Understanding ARFID with Teresa Foley OT and Specialist Feeding Therapist

So I suppose for anyone listening then that may not be aware, you've mentioned a few different things there.

You mentioned ARFID, paediatric feeding.

Is that disorder? Is that correct? And then also autistic eating.

Do you want to explain to anyone that's listening what is ARFID and maybe the other terminology as well so they understand the difference?

I think that's probably the best way to kind of identify those different categories.

And, you know, that's probably my categorization of them.

So the way I think ARFID is the one that we hear the most about and definitely kind of out there on social media or whatever, I think the term ARFID can be thrown around a lot.

to describe a child who is really struggling with food and eating.

But interestingly, then when you do, if a child or a family do attend for like a diagnostic appointment with a feeding clinic or a team or their local therapist or whatever it is, what we might think might be art, it might not always be when you kind of drill down into the diagnostic criteria.

And I suppose that's why I'll talk about autism and ARFID kind of together if that's okay because you know I've worked with thousands of autistic children and families in my career and I would say most of those children would have some what I would call eating differences are they very severe eating challenges not always and so The latest evidence does say that 89% of autistic individuals present with eating differences but not all of those will be severe enough or restrictive enough to warrant a diagnosis of an eating disorder which is technically what ARFID is.

So I suppose to give you an example of that you know thinking of a lot of the children who come to see me in my clinic you might have Say, for example, an eight-year-old autistic boy who really likes chicken nuggets, potato waffles, all of one specific brand, you know, they only like maybe the bird's eye potato waffles.

They only want the super value chicken dippers and maybe they'll have two types of crackers and one brand of crisps and maybe they drink milk.

And so, yes, their eating profile is very restricted and rigid and they might even do things like drop foods, which we'll talk about in a moment.

but actually when you you know maybe go when the child is seen by a dietician or a pediatrician and their weight and height are tracked and maybe they're growing well they're gaining weight they're doing everything that they need to do they're healthy they're if they have bloods done their bloods are fine then actually that child is is fine you know okay no parent in the world has ever wished that their child would survive off a diet of seven base carbohydrates But actually, if that's serving the child and if they are able to live a full life with those restricted eating preferences, that's okay.

And that can be really hard for parents to wrap their head around.

because we all have, I say the shoulds.

Our children should be eating all this fruit and vegetables.

Our children should be having a different dinner every day.

But just remember that if an autistic child or individual has these quite rigid or strong preferences around food and eating, but they're thriving and growing and are able to eat in all the places, if they're able to eat at school, able to go to a birthday party and maybe bring their own snacks with them, that is okay that is their chosen way to eat now it can be frustrating for parents absolutely and parents might say to me i have to go to three different supermarkets to get the specific brand of waffles i get it that is really frustrating however it might not align with the criteria of an eating disorder so then on the other hand then ARFID is avoidant restrictive food intake disorder is the full title um And this is very much, it is an eating disorder.

So it's identified in the literature as an eating disorder in the same way that we have anorexia nervosa, bulimia nervosa.

It is an eating disorder.

And that can be a little bit alarming for parents if they do get that diagnosis.

You know, to be told that maybe your four-year-old has an eating disorder.

That's a lot to hear.

It's a lot to take on.