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A large number of young people with subtle neuro-developmental difficulties are referred to child
and adolescent mental health services each year due to concerns about emotional and behavioural
problems. Whilst they often fail to meet the strict diagnostic criteria for a particular diagnosis, these
young people present with substantial elements of ADHD, Autism, Dyslexia, Dyspraxia, OCD and Tics.
The difficulties which these young people experience relate predominantly to the way in which
they process complex sequences of internal and external information. This includes their processing
of somatic sensations including taste. Young people with subtle processing problems therefore often
struggle with unhealthy eating and obesity.
One difficulty is their tendency to fussy eating. They often have a very limited food repertoire,
do not like different food items touching on their plate or having any sauces on their food. The other
difficulty is their limited ability to track body sensations including feelings of hunger or satiation.
Children with subtle processing problems can therefore be much focussed on specific brands, often
foods that are highly processed. They tend to eat impulsively, both in terms of volume and when they
want to eat. In addition, as they struggle to conceptualise feelings of fullness, they tend to eat by sight or
according to the amount of food available.
This paper therefore explores how young people with subtle neuro-developmental difficulties
find issues around eating and food confusing and overwhelming, which then acts as a foundation for
childhood obesity and lifelong habits of unhealthy eating.
Biography
Samuel Stein is an Attending in Child, Adolescent and Family Psychiatry. He graduated from the University of
the Witwatersrand Medical School in 1986, and undertook his psychiatry training in Oxford, Cambridge and at St.
Mary's Hospital in London. Prof Stein is a Fellow of the Royal College of Psychiatrists and has edited several books
including:
Disorganized Children
. He is also a Visiting Professor at the Institute for Health Research at the University
of Bedfordshire and the Post-Graduate Medical Institute at Anglia Ruskin University. Prof Stein has a commitment to
service-oriented research and many of his initiatives have been implemented nationally as examples of accessible and
effective good practice.
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