Abby Barnes, M.S., CCC-SLP
Gagging at the dinner table, battling over a bite—mealtimes can be stressful when a child eats only a few foods or avoids trying new ones. As a parent, you’re doing the best you can. But what should you do when your child refuses certain types of foods or gets anxious at meals? Some feeding problems aren’t just “picky eating”; they’re rooted in sensory issues. In many cases, sensory feeding therapy can lift some of this stress and help your child try more foods.
At Expressable, our feeding therapists work with families whose children experience sensory food aversion—when the sight, smell, or texture of food leads to strong reactions or refusals. Feeding therapy can make eating feel safe and enjoyable again. In this article, we explain the signs that a child might have sensory food aversion, what happens at feeding therapy, and how feeding therapy helps your child explore new foods with confidence.
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Get startedWhat is sensory food aversion?
You may have heard the term “sensory aversion” if you’ve done research about picky eating in kids. But what does it mean to have sensory food aversion?
“Sensory food aversion happens when a child struggles with the sight, smell, taste, texture, or temperature of food,” explains Olivia Frieling, MS, CCC-SLP, a speech and feeding therapist at Expressable. These challenges can make mealtimes stressful, but understanding them is the first step toward help.
How do you know if your child has sensory food aversion?
Children with sensory food aversion may show behaviors such as:
Seeming grossed out by looking at a new food on their plate
Feeling uneasy from the smell of a new food
Refusing flavors like savory, spicy, etc.
Disliking certain textures, such as the texture of meat or anything juicy or stringy like fruit or vegetables
Some children may show big reactions to foods they don’t like, while others may be more quiet in their refusals.
Some children may react strongly, while others quietly refuse foods. No matter the severity, a child should be able to eat a variety of foods and get enough nutrition. Watching for these signs can help you understand if your child might benefit from a feeding therapist.
Here are some other signs of sensory aversion in kids:
Frequent gagging
Covering the mouth or nose and refusing food
Spitting out food
Negative reactions or anxiety around eating and mealtimes
At what age do children develop sensory aversions?
Sensory aversion to food can start at any point. For some children, it seems to be there from birth. They may have difficulty drinking from a bottle, then have more difficulty as they begin eating foods.
Other times, food aversions seem to begin at a later age. If your child is showing sensory aversions at any point, it’s important to see a speech therapist who specializes in feeding, also known as a feeding therapist. Look for someone who helps children with sensory food aversion.
What is feeding therapy?
Pediatric feeding therapy helps children who have some type of difficulty with the physical act of eating or swallowing. Feeding therapy can help make mealtimes easier and more enjoyable.
Childhood feeding therapy is provided by a speech-language pathologist, also known as a speech or feeding therapist, who specializes in this area. The speech therapist helps the child improve their ability to safely eat the least restrictive diet possible, which means as many foods and liquids as possible.
How is feeding therapy done for children with sensory food aversion?
Feeding therapy usually starts with an evaluation with a feeding therapist. During the evaluation, the therapist observes:
Your child’s reactions to different foods and liquids and how much they consume
Their oral motor skills, which is a person's ability to move their tongue, teeth, and jaw with appropriate strength and range of motion in order to chew and manage food and liquid
Signs or symptoms of aspiration (when food or liquid enters the airway)
Many children have sensory aversions without oral motor problems or aspiration risk. In these cases, therapy will focus on improving the child’s tolerance and willingness to try new foods.
The speech therapist will create a treatment plan with goals to be targeted in therapy. “Goals may include increasing the child’s tolerance of the textures, tastes, sights, or smells of the foods that give them difficulty,” says Frieling. The feeding therapist will observe their reactions and aversion, then decide how to go about increasing their tolerance.
Connor's story
At age 2, this adventurous eater suddenly started refusing most foods. Feeding therapy helped him and his family get back to stress-free meals.
Read Connor's storyWhat happens at feeding therapy sessions for sensory food aversion?
At times, feeding therapy may feel uncomfortable for children. After all, they will be doing tasks that are new for them. However, feeding therapy should never be distressing. The feeding therapist will monitor your child and make sure that therapy tasks are at the right level for them.
1 Feeding therapy may begin with using special tools, like a textured brush or a brush that vibrates
These tools can be used in the mouth to help “wake up” the mouth and prepare it for tasting or trying new foods.
2 The child may then spend time looking at the food, smelling it, and talking about it
Therapy often involves experiencing and interacting with foods in a new way, before beginning to taste them. Tasting food right away is often too fast for kids with sensory aversions. “We may simply place the food on the table. The child’s task may be to look at the food, then talk about what it looks like and what color it is,” explains Frieling. After this, they may move on to smelling the food and discussing the smell.
3 Next, the child may touch the food and begin “food play”
Food play is a big part of feeding therapy. The speech therapist gives the child different tasks to do with the food, such as painting with a puréed food, or making stamps with broccoli and veggie dip on a piece of paper. It can be anything that’s fun for the child and helps them better tolerate interacting with the food. Frieling notes that helping kids become more familiar with food, and making it feel less scary, can help them decrease their aversions.
4 Once the child is ready, they’ll begin tasting the food
Some kids may need to go as slowly as touching a food to their lips, then their teeth, then beginning to actually taste it or take a bite.
As the child begins tasting new foods, the speech therapist will help them increase the amount they can eat. The feeding therapist will also teach the parent or caregiver how to begin incorporating the food at home. Sometimes kids may eat their new foods in therapy, but not at home. Practicing eating the food at home–when the speech therapist says the child is ready–is a huge step in the feeding therapy process. Your child’s feeding therapist will guide you through this phase!
Can children do feeding therapy online?
Some types of feeding therapy can be done through teletherapy, but not all. This decision should be made by your child’s pediatrician and feeding therapist. The feeding therapist may need to be physically present to observe the child’s oral motor and swallowing abilities with the foods and liquids presented.
In many cases, children who don’t have known airway safety concerns may receive online feeding therapy.
In many cases, children who don’t have known airway safety concerns may receive online therapy. This will take some planning and communication by the speech therapist and parent or caregiver. The speech therapist will ask for certain foods to be brought to the session. The speech therapist will then guide the child and caregiver through the exercises to do with each food.
No matter what goals are being targeted in therapy, and whether it’s online or in person, it’s extremely important for the parent or caregiver to be involved. This way, the caregiver will learn what can be done at home to support what the child is learning in therapy.
How long does feeding therapy take for children with sensory food aversion?
The rate of progress is different for each child. Some children may move through the feeding therapy steps quickly. Others may need more time. “It’s not uncommon for a child to work on a specific level for a few therapy sessions before being ready to progress to the next level,” Frieling says.
Be patient with all the work your child is doing, and be proud when they reach new goals! There is no achievement too small when it comes to addressing sensory food aversions.
Take the next step
Take our free screener to see if your child with benefit from a feeding evaluation
Learn more about the signs of sensory food aversion
Get matched with a licensed feeding therapist at Expressable
You’re already doing an amazing job by observing and supporting your child at mealtimes. Let us guide you in helping them explore new foods, feel confident at the table, and enjoy a wider variety of healthy meals.
Frequently asked questions
What is an example of a food sensory issue?
Food sensory issues can look different in different people. Some children may respond negatively to the sensation of mixed food textures, like a soup with vegetables in it. Others may not like crunchy textures like crackers or juicy textures in fruit.
Can you have food aversions and not be autistic?
Having sensory food aversion does not mean a child is autistic. However, sensory feeding disorders often occur in children who are autistic or neurodivergent.
Do children with ADHD have sensory issues with food?
Yes, selective eating and sensory aversion are common in children with neurodevelopmental conditions like ADHD.
How do you fix food sensory issues?
Feeding therapy can help increase the variety in a child's diet. Goals may include increasing the child’s tolerance of the textures, tastes, sights, smells, or temperatures of the foods that give them difficulty. Therapy follows a step-by-step process, helping kids become more familiar and comfortable with different foods.
How do you know if your child needs feeding therapy?
If your child consistently avoids certain foods, reacts strongly to smells or textures, or eats a very limited diet, they may benefit from feeding therapy. A feeding therapist can evaluate their needs and create a customized plan to help them gradually try new foods.
What happens at feeding therapy for sensory food aversion?
Therapy usually starts with an evaluation of your child’s eating behaviors, oral motor skills, and reactions to foods. Feeding therapy involves step-by-step exposure to new foods. Children may look at, smell, touch, and eventually taste foods, with guidance from a feeding therapist. Therapy is fun, safe, and designed to reduce fear while increasing comfort with foods.
Key takeaways
Sensory food aversion happens when a child struggles with the sight, smell, taste, texture, or temperature of food.
Signs of sensory feeding issues include seeming grossed out or uneasy around a new food, refusing certain flavors or textures, frequent gagging, spitting out food, or negative reactions at mealtimes.
Childhood feeding therapy is provided by a speech therapist who specializes in feeding.
Feeding therapy is designed to reduce fear while increasing comfort with foods. Children may look at, smell, touch, and eventually taste foods, with guidance from a feeding therapist.
Some types of feeding therapy can be done through teletherapy. A feeding therapist guides sessions remotely with parent support at home.
How Expressable Can Help
Concerned your child isn't reaching age-expected milestones? Looking for communication support from a professional? Expressable is a national online speech therapy practice serving children and adults. We treat all major areas of communication and feeding, offer flexible hours including evenings and weekends, and accept most major health insurance plans. We’re proud to have earned more than 3,000 5-star reviews from our clients (4.9/5 average).
Our therapy model is centered on parent and caregiver involvement. Research proves that empowering caregivers to participate in their loved one’s therapy leads to better outcomes. That’s why we combine live, 1-on-1 speech therapy with personalized education and home practice activities for faster progress.
Communication is more than words. It’s how we share how we feel and show who we are. We’re here to help you or your child do just that.
