Overcoming fear of food
Apr. 18, 2017
These children often have trouble communicating with others. But researchers are starting to realize that many also have difficulties with eating--and it's not just a question of taste.
Masaki Suda of Shizuoka city was diagnosed with Pervasive Developmental Disorder, or PDD, when he was three years old. He has difficulty communicating, and trouble eating.
His dinner was sweet and sour pork, spaghetti, and rice.
"I don’t want rice," he says.
Masaki skips the rice, and ends up not eating much. Instead he goes for some cheese in the refrigerator.
Masaki’s food issues began when he was four. By the time he started elementary school, he was only able to eat cheese, croquettes, natto, potato salad — and nothing else.
Masaki used to always avoid eating carbohydrates. He lost weight instead of gaining it like most children.
Now 10 years old, he weighs just 21 kg.
His mother says, "He’s really thin, you can see his bones and skinny legs--he clearly isn’t getting enough nutrition."
Professor Satoru Takahashi of Tokyo Gakugei University has years of experience counseling children with developmental disabilities.
In one survey, more than half were found to have difficulties with eating. Researchers have been trying to figure out why.
Professor Takahashi interviewed 137 people with developmental disabilities about their diets.
He discovered they have unusual sensory perceptions, such as extreme sensitivity.
For example, to most people strawberries look round, red and delicious. But for many in the survey, the fruit filled them with disgust and even fear.
They worried that seeds on the surface would fly out and get into their eyes.
Many also said a croquette's crispy bread crumbs feel like needles in their mouths.
Takahashi says, "Traditionally, their eating problems have been thought of as selfishness or simply fussiness. But it’s actually a physiological issue. And this can lead to problems with how the food looks, how it feels inside the mouth, and the ability to chew and swallow it."
These sensations are unique to people with developmental disabilities, which makes it hard for others to understand. As a result, such eating problems have long been overlooked.
That was true of one teenager, now is in his second year of high school.
He was diagnosed with Attention Deficit Hyperactivity Disorder early in elementary school.
He's sensitive to any foods with smooth textures, such as mushrooms and beans. They feel like rubber or plastic in his mouth. It makes him feel nauseous, and causes his body to reject the food.
In Japan, many public schools offer only one lunch menu each day. That means all students eat the same meal, except for those who are allergic to certain ingredients.
The boy says he was unable to eat much at lunchtime in preschool and elementary school.
He tried to tell people he couldn’t eat the food, but they dismissed him as “selfish.” Gradually, he grew fearful of eating in front of others.
He says, "It was hard. The teachers all thought my eating problem was ridiculous, and forced me to eat. I was always scared that the same thing would happen again. It was traumatizing."
As a high school student, his fears remain. He continues to be very selective about what he eats. His doctor told him that he is pre-diabetic, so he gets routine blood tests.
His mother thinks that if people around him had been more understanding, things may have turned out different.
She says, "As adults, we have to look out for children with special needs. I'm sorry that I failed to do so."
Reika Ikehata from NHK World's Science and Culture Department covered the story. She joined Newsroom Tokyo's Aki Shibuya in the studio.
Shibuya: Food selectivity seems to be a serious problem for these children.
Ikehata: That's right. It's not just about how food looks. They are often extremely sensitive to sound and smell. Some of them can't even stand the sound of chewing.
Shibuya: What research is being done on the subject?
Ikehata: Well, this issue has been getting attention around the world. Overseas researchers often interview parents about what foods their children dislike.
In Japan, researchers have started to talk to the children too. They've realized that this isn’t just a matter of taste. These children have suffered from a lack of understanding.
Shibuya: So how can we help these children?
Ikehata: Well, they are often obsessive or extremely anxious about things they’ve never experienced. It’s important to ease those anxieties first.
One way is to start preparing food that’s easy for them to eat while they’re still young.
At a rehabilitation center for children with developmental disabilities in Hiroshima City, staff hold a detailed interview with parents of each patient about their child’s eating habits. They use the information to personalize the meals.
Today’s menu is sukiyaki, a beef dish. For children who can’t eat solid food, the ingredients are pureed in a blender or soaked in liquid to make them softer. But for those who can’t eat mushy food, the ingredients are deep fried to give them a crunchy texture.
Staff members also show illustrations to reassure the children that it’s OK to eat the food.
As a result of these persistent efforts, the facility reports that more than 90 percent of the children who once had difficulty eating can now eat without any special treatment.
One mother says, "I never thought my child could eat so much."
Another says, "My kid has learned to enjoy meals, and is even telling me 'Food is delicious because eating is fun'."
Shibuya: So food selectivity can be treated by paying attention to each child’s needs from an early age?
Ikehata: Yes. Many of the children who enroll at the center can only eat one dish. For one kid it was spaghetti, for another it was fried egg.
At first, the center lets them just eat the food they like. But it gradually starts to introduce new dishes.
Shibuya: It seems they've been very successful. How about regular schools? What can they do to support these children?
Ikehata: Many schools in Europe and the United States have cafeterias where children can choose what they eat. Even when there's no option, the school may show the menu to children beforehand and explain the ingredients. This helps reduce their anxiety and makes it easier for them to eat.
All over the world, people are only just starting to understand this issue. If we're going to do more, the government needs to get involved.