Online Therapy for Feeding Difficulties, Restricted Diet, and ARFID

Feeding difficulties and restricted diets in children can be a challenging and stressful experience for both the child and their family. As a psychologist specializing in this area, I understand the complex interplay of physical, emotional, and behavioral factors that contribute to these issues. My approach is rooted in evidence-based practices and a deep commitment to neurodiverse affirming care. I work closely with families to create individualized strategies that promote positive eating experiences, improve nutritional intake, and reduce mealtime stress. Through telehealth services, I provide accessible and convenient support, ensuring that every child receives the compassionate and effective care they need to thrive.

Online Feeding Therapy with Jess!

Transform Mealtime Struggles into Successes

Whether your child is a picky eater, has difficulty with textures, or struggles with mealtime behaviours, I am here to help. As a dedicated psychologist, I offer personalised support and strategies to make mealtime a positive experience for everyone. I work closely with children and parents to address difficulties related to mealtime.

Telehealth Therapy to address:

1. Refusal to Eat:

  • Consistently refusing to eat certain foods or entire food groups.

  • Frequent mealtime battles and resistance.

2. Limited Food Variety:

  • Eating only a very narrow range of foods (picky eating).

  • Avoidance of foods with certain textures, colors, or smells.

3. Long Mealtimes:

  • Taking an excessively long time to eat meals.

  • Difficulty chewing or swallowing food.

4. Sensory Sensitivities:

  • Strong reactions to the sensory properties of food (e.g., texture, temperature).

  • Refusal to eat foods that are mixed together or touch each other on the plate.

5. Anxiety Around Food:

  • Visible distress or anxiety at mealtimes.

  • Fear of trying new foods (food neophobia).

Why does my child experience difficulties eating?

Children may experience feeding difficulties and have a restricted diet due to a variety of reasons, including:

  1. Sensory Processing Issues: Children with sensory sensitivities may be overwhelmed by the textures, smells, or tastes of certain foods, leading to a limited diet.

  2. Medical Conditions: Conditions such as gastroesophageal reflux disease (GERD), food allergies, or intolerances can cause discomfort and lead to food avoidance.

  3. Oral-Motor Difficulties: Problems with chewing, swallowing, or coordination can make eating challenging and uncomfortable for children.

  4. Developmental Disorders: Autistic children or children experiencing other developmental delays may have a limited range of acceptable foods due to sensory sensitivities or rigid preferences. A lot of autistic children experiencing difficulties with food meet the criteria for ARFID (Avoidant Restrictive Food Intake Disorder).

  5. Behavioral Factors: Negative past experiences with food, such as choking or force-feeding, can result in anxiety and avoidance of eating.

  6. Psychological Factors: Anxiety, stress, or other emotional issues can impact a child's appetite and willingness to try new foods.

  7. Routine and Environment: Inconsistent meal routines, lack of exposure to a variety of foods, or a stressful mealtime environment can contribute to feeding difficulties.

  8. Picky Eating: Many children go through phases of picky eating where they may reject certain foods or prefer a limited range of items.

  9. Physical Disabilities: Conditions that affect a child’s physical abilities, such as cerebral palsy, can make self-feeding difficult and impact their diet.

Avoidant/Restrictive Food Intake Disorder (ARFID) is distinct from typical picky eating and other feeding difficulties in children. While picky eating often involves selective eating habits that most children outgrow, ARFID is a more severe and persistent condition. Children with ARFID may avoid certain foods due to sensory sensitivities, fear of adverse consequences like choking or vomiting, or a lack of interest in eating altogether, leading to significant nutritional deficiencies and weight loss. Unlike common feeding difficulties, ARFID can cause considerable health and developmental impacts, requiring a comprehensive and specialized therapeutic approach to address the underlying psychological, sensory, and behavioral factors.

Avoidant/restrictive food intake disorder (ARFID) is a fairly new eating disorder. Children with ARFID are extremely selective eaters. They may have little interest in eating food, experience fear of adverse consequences (such as chocking) or experience severe sensory sensitivities. They may eat a limited variety of preferred foods, which can lead to poor growth and poor nutrition.

Jess works on Telehealth with both adults and children (with the support of a parent) to teach strategies to practice at home to reduce symptoms of picky eating, feeding difficulties, anxiety, and ARFID.

What is ARFID?

  • Very selective eating with strong negative reactions to smells, tastes, textures, or colors of foods.

  • Some kids may have an overall lack of interest in eating and have a very low appetite or find eating minimally rewarding or not at all. These kids often deny feeling hungry.

  • Some kids may fear adverse consequences if they ear; for example, experiencing pain, choking, or vomiting.

Signs of ARFID

Treatment for ARFID

Treatment can help restore good physical and mental health and balanced eating habits. Since ARFID is a fairly new diagnosis, little is known about its optimal treatment. However, from new research coming out we know that some treatments have shown to have good results in reducing ARFID symptoms. These treatments are CBT-AR, FBT + UP, and some feeding therapy strategies. There is no one-size-fits-all approach and it is important to modify there treatments and adapt them based on the individual’s difficulties.

CBT-AR for ARFID

The goal of CBT-AR is to help patients achieve a healthy weight, resolve nutrition deficiencies, increase variety to include multiple foods from each of the five basic food groups, eliminate dependence on nutritional supplements, and reduce psychosocial impairment. CBT-AR involves different strategies depending on what is causing ARFID: sensory sensitivities, fear of adverse consequences, or lack of interest in food.

FBT + UP

Family-based treatment (FBT) in combination with the unified protocol for Transdiagnostic treatment of emotional disorders in children (UP) has highlighted promising results in resent research studies. This approach uses a combination of strategies to implement at home as well as treatment for anxiety and emotional disorders that may sometimes play a role in trying new types of foods.

Jessica is a dedicated and compassionate registered psychologist specialising in treating ARFID, Feeding Difficulties, Body Image issues, Eating Disorders, Autism, and ADHD. Jessica has experience working with Autism and ADHD, helping children and adults navigate anxiety, social skills, emotional regulation, and executive functioning difficulties. Jessica understands many of the sensory difficulties that neurodivergent children and adults experience, which can also lead to restricted diets. She is passionate about treating Avoidant Restrictive Food Intake Disorder and other feeding difficulties in both children and adults, and incorporates therapies such as FBT+UP, CBT-E, CBT-AR, Responsive Feeding Therapy, and Oral Sensory Motor Therapies.

Jessica's approach is empathetic and client-centered. She is committed to fostering a safe and supportive environment where clients can explore their feelings and develop resilience. She incorporates games and fun activities into her therapy approach with children.

Jessica has studied in the UK and Australia and she is registered with the Australian Health Practitioner Regulatory Agency (AHPRA) and the British Psychological Society (BPS).

Jessica loves languages and is fluent in English, Italian, French, and has studied Spanish, German and Latin. She also loves dogs, reading, and photography.

Jessica Pezzato
Registered Psychologist
BA; MSc.Psych; CEDC

AHPRA Reg: PSY0002443042