as an evidence-based strategy for children with sensory integration difficulties is very limited. It is important to remember that children with SI difficulties may not perceive hunger due to difficulty with interoception, or the stress at mealtimes caused by over-reactivity to sensory information may over-ride the sense of hunger.
A detailed assessment of the child’s sensory profile and ensuring that parents and any other adults who manage meals understand how this impacts on mealtimes will be important to avoid negative mealtime experiences.
Some alternative strategies to trial, which reduce the risk of negative mealtime experiences, could be to:
- Ensure meal times consistent of familiar foods alongside small portions of less familiar/new foods so successful eating is more likely to happen
- Create appropriate opportunities to explore foods so the child can become more familiar with the sensory proprieties of the food away from mealtimes (eg, involve them in meal preparation or create opportunities to engage in play with food)
- Avoiding snacking and grazing in between meals so a natural hunger develops
As always, when working with any client with feeding and eating difficulties, if you have any concerns regarding weight gain or risk of malnutrition, it is recommended they consult their GP.
Professionals supporting individuals with feeding difficulties may be interested in this online course: Supporting Individuals with Feeding Difficulties: Sensory Integration in Practice - A Multidisciplinary Perspective