Understanding Sensory Processing in Feeding Therapy
Feeding therapy encompasses a complex interplay between sensory and motor functions, particularly in pediatric populations. To support children effectively, it is crucial to understand sensory processing and how it influences feeding behaviors. This blog will delve into sensory processing, building a sensory profile, the relationship between body and oral motor functions, specific sensory considerations in feeding, and the interplay between sensory and oral motor components.
1) What is Sensory Processing?
Sensory processing refers to the way our nervous system receives, interprets, and responds to sensory input from the environment. This includes information from our five primary senses (touch, taste, smell, sight, and sound) as well as additional senses such as vestibular (movement), proprioception (body position), and interoception (internal body states like hunger and pain). In feeding therapy, sensory processing plays a vital role in how children perceive and interact with food.
2) Building a Sensory Profile
A sensory profile is a therapists assessment of a child's sensory preferences, sensitivities, and thresholds. Oftentimes children’s sensory needs and abelites will be described in detail and an opinion will be formed either through the therapists observations or through administration of a sensory test or questionnaire. A child have a big picture profile as well as differences in their profile of individual sensory areas. For example, Derek may be a “sensory seeker” overall, but he may be a “sensory avoider” when it comes to tactile input or touch input. This is an over generalized explanation , but you get my point. By identifying patterns, therapists can tailor interventions to accommodate a child's sensory needs, making feeding experiences more positive and effective. A child’s sensory profile also provides clues to behaviors and potential underlying deficits that explain their reactions to sensory input during mealtimes.
All people and all children have sensory needs, so even when a child does not have an atypical profile, we can still utilize the sensory system to promote increased interest, comfort and participation in eating, feeding and swallowing.
3) What is Seen in the Body is Seen in the Face and Mouth
Sensory processing needs, preferences, and challenges often manifest similarly in both the body and the oral structures. For example, a child with hypersensitivity (overly sensitive to input) might show aversion to certain textures both on their skin when wearing clothing and in their mouth when interacting with textures of foods. Understanding this connection helps therapists address feeding issues more holistically. For instance, a child who avoids certain fabrics or activities might also avoid foods with similar textures, highlighting the importance of a cohesive sensory strategy. This is true of motor development as well, what is seen in the body is often seen in the face and mouth.
4) Feeding Specific Sensory Considerations
When addressing feeding therapy, it's essential to consider the child’s ability to interact with sensory aspects of food:
Smell: The aroma of food can be either inviting or off-putting. Children with heightened olfactory sensitivity may reject foods with strong smells. Some smells like cinnamon are known to be a sensory regulator for some children, and then can be used to decrease overstimulation before or during mealtimes.
Color: Visual appeal plays a role in food acceptance. Bright, unusual colors might be overstimulating for some children, however, most people demonstrate positive hunger responses to the inclusion of the color red or orange in the environment when eating. Ever wonder why so many restaurants are painted red? If a child has had repeated negative oral or sensory interactions with foods, they may learn to avoid all foods of that color.
Texture: The feel of food in the mouth is a significant factor. Some children might prefer smooth textures over chunky while others need to be presented with firmer more textured foods to help them be aware of where the food is in their mouth to coordinate chewing it and swallowing it. Even if a child does not have sensory processing differences, we may choose to increase / decrease the texture of the food based on the child’s oral motor response to more / less texture.
Flavor: Taste preferences and aversions are crucial. Some children might have a heightened sense of taste, making certain flavors overwhelming. Other children may benefit from increased intensity of flavors or the option to explore flavors like salty, spicy, sour, etc to help them enjoy meals. For a child who has limited opportunity to explore foods orally (perhaps they have a feeding tube) they may particularly enjoy interacting with high flavor tastes of food within what they can safely manage.
Temperature: Some children may be overly sensitive to how hot, warm or cold foods or liquids are and display strong preferences, while other children may respond with better awareness and oral control (such as swallowing coordiantion and safety) when presented with warmer or colder liquids.
Proprioceptive Input: Children with limited diets, picky eaters or tube fed children for example, often demonstrate oral sensory seeking behaviors. This may look like chewing on their shirt or putting toys or their hands in their mouths past the age that this is typical in development. Before we ask a child to redirect this type of behavior, consider how to help them meet this missing experience for grounding patterned oral proprioceptive input that that are not getting from chewing foods.
Touch to Face: Touch to the face in other daily routines will often translate over to touch to the face or textural sensativity in the context of feeding. Be sure to consider what adverse touch experiences the child may have had, such as having a tube in their nose or mouth at birth or during a surgery, or well-meaning parents being overly forceful with dental hygiene. Most children who have texture sensitivities with foods benefit from a positive daily touch routine to their face and mouth.
High Control: Children with a history of adverse oral experiences, such as gagging or choking, may develop high control behaviors that present as sensory sensitivities. They might insist on foods being prepared a certain way or reject new foods altogether, viewing them as threats based on past negative experiences.
5) What Could Be Hiding Behind Sensory?
While sensory issues are often the most visible signs of feeding difficulties, underlying oral motor deficits frequently contribute to these sensory reactions. Oral motor components, such as tongue movement, lip closure, and chewing efficiency, significantly influence a child's sensory experience with food.
For example, a child who struggles with tongue lateralization might find textured foods challenging because they cannot effectively move food around their mouth. This difficulty can manifest as a sensory aversion. To address the root cause of feeding difficulties, it's essential to target both sensory and oral motor components. This means implementing exercises to improve oral motor skills alongside sensory strategies, ensuring comprehensive and effective intervention.
Conclusion
Understanding sensory processing in feeding therapy is crucial for developing effective interventions. By building a sensory profile, recognizing the interplay between body and oral motor functions, and addressing both sensory and oral motor components, therapists can create tailored strategies that support children in overcoming feeding challenges. This holistic approach not only improves feeding outcomes but also enhances the overall quality of life for children and their families.
Happy Eating!
