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A Case for Giving Autistics Back Sensory Play

I am an independent Nurse and Sleep Consultant at ‘Neurodivergent Nurse Consulting’. My work specialises in supporting neurodivergent (ND) people; many of the young people I support are Autistic.

I had been contacted by the parents of a nursery-aged child to see if I could provide some insight and support in regards to their child’s eating.

They described their child as having ARFID (avoidant restrictive food intake disorder). Parents and carers often describe the condition as ‘extreme picky eating’.

ARFID Awareness UK describes ARFID as

“a pattern of eating that avoids certain foods or food groups entirely and/or is restricted in quantity (eating small amounts).”

The family is local and we were able to arrange a consult between me and both parents in their home.

After we sorted out our tea, we gathered round their kitchen table to start our discussion. The child’s mum spoke up quickly.

“Since booking today, we’ve had a lot more concern about her at school. The teachers are saying that she isn’t really engaging in activities anymore.”

Table in a school setting with three wooden trays all filled with paint. A variety of materials to use the paint are in the paint trays and on the talbe. These include different paint brushes, sponges and stamps. There is are wooden windows in the background.
Photo by Gautam Arora on Unsplash

The child’s other parent continued “Yeah, they say she won’t join the other kids at the play areas. If a teacher tries to help guide her over, she will throw herself to the floor and run off. She only wants to play outside and keeps running to the back door.”

Mum again, “It’s just not like her. Up until this, she loved nursery and the teachers would say that she loved joining in. Now, she’s quite anxious.”

I listened to all of this while thinking…

‘Where to start?’

There are so many possibilities as to why this young child is showing increased anxiety and communicating that they don’t want to engage in many of the learning activities at school.

We started brainstorming and wrote up some questions for the staff to hopefully give us some more insight. We agreed that over the next weeks, it would be helpful to create more downtime for the child and focus on family time.

We also did begin reviewing the foundations of food and eating support that I provide. At the top of the ‘Quick Tips as We get Started’ sheet is…

‘Respect no, respect when a food is refused.’

Both parents raised their eyebrows and said “That’s not what we’ve been told before. We just stopped seeing another provider who would have her play with the foods that she disliked and earn a bite of chocolate if she ate some of a food that she has been refusing. It was always quite upsetting, she was always upset.”

What they were describing was food therapy based on desensitization practices to increase the variety of food that someone eats. This form of food therapy is commonly used with Autistics.

Ok. This was really good to know. I’m really glad that they felt able to tell me. I also understand that sometimes people hold back information from assessment forms as it can feel quite vulnerable sharing such personal information to someone they don’t know yet. People can even feel funny about approaching a second opinion.

We set a follow up for in two weeks time. We hoped to also have more information from the nursery staff to help us make some plans in that setting too.

Before we got to that next consult, I got a call from the child’s mum that went something like this

“She didn’t want to eat the play-doh or sand or I don’t know, whatever! I think she thought she was going to have to eat some of the things that were put out to play with.”

This was a huge lightbulb moment.

In nurseries, it’s quite common for tables to be set up as ‘invitations to play’ where materials are strewed about and ready for the kids to discover.

Many of these invitations to play use a variety of materials and involve sensory play and exploration.

Photo by Jessica Hearn on Unsplash

This child was associating sensory play at nursery with the sensory desensitization food therapy.

But shouldn’t the child ‘just know’ that of course something like the glue isn’t edible?

I counter this argument with us recognizing that she though the yogurt at food therapy was inedible. She strongly refused the yogurt but she was guided by a professional through steps to play with it, put it on her body and smear her lips with it.

I think that we can see how this can then become confusing for her and massively anxiety-inducing.

This child had been put into a situation where their self-advocacy and bodily autonomy were not respected. Despite saying no, the child had to play with and even consume items that they found disgusting and inedible.

They must have been wondering what else will they have to eat? Is this food? I imagine that they would start to feel confused and not sure who or what to trust.

This actually became priority number one — regain trust.

The parents and I created some action plans of messy play to do with their child at home. The materials were to be picked out by the child and used in whatever ways she came up with. So quite strict instructions to have fun!

We also realized that their daughter needed some clear communication. The parents and staff used quick scripts like ‘this is just to play with, not eat’ when using play materials.

Over a few weeks, the child began to trust that she could play without the pressure of having to eat something that she didn’t want, couldn’t or shouldn’t. In addition, her parents continue to listen to her when she says ‘no’ to a food.

Conclusion

Sensory play is an integral part of learning and having fun. This is true for Autistic people too. Many Autistics point to sensory play as one of our community’s most common trait. It is often part of deep interests, regulation and Autistic joy.

Subverting sensory play to make someone eat foods that they are unable to takes away an Autistic person’s agency and creates food trauma.

Sensory play needs to stay as play.

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