Sensory Integration Education

Does your child struggle to easily eat at the table at mealtimes? Even discounting a limited range of preferred foods, there are things impacting eating skills that you may not have considered. There is a multitude of underlying factors to eating difficulties: here is a brief look at just three aspects which may be hampering your child’s eating skills. 

Let’s first look at some mealtime behaviours which may suggest your child’s eating skills need some support. Does your child

• Get tired during eating?
• Spend less than 5 minutes eating?
• Extend mealtimes over 30 minutes?
• Refuses to sit at the table or jumps down from the table after only a few minutes?
• Takes a drink of water with every mouthful?
• Slump over the table when eating or support themselves on one arm whilst eating?
• Overstuff their mouth?
• Frequently miss their mouth?
• Struggle to manipulate food or use cutlery?

Important: If you are concerned about your child’s development and eating skills, raise it with a health professional, for example, your GP, health visitor, speech and language therapist or occupational therapist. 

Apart from food taste, presentation and texture preferences what are the other things affecting your child’s eating? The physical act of sitting up at a table, selecting and manipulating food into your mouth and then using your tongue to purposefully move it around your mouth to chew and then swallow it is actually very complicated and a big draw on our resources. As adults, we most likely do this act a few times a day with ease and without thinking too much. But some children can struggle with all elements of the act of feeding themselves. Let’s take a closer look at three things impacting eating skills. 

1. Posture Affects Eating Abilities

How does your child sit at the table to eat? If they are hunched over the table, slumping to one side, leaning far back in the chair or using an arm to prop themselves up, this could be a sign of poor postural tone. Another indicator is your child wrapping their legs around the chair legs to give themselves more support. 

Does your child W-sit on the floor or attempt to W-sit in chairs? W-sitting is a common sitting position among children where their knees are positioned in front of them, while their ankles and feet rest on either side of their hips, forming a distinct W shape. This posture is often adopted by young children during play because it provides them with a broad base of support. By assuming the W position, children can rely less on their core muscles to maintain an upright sitting posture. W-sitting is part of typical development but prolonged and frequent use of this sitting style can potentially signal underlying issues with a child's gross motor development.

But how does poor postural tone affect eating abilities? Slouching at the table affects the alignment of the spine and compresses the digestive organs, potentially causing discomfort and digestion problems. Moreover, a child with poor postural tone will be expending effort to keep their head raised. Their brains may also be working hard to maintain a posture that keeps the lungs open for easy breathing. They are already focusing hard on prioritising their safety and breathing - add in the complexities of feeding themselves and we may have an overly-demanding situation for your child.

Children with low postural tone can get stuck only eating foods with low oral motor demands like yoghurt or purees because they prioritise the demands of keeping the brain safe and breathing. Foods that involve different styles of chewing simply demand too much on their system which is already working hard.

It takes more effort to maintain a static posture, where we have to sit still and straight up, than a dynamic posture where we are moving around. Children with postural difficulties struggle to sit for long enough time to eat enough in a single mealtime so they might take a few bites and then run off. 

A word on high chairs: some styles do not have a footrest leaving the child’s feet to dangle unsupported in space. Some children find this very unsettling and it places extra stress on their system as their brain constantly checks that they are in a safe position. Check out our Sensory Chat Podcast on Toddlers and Eating.

Check Your Child’s Seating Arrangement

^{Things Impacting Eating Skills: Posture and seating set up at the table}

Check that you are setting your child up for success at the dinner table. Ensure they have a supportive chair which allows them to rest their feet on a stable surface. The table top should be level with the point about halfway between their chest and their navel. Their thighs should be parallel to the floor and check for 90° angles at the hips, knees and ankles. Their knees should reach the front of the seat so they can comfortably bend their knees downwards instead of sticking their legs out in front of them.

2. Gross and Fine Motor Development Affects Getting Food Into the Mouth and Moving It Around the Mouth

How can colouring in, threading beads or swinging a racquet improve your child’s eating skills? When it comes to eating, our gross and fine motor skills play a crucial role in getting food into our mouths and efficiently manoeuvring it within our mouths. Gross motor movements involve coordinating our larger muscle groups, such as our arms, legs, and core. It is essential to have good overall body coordination to develop effective oral motor coordination, which involves utilising the muscles in our mouth for efficient eating.

To achieve good gross motor development, children need to be able to effortlessly cross their midline. Crossing the midline refers to reaching across the imaginary line that divides the body into left and right halves. When children can't effectively cross the midline with their limbs, it often indicates that they may struggle with crossing the midline with their tongue as well. The lateral movement of the tongue from one side of the mouth to the other is crucial for manipulating solid food in the mouth and chewing it properly. Therefore, physical skills related to gross motor development can directly impact a child's ability to eat a variety of foods. 

Bilateral motor coordination, which involves using both sides of the body in a coordinated manner, is also essential for supporting eating skills. If you can't use both sides of the body together in a coordinated manner using cutlery is hard and even holding the plate still with one hand and using a fork or knife with the other is hard. Here non-slip or suction mats to keep the plate or bowl steady are helpful for children with coordination issues so that they can use the dominant hand solely for cutlery.

Effective fine motor skills (hand use) are needed for children to be able to manipulate their food, to have control over their food and use cutlery. They need to be able to tear the food into smaller pieces, add sauces, dip into other foods, scoop foods, peel the skin off things, and open packets - to generally use their hands to fashion the food into a way that they are comfortable eating it. 

How to Foster Gross and Fine Motor Skills

Things Impacting Eating Skills: Fine motor skills can be developed through play

By understanding the connection between gross and fine motor development and eating skills, you can support your child's overall oral motor development. Encouraging activities that promote crossing the midline and bilateral coordination, such as playing with toys that involve reaching across the body, participating in sports, crawling, riding a bike and climbing.

Fine motor skills can be developed through play and you can offer many play opportunities with food and utensils (without any focus on eating) to help your child develop the dexterity and coordination needed for self-feeding. For example, you could play with cutlery and utensils with play, clay, rice or cooked spaghetti. You could set up a pouring station with different sizes of containers and objects like water, rice, or beans. Encourage your child to pour and transfer these materials from one container to another using tools like a small pitcher, tongs, or a ladle. Provide your child with opportunities to sort and manipulate small objects using their fingers. This can include activities like sorting beads, buttons, or pasta shapes into different compartments or threading pasta onto string. Rolling, pinching, and moulding play clay can improve hand strength and dexterity. Encourage your child to create shapes, roll small balls, or even imitate food items using the dough. You can purchase velcro fruit and vegetable sets which are a fun way to learn to chop with a play knife. These activities enhance finger control and coordination, which are crucial for using utensils and manipulating food.

3. Sensory Aspects of the Environment Affect Your Child’s Focus on Eating

Think about the room where your child normally eats. Is it overly bright or dimly lit? Is there often a tv or radio on in the background? Are there strong smells from cooking, clearing or scented air fresheners? Is it generally just a busy room with lots of distractions? When it comes to children's ability to focus on the complex task of feeding themselves, the sensory aspects of their environment play a significant role. 

Things Impacting Eating Skills: Sensory aspects of the eating environment

By carefully considering and optimising the sensory environment in which your child eats, you can significantly enhance their ability to concentrate and engage with their meals. You’ll know your child’s individual sensory preferences best but here are some ideas for tweaking the dining area to meet your child’s sensory needs.

Creating a More Sensory-Friendly Eating Space

Lighting: The lighting in the dining area can have a substantial impact on your child's eating experience. Dim or excessively bright lighting can make it challenging for children to visually assess and engage with their food. Natural or soft, ambient lighting is ideal, as it creates a relaxed atmosphere that promotes focus and attention. 

Smells: The presence of strong or unpleasant smells in the dining area can negatively affect your child's appetite and focus. Strong cooking odours, cleaning agents, or even scented candles can overpower the senses and distract from the eating experience. If you think strong odours may be a problem, try airing out the room before serving food or switching to unscented products. 

Noise Levels: Excessive noise or loud background sounds can be highly distracting for children during mealtime. Loud conversations, television or radio volume, or other external noises can divert your child's attention away from their food. Experiment with turning off devices and creating a calmer quieter environment at mealtimes. 

Visual Distractions: A cluttered or visually stimulating environment may impede your child's ability to focus on eating. Too many toys, decorations, or excessive movement in the dining area can draw their attention away from their food. Simplifying the surroundings and minimising visual distractions may support your child to focus on the task at hand.

How Else Can You Support Your Child’s Feeding Skills?

We recommend this three-part online on-demand course Supporting Children with Feeding Difficulties For Parents and Carers. 

The course is delivered by Laura Osman, Highly Specialist Speech and Language Therapist, Advanced Sensory Integration Therapist, Feeding Therapist and Teacher and Louisa Hargett, a Highly Specialist Occupational Therapist, Advanced Sensory Integration Therapist, Feeding Therapist and Teacher. This engaging and popular course, packed with expert advice direct from Laura and Louisa includes:

 1) Reasons why children don’t eat 

• Understand the reasons why a child does not or will not eat and use this knowledge to reflect on your own child’s challenges. 
• Be empowered to identify professionals who can help.
• Be able to effectively describe the feeding challenges that your child is experiencing to a range of professionals.

2) How to help a child who won’t eat

• Use practical and positive strategies to improve your child’s feeding skills and experience of feeding. 
• Creatively use what is already available to you to support feeding skill development. 
• Understand the importance of being playful in developing feeding skills. 
• Know when to seek help and understand the role of different professionals in developing feeding skills. 
• Understand what is involved in a feeding assessment.

3) Creating positive feeding and mealtime experiences

• Identify your role in supporting your child’s feeding.
• Develop knowledge of positive strategies to implement change to mealtime routines and experiences at home. 
• Know how to collaborate and work effectively and efficiently with professionals.
• Use resources already available to you to support a child’s feeding development.

Supporting Children with Feeding Difficulties For Parents and Carers comprises 6 hours of content with downloadable resources for only £49.