Tracey DeMaria, Occupational Therapist

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

Think like an OT: modify a favorite leisure activity (sunbathing) so it’s safe for the skin 😂Image description: Person l...
08/20/2026

Think like an OT: modify a favorite leisure activity (sunbathing) so it’s safe for the skin 😂

Image description: Person lying in a recliner chair outside covered in multiple towels.

So excited for people to hear this panel discussion! ❤️ link for the Summit in comments!
08/18/2026

So excited for people to hear this panel discussion! ❤️ link for the Summit in comments!

What a panel! We recorded some bonus content for the Think Sensory Summit! Bryden Carlson-Giving, Kelly Mahler, Tracey DeMaria, Occupational Therapist and myself talked about OTs role in Mental Health in the Schools! We identified the problem, the opportunity and offered some really empowering solutions!

Link in the comments to get the all access pass!

Thank you to my friends for such an amazing dialogue. Ya'll make me smarter!

Excited to be part of this wonderful educational summit again! Stay tuned for more details!
07/22/2026

Excited to be part of this wonderful educational summit again! Stay tuned for more details!

We are BACK and BIGGER THAN EVER!! Today, we're officially announcing our 2ND SUMMIT! The Think Sensory Summit is a FREE neurodiversity-affirming virtual summit for therapists, educators, parents, and anyone else supporting neurodivergent youth.

This year's sessions are co-hosted by Greg Santucci, Occupational Therapist, and Mick The Occuplaytional Therapist, and our speaker lineup is UNBELIEVABLE. We're still pinching ourselves over the amazing multi-disciplinary group of experts joining us this time around.

✨ Alfie Kohn
✨ Dr. Barry Prizant
✨ Dr. Ross Greene
✨ Kelly Mahler
✨ Jac and Amy
✨ Jessie Ginsburg
✨ Chris Wenger
✨ Maria Davis-Pierre
✨ Kristy Forbes
✨ Dr. Destiny Huff
✨......AND MORE!!!

Registration is open now (Leave us a comment and we'll DM you the link to register!) It takes 30 seconds to sign up, it's completely free to attend, with the option of upgrading to an all-access pass for early access to select sessions, bonus content, and session replays (and access to season one).

Last year, more than 24,000 of you joined us!! So we're leveling up! This year, we’re adding another full day of sessions, bringing together an even bigger group of speakers, and creating what may be one of the most ambitious neurodiversity summits of its kind.

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

07/16/2026

Such an honor to contribute to the amazing project Kelly Mahler put together to support the importance of moving away from focusing on compliance with children. It’s all about relationships.

07/10/2026

My friends are such amazing humans Kelly Mahler Bryden Carlson-Giving

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

Address

Easton, PA

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