We have 8 senses – sight, smell, taste, hearing, touch, vestibular, proprioception and interoception.  

There are 3 key types of sensory processing difficulties that can affect the way we process information through any of our 8 senses. These include: 

· Sensory modulation – difficulties filtering sensations, which influence our arousal levels. 

· Sensory discrimination – difficulties with perception, which influence our awareness. 

· Praxis – is influenced by sensory discrimination, the connection with the way we plan and sequence motor steps. 

For individuals without sensory processing difficulties, integration (noticing, processing and using) sensory information occurs at a subconscious level.

As Occupational Therapists we see feeding, eating and mealtimes a central occupation of all individuals. If a breakdown in sensory processing occurs at any level, it will directly influence an individual’s ability to participate in this routine. 

 There are several key considerations when assessing and providing therapy to support feeding/mealtime challenges. These include: 

· What behaviours are being observed before, during and after mealtimes?

· What mealtimes are taking place?

· Who is present during mealtimes?

· What is the motor skill level of the child (eg: can they use cutlery and sit at a table independently?) 

· Does the child have a history of reflux or other digestive issues? 

· Does the child toilet and have a bowl motion regularly? 

· What is the sensory nature of the food being offered (smell, texture, temperature, consistency)? 

· Does the child have difficulties in any other self care activities? 

· Does the child engage in mealtimes differently across different settings? 

 Often the therapist will consider both the sensory, motor and social/emotional elements of the entire mealtime. This could be via a parent interview, mealtime observation and clinical assessment of underlying motor and sensory skills. 

Try to:

› Eat together as a family – whilst this can be difficult with our busy lives, sitting and eating together is not only an opportunity to engage socially as a family, but also a natural opportunity for your child to observe what’s expected as part of this routine. 

› Involve your child/children in shopping and preparing the meal – this will allow them to build their understanding of the process involved in mealtimes. It will also be an opportunity for those children who are really fussy eaters to be exposed to a larger repertoire of food types and textures. 

› Take the pressure off – children pick up on our internal state. If we are pressuring our child to eat quickly, try new things or use cutlery properly, the joy of mealtimes is lost. There will be an accumulation of anxiety around this routine activity which will actually be counter productive to any development in this area. 

Find one meal a week where you can cook with your child. 

Author: Kim Elter – Occupational Therapist