AFRID - GP appointment - suggestions needed

[Hufflemuff]

Just that really. We have a GP appointment to discuss my DD, 11 (year 6) issues with food. Its definitely Arfid IMO.

What resources should I take to the meeting, what referrals should I be asking for. I don't want to be fobbed off.

I have a letter from the school which I am going to take. The school were very good at providing this. Basically DD won't eat at school at all now, she refuses to enter school hall as the smells and sight of food really makes her feel uneasy. She has a big breakfast, but she's not eating all school day long. So her mood dips and she's snappy in afternoon's (hangry). I'm hoping this will impress the seriousness onto them.

I'm thinking I'll also write out a food diary of 7 days of food. Which should demonstrate how repetitive and unhealthy the food choices are.

Ultimately I'm praying for a referral to propper therapy. She can't live her whole life like this, even she gets upset about how limited her food choices are and wants to change/sees it as a problem she can't control 😪

Even just the smells make her uncomfortable? Is there anything else going on besides possibly ARFID? ARFID usually doesn't mean avoiding food completely for a long period of time/fasting. Your kid should still be able to eat during school, even if it's just her usual things... Are you not sending a lunch with her of things you'll know she'll eat?

There might be something else going on as well as/besides ARFID if she can't eat at school at all, not even her safe foods your pack for her.

I think your child may need assessments before diagnosis and therapy for it, definitely put forward your ARFID suspicions, but remain open for other possibilities. Don't gun straight for the therapy, as you may be missing something major without proper exploration.

I think the best thing you can do is write down all what you have noticed about your child, including the food diary, with no bias towards one particular diagnosis. Definitely mention she won't eat for hours, and your child's reasoning why. Might want to get your child to talk about what she does eat, where she does eat, and why she's OK to do that too - that will make a difference.

It’s a good idea to take a 7 day diary, but show food offered, food eaten, and quantity of food eaten (to show her diet isn’t only poor because you aren’t “bothering” to offer a healthy diet). Include drinks too.

Also maybe write a complete list of every food she will accept, to show that it is limited.

Also write down other ways in which it affects her life - does it stop her doing things socially? How does she react to food being around her? Can she sit at the table with you at home? Is it a sensory response, or a fear response? How does it impact family life? Does it affect taking medicine too? Will she take supplements? Has it impacted her physical stamina or capacity for exercise or energy? Do you try to encourage her to eat/eat more? Or does this make it worse?

The likelihood is, they will only care if she is very underweight or losing weight, and lots of the ARFID pathways (of which there aren’t many) will refuse her if she is a healthy weight, or nearly so, but one of the ARFID criteria is that it is severely impacting the person’s life I believe so it’s worth proving this too.

You could ask for a referral to a diatician too - the techniques they suggest for increasing foods accepted often won’t work for ARFID and can be more traumatic, but they can at least run through what nutrition she is gaining/missing from her usual diet and sometimes that can be reassuring that it’s not as bad as you think.

In reality, there’s not much help out there unless you are very lucky with where you live, but it can be helpful to have it in writing in case you need to try to get further accommodations at school or something.

Also just to add, my son also doesn’t eat at school at all, no matter what safe foods we provide, and no matter how hungry he is. There’s really no hard and fast rule.

ARFID also often occurs alongside other types of ND - not always, but it is worth considering if you think there is more going on as if she needed for example an ASD assessment you’d want to get on the list asap!

Some children with SPD or ARFID wouldn’t be able to eat in a busy school dining room.
The noise, sights smells etc would lead to sensory overload. For some even eating in close proximity to others at home is an issue e.g.watching or listening to others eat.
Have you spoken to school about a quiet space for her to eat? I know she’d need supervising.

As a PP has said there’s not much help available even now. There’s a FB group and I’d recommend any books by Dr Gillian Harris and Dr Elizabeth Shea. They are Clinical Psychologists and experts in this area. Most dieticians don’t have the expertise.

Sorry to drip feed, she is on the list for an ADHD diagnosis - which she absolutely has 100% she is also awaiting an Autism assessment but I don't think she has that. They only put her forward for that because of the eating and also she had issues with chronic constipation in years 1-4 at school - but it wasn't from withholding or fears etc... they literally just put in for the assessment because they said its better to be on the list than not be on it.

School would let her eat in classroom quietly but she doesn't want to. At home she prefers to leave the room if we are eating something smelly like a curry. In a restaurant if she's done; she wants to leave immediately because the feeling of being full and having to sit down is like unbearable for her.