Tracey DeMaria, Occupational Therapist

Tracey DeMaria, Occupational Therapist Tracey DeMaria, OTD, OTR is neurodiverse OT 🌈 author 📖 Obsessed with regulation! Empower children

AOTA conference blew my mind this year. My heart and brain are so full! Lots of belonging and incredible time spent with...
04/27/2026

AOTA conference blew my mind this year. My heart and brain are so full! Lots of belonging and incredible time spent with deep-hearted big thinkers devoted to creating meaningful positive change.

How incredibly humbling and amazing it was to be on the stage with these OT power houses advocating tirelessly to create...
04/24/2026

How incredibly humbling and amazing it was to be on the stage with these OT power houses advocating tirelessly to create meaningful change. It may start out as a few ripples but looking forward to the big wave 🌊!

That’s the face every one should have that this amazing book exists!! To the amazing Bryden Carlson-Giving and all the c...
04/22/2026

That’s the face every one should have that this amazing book exists!! To the amazing Bryden Carlson-Giving and all the contributing authors. As a neurodivergent human and OT I personally thank you for putting this into the world and into our profession. I think I have found required reading for my class finally. I can’t wait to sink into this and wear it out!! And I listen to my books so that says alot!

I really appreciate this research. It is proving what I have observed clinically and personally for years. If you look a...
04/22/2026

I really appreciate this research. It is proving what I have observed clinically and personally for years. If you look at the face pf someone with ARFID when they are trying to eat something- even a safe food sometimes- the faces clearly show disgust. I’ve heard “I just don’t like food.” I’m a sensory craver with food so I don’t related BUT if I had to touch sand or listen to chewing noises 3 times a day to be healthy or just survive it would be incredibly painful for me- every time! I would never just get used to it. I would NEVER habituate. But occasionally I may comply if you bribe me. That wouldn’t change my disgust and discomfort and distress. We need way more compassion and alternative approaches that center on acceptance and listening to lived experiences in this area.

ARFID stands for Avoidant/Restrictive Food Intake Disorder. It's an eating disorder where someone avoids or restricts food, but the reason has nothing to do with body image or trying to lose weight. That distinction is what separates ARFID from something like anorexia. The food avoidance is happening for completely different reasons.

ARFID has three main presentations, and someone can have one or more at the same time.

• The first is "picky eating," which means avoiding foods because of how they taste, feel, smell, look, or sound. This is important to flag because the everyday meaning of "picky eating" is misleading here. In ARFID, this is NOT a kid being difficult or a kid who would eat if they got hungry enough. It's a sensory-based response that the child genuinely cannot push through, and trying to wait them out can lead to real malnutrition or weight loss

• The second is "fear of aversive consequences," which means avoiding food because of fear of something bad happening. Common fears include things like choking, vomiting, or stomach pain.

• The third is "lack of interest," which is where someone just doesn't have much appetite or interest in eating. Food isn't appealing or unappealing to them, it more or less just doesn't register as something worth pursuing.

Researchers already knew that two things show up a lot in ARFID. One is sensory sensitivity, which means a body that reacts strongly to sights, sounds, smells, tastes, textures, and touch. The other is food disgust, which is that strong "ew, no" reaction to certain foods.

What no one had looked at yet was whether these two things work together, and whether they look the same across all three presentations of ARFID.

That's what this study set out to answer.

WHO WAS INCLUDED

The researchers ran an online survey and ended up with two separate samples.

The first was 270 parents reporting on their children, ages 2 to 17. About 60% of these kids were boys, and 28.5% had a neurodevelopmental difference. Specifically, 14.4% had suspected or confirmed autism, 10% had ADHD, and 10.4% had a learning or reading difference.

The second was 491 adults, ages 18 to 73. About 77% were women, and 18.3% had a neurodevelopmental difference, mostly ADHD (10.8%) or autism (7.5%).

People were recruited through social media posts, ARFID and autism support groups, parenting groups, pediatricians, speech therapists, psychologists, and kindergartens.

Anyone who failed two simple attention checks built into the survey was removed.

A subset of participants also did a phone interview with trained researchers to confirm whether they actually met the clinical criteria for ARFID. Of the 98 children who did the interview, 75.5% met the diagnosis. Of the 149 adults who did the interview, 64.4% met the diagnosis.

HOW THEY DID IT

Everyone filled out three short questionnaires. Parents filled them out about their kids. Adults filled them out about themselves.

The first measured sensory sensitivity across the five basic senses (sight, hearing, smell, taste, touch) plus texture. People rated themselves on a scale from 0 to 10, where 0 meant under-sensitive, 10 meant over-sensitive, and 5 meant no difference from typical.

The second measured food disgust using 8 questions covering things like decaying food, mold, hygiene problems, and contamination.

The third measured ARFID symptoms across the three presentations. For kids, parents answered yes-or-no questions about whether their child showed each pattern. For adults, they used a more detailed nine-item scale.

The researchers then used a statistical method called mediation analysis.

In plain English, they were testing whether sensory sensitivity leads to food disgust, which THEN leads to food avoidance, rather than sensory sensitivity directly causing the avoidance on its own.

WHAT THEY FOUND

The results came out almost identical for kids and adults, which strengthens the findings.

For picky eating, food disgust played a huge role. Kids and adults with higher sensory sensitivity had higher food disgust, and that disgust was strongly tied to picky eating symptoms. This was the largest effect in the whole study. The model explained about 30% of the variance in kids and 33% in adults, which is large.

For fear of aversive consequences, food disgust played a smaller role. It still acted as a bridge between sensory sensitivity and the symptoms, but the effect was much weaker. FEAR seems to be the main emotion driving this presentation, not disgust.

For lack of interest, food disgust did NOT play a role. Sensory sensitivity was still connected to lack of interest, but disgust wasn't the bridge. The researchers interpret this as meaning that for people with this presentation, food isn't experienced as gross or aversive. It's just not interesting.

WHAT THE AUTHORS CONCLUDED

The big takeaway is that the three presentations of ARFID are NOT all the same thing under the surface.

They may have different causes, which means they may need different approaches.

Food disgust seems to be central to picky eating in ARFID. It plays some role in fear of aversive consequences. And it doesn't really apply to lack of interest at all.

The researchers suggested that for picky eating specifically, addressing food disgust directly in treatment might be useful. They also pointed out that disgust is harder to "unlearn" than fear, which might be one reason ARFID can be so persistent. (Which we think makes sense given that you can't desensitize people to their sensory aversions)

What this study can't tell us - the researchers were honest about the limits.

• Because everything was measured at one point in time, they can't say for sure what causes what. Sensory sensitivity might lead to disgust, which leads to avoidance. But it's also possible that the avoidance comes first and shapes the disgust over time.

• Both samples were highly educated (the parents and the adult participants) which doesn't reflect the full range of people who experience ARFID.

• The sensory sensitivity questionnaire had only moderate reliability. Someone might be very sensitive to sound but not to taste, and a single overall score can miss that.

• The food disgust scale also had trouble with younger kids. Some parents had a hard time answering for very young children, which suggests we need better tools for that age group.

WHY THIS ALL MATTERS

First, the framing that "picky eating is just a phase" or "they'll eat when they're hungry enough" is wrong when it comes to ARFID.

The picky eating in this disorder is a sensory and disgust-based response that the body produces automatically.

It's NOT stubbornness, it's not bad parenting, and it's not something a child can override by getting hungry enough. Kids with ARFID can lose dangerous amounts of weight or end up needing feeding tubes because their bodies genuinely cannot push through it.

Disgust isn't a behavior or a choice. It's an automatic, full-body response. The "ew, no" reaction kids and adults with ARFID have to certain foods is happening at a level below conscious decision-making.

Telling someone to just push through it, or shaming them for not trying harder, doesn't reach the place where the response is actually happening. It just adds shame on top of an experience they didn't choose.

The traditional approach to this kind of food avoidance is desensitization, slowly exposing someone to the food until the response goes away. But you cannot desensitize someone out of their sensory aversions. Sensory differences are part of how a nervous system is wired. They aren't a problem to be solved or a wrong response to correct. Pushing kids through food exposures they aren't ready for can actually deepen the avoidance and the disgust response, not reduce it.

What may help more is honoring what the body is telling someone, expanding what's available within their safe foods, and supporting the nervous system overall.

The goal isn't to make a child eat foods their body rejects. It's to make sure they have enough safe and accessible options to be nourished, and to support them with respect for what their sensory system is actually doing.

The lack of interest presentation may also connect to interoception. Interoception is the sense that picks up internal body signals like hunger, thirst, and fullness. Many neurodivergent folks have differences in interoception, where these signals can be muted, delayed, different, or hard to read. If your body isn't clearly telling you that you're hungry, food isn't going to register as something to pursue.

This isn't a person choosing to ignore food. It's a nervous system that isn't sending the cue clearly in the first place. If your body doesn't send hunger cues reliably, external structure could fill that gap.

It's also worth saying: lumping all food avoidance together misses important differences. A kid who avoids food because of texture and taste needs different support than a kid who avoids food because they're scared of choking, who needs different support again from a kid who just doesn't feel hunger.

One-size-fits-all approaches don't work here.

**Note: This graphic is a screenshot of recently published research. It shows the title of the study, the authors' names, and the DOI link. The caption summarizes the research and the researchers' findings and conclusions. This is shared strictly as information to our audience and is not intended as an endorsement or a claim that the research findings are definitive.**

[ Alt Text: Screenshot of a research article listing from the journal Appetite, Volume 217, dated 1 February 2026, article number 108329. The title reads "Sensory sensitivity and food disgust in ARFID presentations across ages." Authors listed are Lena Kramer, Alexander Nettlau, Anne-Kathrin Merz, Annick Martin, Anja Hilbert, and Ricarda Schmidt. The Think Sensory logo appears at the bottom on a dark teal background. ]

This week at the AOTA INSPIRE conference. How lucky am I to present with these OT GOAT's?! It's late in the day but you ...
04/19/2026

This week at the AOTA INSPIRE conference. How lucky am I to present with these OT GOAT's?! It's late in the day but you don't want to miss it :)
Thursday 4/23/26 5:30 PM - 6:30 PM
Location: Anaheim Convention Center, ACC Room 204A

I'm also presenting a poster session if you are intersted:
Poster 4-320: Impact of the How to Surf the WAVES Program on the Occupational Competence of Elementary School-Age Students: A Pilot Study
4/24/26
Time: 12:45 PM - 2:45 PM
Presented During: Poster Session #4 - Poster 4
Presented During Time: 12:45 PM - 2:45 PM
Location: Anaheim Convention Center, ACC Hall A

02/06/2026

I know our country and the world is divided but I love that my feed is filled with like minded humans 💕🤍

01/12/2026

Thank you so much and for putting together the Sensory Journey Summit!! 👏 always wonderful to get together share ideas and try to push ourselves and those around us to support children the best we can.

Grateful for   spreading the message of compassion, connection, and regulation ♥️
12/28/2025

Grateful for spreading the message of compassion, connection, and regulation ♥️

Why not try it? Love sour candy!!
11/26/2025

Why not try it? Love sour candy!!

Sour candy can literally help stop a panic attack.

According to mental health experts, the intense flavor acts as a grounding technique—its sharp, jarring taste pulls attention away from overwhelming thoughts and into the immediate physical sensation.

This redirection can help interrupt the cycle of spiraling anxiety, bringing individuals back to the present moment. Additionally, the act of chewing and the surge in saliva production may support the body's calming response, offering a sense of control during distress.

While not a cure or replacement for therapy, this sensory-based strategy can serve as a quick, practical tool in moments of high anxiety. As noted by experts cited by Utah State University, sour candy can be particularly helpful in grounding exercises used during panic attacks. However, they caution that frequent or intense anxiety should always be assessed by a healthcare professional to ensure appropriate long-term care.

Source: Utah State University Extension. (2023). Managing Anxiety with Grounding Techniques.

Al-Ghaili O

UPDATE-
We are so grateful to everyone's reaction to this post. Please give us feedback if you have tried it and how it worked for you! And if you are able please follow us! Please donate and help us in our mission to continue to raise awareness and support parents and caregivers raising children with Complex Trauma! 💚
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Mailing Address
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EIN-83-2090828

This is a summit of professionals you do NOT want to miss if you have a child in your life, especially those that maybe ...
11/23/2025

This is a summit of professionals you do NOT want to miss if you have a child in your life, especially those that maybe need extra support.
All for free, unless you want it sooner.🤩
I am humbled to be inlcuded with this list of incredible child-first professionals. 💙
Sign-up now in case you are like me and forget things easily 😜

So excited to be a part of this amazing Sensory Journey Summit team of professionals ❤️
10/25/2025

So excited to be a part of this amazing Sensory Journey Summit team of professionals ❤️

Today, we're officially announcing our first annual Sensory Journey Summit! A FREE neurodiversity-affirming virtual summit for parents, educators, therapists, and anyone else supporting neurodivergent kids.

We've put together an AMAZING speaker lineup featuring some of the top global experts in their fields—people who are truly pushing the needle forward in neuroaffirming practice:

✨ Dr. Ross Greene
✨ Robyn Gobbel
✨ Dr. Mona Delahooke
✨ Kelly Mahler
✨ Mr. Chazz
✨ Speech Dude
✨ Kelsie Olds (The Occuplaytional Therapist)
✨ and MORE!

Registration is open now (link the comments) and it's free to attend, with the option of upgrading to an all-access pass to get early access to select sessions, bonus content, and session replays.

The proceeds from our summit are funding the development of our app as we continue to work tirelessly towards increasing affordable access to care and information for neurodivergent families.

So save your seat today! This is one summit you do NOT want to miss!!

Beyond excited to announce that our submission for the 2026 AOTA conference has been accepted. Cannot wait to be a part ...
09/16/2025

Beyond excited to announce that our submission for the 2026 AOTA conference has been accepted. Cannot wait to be a part of this OT powerhouse group of minds! Seriously, if you don’t know Greg Santucci, Occupational Therapist, Kelly Mahler and Bryden Carlson-Giving you should fix that immediately.

I'm going to Disneyland!

I actually got emotional when we got the acceptance letter. I am both honored and THRILLED to be presenting with Kelly Mahler (Interoception Curriculum), Bryden Carlson-Giving (Neurodiversity-Affirming Occupational Therapy) and Tracey DeMaria, Occupational Therapist (How To Surf the Waves) at the AOTA National Conference in Anaheim, California, April 23-25, 2026.

Workshop Title: Belonging Over Compliance: Reimagining Occupational Therapy’s Role for Neurodiversity-Affirming, Inclusive Schools

In addition to spreading the word about neurodiversity-affirming care, my goal is to 1) pack our workshop room and 2) fill an entire boat at It's A Small World with OTs.

Hit the ♥️ button if you want to be in that boat! 🤣🤣🤣

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Easton, PA

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