By Dave DeFusco
When Vanessa Murad graduates this May from the Katz School鈥檚 Occupational Therapy Doctorate, she鈥檒l be giving families something many have been searching for: a lifeline. For parents of children with Avoidant Restrictive Food Intake Disorder (ARFID), her capstone research provides clear, compassionate guidance for a condition that is often misunderstood, isolating and difficult to navigate.
Murad鈥檚 鈥淧arent & Caregiver Guide to Avoidant Restrictive Food Intake Disorder (ARFID)鈥 draws on a needs assessment of 33 occupational therapists who work directly with children with ARFID. 鈥淚 had 100% of participants say that a guide like this is needed and doesn鈥檛 exist,鈥 she said. 鈥淭hat was a huge validation.鈥
ARFID, officially added to the fifth edition of Diagnostic and Statistical Manual of Mental Disorders in 2013, is characterized by restrictive eating that is not driven by concerns over body image. Instead, it typically presents in three ways: sensory sensitivities to different textures or smells, fear of adverse consequences, like choking or vomiting, or lack of interest in eating or food. Its complexity鈥攁nd the relative lack of research鈥攎eans many families are left navigating it with limited support.
鈥淚鈥檝e always loved feeding therapy,鈥 she said, 鈥渂ut when I learned about ARFID, I kept choosing it for every research project I could.鈥
The project also reflects a key collaboration with Anne Sinha, an occupational therapist specializing in ARFID whom Murad met at a national conference. Sinha鈥檚 experience helped translate theory into practice.
鈥淭here鈥檚 not a lot of research鈥攎aybe 20 articles that connect occupational therapy and ARFID,鈥 said Murad, 鈥渟o a lot of what we included comes from clinical trial and error鈥攚hat鈥檚 actually worked with kids.鈥
At the heart of Murad鈥檚 work is the perspective of occupational therapy itself, a discipline uniquely positioned to address feeding challenges. Rather than focusing solely on food intake, occupational therapists analyze the entire mealtime experience: the child鈥檚 sensory system, emotional responses, physical positioning and environment.
鈥淲e break down big, overwhelming problems into manageable parts,鈥 said Murad. 鈥淭hat鈥檚 what helps families move forward.鈥
Her guide translates that philosophy into actionable strategies. One of the most important, she said, is maintaining neutrality at the table. Caregivers are encouraged to keep a calm voice and neutral expression regardless of whether a meal goes well or poorly. 鈥淚f you react strongly, children start to associate eating with that reaction,鈥 said Murad. 鈥淣eutrality builds trust and reduces pressure.鈥
Other recommendations focus on creating predictability and safety. Parents are encouraged to consistently include 鈥減referred foods鈥濃攊tems a child feels comfortable eating鈥攚hile gradually introducing new ones. The approach is gentle and incremental, allowing children to explore unfamiliar foods without fear. For those with sensory challenges, even small adjustments, like adding a crunchy food to help with swallowing or providing a weighted object for focus, can make a meaningful difference.
To ensure her guide resonated, Murad tested it beyond the clinical world. She shared drafts with family members unfamiliar with ARFID, refining the language until it was clear, approachable and reassuring. 鈥淚t has to be easy to understand,鈥 she said. 鈥淵ou don鈥檛 want it to feel overwhelming or scary.鈥
That emphasis on empathy carries through to her broader outlook. Progress, she said, is rarely linear. Families may see setbacks alongside successes, and patience is essential. 鈥淚t鈥檚 about trusting your child and staying consistent,鈥 she said. 鈥淲ith support, meaningful change is possible.鈥
