The impact of sensory-based feeding difficulties on children and their families : caregivers‚ÄövÑv¥ perspectives

Sensory-based feeding difficulties occur when a child displays a heightened oral and tactile sensitivity towards foods that are commonly accepted in childhood. This often leads to food refusal and restricted dietary intake. Children with sensory-based feeding difficulties are often labelled as picky or fussy eaters, which leads to an assumption that the child will simply outgrow the difficulty. This assumption is incorrect, and can lead to delays in children with sensory-based feeding difficulties accessing early intervention services. To date, little research has been completed that directly identifies a sensory base for picky/fussy eating and how this sensory-based feeding difficulty then impacts both the child, in terms of their physical/social/psychological health and wellbeing, as well as the child‚ÄövÑv¥s family in terms of social and emotional wellbeing. There is a paucity of qualitative studies that explore the context within which sensory-based feeding difficulties occur. This study explored the direct impact of sensory-based feeding difficulties on children‚ÄövÑv¥s health and wellbeing, as well as the wider impact on the family, using a hermeneutic phenomenological approach. Purposive sampling was used to recruit 15 participants across Tasmania via social media. Participants were parents of children with sensory-based feeding difficulties. Participants took part in semi-structured face-to-face interviews between 30 and 60 minutes long in a range of settings, including caregivers‚ÄövÑv¥ homes, public venues, and the University of Tasmania campuses. Three rounds of data analysis were completed using both wholistic and selective readings of interview transcripts. Eleven overarching themes were identified as a result of data analysis, which provided significant insight into what it means for the child and family living with, and supporting a child with, sensory-based feeding difficulty. Caregivers reported that their children experienced high levels of constipation, growth disruption and malnutrition. Caregivers also explained the psychological impact on their child, with many children reported to be anxious, both generally and during mealtimes. They also shared experiences of social isolation in relation to the child and the family unit. Caregivers revealed the significant emotional impact that caring for a child with a sensory-based feeding difficulty had on their own wellbeing. They shared feelings of guilt, self-blame, stress and embarrassment. They also shared their frustration at trying to access support services, and the frequent judgement from others they experienced when discussing their child‚ÄövÑv¥s difficulties. This study explored the experiences and barriers encountered by families with a child with a sensory-based feeding difficulty. Several considerations for professional practice are offered, including the way in which therapists assess and provide intervention, and support caregivers. The role of cross-disciplinary education and access to services is also discussed. In addition to these professional considerations, a number of recommendations for future research are made. These recommendations include further exploration of: family connections; early screening tools and identification of sensory-based feeding difficulties; long-term implications, including possible correlations with chronic disease and adult eating disorders; the child‚ÄövÑv¥s perspective; and differences between typically developing children and children diagnosed with autism spectrum disorder.