HOME-BASED ARFID SUPPORT
ARFID SUPPORT COMES TO YOU. HELPING YOUR CHILD AT HOME WHERE THEY FEEL SAFE AND WHERE MOST OF THEIR EATING TAKES PLACE.
Your pediatrician tells you “when they’re hungry enough, they’ll eat,” but not your child! They would sooner starve than eat something on their “no-no” list. Maybe your child sticks to a range of just a few favored foods. Perhaps they can tell the difference between Applegate chicken nuggets and Perdue and will absolutely only eat Applegate - prepared at home only and served on a specific plate. Maybe your child eats a pretty wide range but they have such a low interest in food that they could go all day without eating if not pushed. It’s possible that your child ate pretty well until they got in their heads that they could choke at any moment and now they’re just refusing solid food all together.
There have been fights, tears and endless conflict. Or maybe you’ve just given up because you want to keep the peace and challenging your child doesn’t seem to work anyway.
A highly selective or avoidant eating style in children can wreak havoc on family life and can lead to serious nutritional deficiencies, inadequate growth, problems with mood (we all know how easy it is to get “hangry”), social struggles and more.
It’s ARFID
Have you heard of “ ARFID?” No, ARFID is not a Sesame Street character! It’s actually a clinical eating disorder that is often mischaracterized as “picky eating” or “just not that into food". Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterized by an extreme avoidance or restriction of certain foods or food groups, leading to significant nutritional deficiencies and impaired physical and psychological well-being. Unlike other eating disorders, ARFID does not involve concerns about body weight or shape, but rather revolves around sensory sensitivities, fear of aversive consequences, or other factors related to food.
An evaluation with a therapist who specializes in eating disorders - and ARFID, in particular - can pretty quickly establish if your child meets criteria. This evaluation can also direct you to the most appropriate treatment for your child.
How Treat ARFID
There are several legitimate approaches to treating ARFID in children. Columbus Park blog outlines a number of them including Family-Based Treatment for ARFID and Feeling and Body Investigators, a novel treatment for ARFID in kids. In this blog, we’re going to focus in on Columbus Park’s core approach to ARFID, where we bring in elements of the most potent ARFID treatments, delivered to your child, in their home environment.
TREATING ARFID: HOME-BASED SUPPORT
For school-age children with ARFID, we see that sessions are most effective when conducted in a safe, familiar space - at home where your child feels most secure and where much of their eating takes place. It’s a big plus that parents are present, too, so they can learn and work towards a new, more grounded and harmonious approach to food in the household.
The idea is the provider first establishes a playful, inviting and safe relationship with your child. Your child should look forward to seeing this provider each week; it’s fun, after all. Collaboratively, your child and their home feeding coach begin to identify “food experiments” that they’d like to engage in together. The foundation of food experiments is Exposure Therapy which is a well-studied therapeutic technique used to treat anxiety disorders, phobias, and PTSD by gradually exposing individuals to feared objects, situations, or memories in a safe and controlled environment. Essentially, the goal of exposure is to help individuals confront and gradually overcome their fears or traumatic experiences through repeated and systematic exposure, leading to decreased anxiety and increased confidence in managing their reactions. Through exposure, the provider and child will slowly but surely conquer the child’s fears and avoidance together.
What Exposure Work looks like
Think about a phobia of spiders. To overcome the fear, first you might just look at pictures of spiders. Then perhaps watch a video. Next you might observe a spider in real life. And so on and so on. Before you know it’s you’re actually touching the spider with little fear or sense of threat. There is a similar approach to food. The ideas is that as the individual slowly begins to experience the food as less threatening, they can approach it, try it and over time perhaps realize that the taste is pretty good. Or at minimum, they can learn to tolerate the food in service of “filling the tank” and taking care of their body. They don’t have to love everything; they just need to expand enough to live in the world and care for their health.
EXPANDING YOUR CHILD’S FOOD REPERTORY
In expanding food quantity or repertory, it’s critically important for the child to feel safe and in control. The feeding coach will work with them in a playful and encouraging manner, helping the child collaborate around goal setting and treatment planning (although the child won’t realize that they’re setting goals or planning treatment!). Exposures happen slowly and within a reassuring and sensitive structure.
Within the home feeding structure, caregivers are given guidance and strategies that they may use at home to support progress and keep the work going between eating sessions. When central adults in the child’s life are well educated and skilled in managing ARFID, critical shifts happen at home, freeing the child up for continued progress forward.
INCREASING FLEXIBILITY
Here’s how it might work in session: Let’s say your child is only willing to eat one type of chicken nugget, prepared in the air fryer and served on their favorite plate. Your feeding coach might work on systematically switching up that nugget. Perhaps starting with serving the favored nugget on an unfamiliar (but totally cool and fun) plate, cutting it up in a novel way, adding salt… then eventually trying out a different brand, and then moving on to a range of chicken preparations. You can see how you create a bridge from a preferred food to a much wider range. And it’s done through play and experimentation. Just like a couple of detectives on a mission.
Future Foodie - Not Really
Hey, your child may never be a gastronome or gourmet but they need to be able to eat at school or go to summer camp… And of course, they need enough nutrition to grow and thrive well into the future.
GETTING HELP
Parenting a child with ARFID is not easy. The limitations and stress (both your child’s stress and yours) are overwhelming for families. It’s so important to get help so as to change the energy and approach to food/eating and get on track for a more balanced and joyful approach to eating for your child’s lifetime. Home ARFID support is highly effective way to guide children to normalized eating.
