As a parent of a child with Avoidant/Restrictive Food Intake Disorder (ARFID) it may feel like you have been struggling for years trying everything to help your child increase their range of acceptable foods. Perhaps your child’s struggle with a limited range of foods is more recent, following a choking or vomiting incident. Whichever course ARFID has taken in your child, it is often a challenging and seemingly daunting disorder to battle. It can be exhausting and worrisome trying to ensure your child meets their nutritional needs on a daily basis when they are restricting full food groups from their diet.
Knowing there is treatment for ARFID can provide hope that your child will continue to grow and thrive with a broader range of preferred foods. Learning how to support them through that treatment will give you the tools to maintain that progress and see them achieve their recovery goals.
Here are five ways you can support your child with ARFID:
1. Start small with exposure to new foods
The desire to have your child increase their preferred food repertoire is often so strong that the risk of pushing too hard too fast is great. Often in treatment, children and adolescents are asked to incorporate foods they may never have had before. As providers and parents, if we set expectations too high, it can ultimately lead us and the patient in believing that treatment is failing. To keep motivation and spirits as high as possible, exposures should be small – start with a bite, and continue to increase over time in size as the exposures become more easily tolerated. This allows yourself and your child to make small, incremental progress and minimize discouragement and frustration.
2. Stick with it
Exposures are not easy. They can elicit high emotional reactiveness for both your child and perhaps you. It is easy to get discouraged if an exposure doesn’t go well and to throw in the towel. It can be helpful to keep in mind that it can take up to 10 exposures of the same food before your child is able to accept the food with less difficulty. Repeated exposures help to increase familiarity with new foods and can demonstrate to your child that you believe in their ability to tolerate this new food.
3. Keep new foods in the rotation
Once a new food becomes well tolerated, it is important to keep that food in the rotation. This doesn’t mean you will be eating this new food every day, but rather one to two times a week to ensure that the gains you make are maintained. Not doing so can increase the chance that you will need to repeat the exposure again from the beginning.
4. Include your child in food decising making
Although the idea of increasing food variety may be anxiety-provoking for your child, including them in the planning of exposures allows them to be curious about the foods they may have. Making it more of an adventure and a chance for a shared experience as a family can increase openness and willingness to try. Children and adolescents may often have an idea of the types of foods they want to try based on feedback from those around them or things they have heard of. Encouraging their engagement and curiosity helps to decrease the potential for struggles at meal times.
5. Take care of yourself
It is essential to ensure you take the time to care for yourself as your health and wellness are as important to the treatment process as your child’s. Maintaining your own balanced diet, getting enough rest, and having your own supports to reach out to when needed, will allow you to have the time and energy to provide to your child for the duration of treatment.
As you and your child progress through ARFID treatment, you can expect highs and lows, setbacks and successes. However, progress is possible and you and your child can be successful with increasing their repertoire of preferred and tolerated foods; ultimately allowing your child to have more freedom from the rigidity of food in their everyday life.
If you are in need of further support, we are here to support you and your family.
Amanda Smith, LICSW, is the Assistant Program Director at Walden Behavioral Care’s Peabody clinic. In this role she oversees the day-to-day care of adolescents in the partial hospitalization and intensive outpatient programs. She works closely with staff, providers, families and clients to help foster a recovery-focused environment. Her career at Walden began in 2010 when she served as a clinical case manager on the inpatient unit for eating disorders. Prior to her current role, she spent time as a clinical case manager in residential and the partial hospitalization and intensive outpatient programs in Waltham. She received her masters of social science administration from Case Western Reserve University.