Does My Child Have ARFID? A Guide for Parents in Wayne, Villanova, and Devon Looking for Specialized Therapy

Written by Dr. Colleen Reichmann, owner and clinical director of Wildflower Therapy

If you're reading this article, there's a good chance you've spent years worrying about your child's eating. Maybe your child eats fewer than ten foods. Maybe family dinners have always been unpleasant, but lately have become an almost unbearable ordeal. Perhaps you've heard comments like, "They're just a picky eater, kids grow out of it" even though deep down, you know this is something different.

Or perhaps your child recently completed treatment through CHOP's ARFID program, and you're now searching for a truly specialized outpatient therapist in the Main Line area who understands avoidant/restrictive food intake disorder (ARFID).

If any of this sounds familiar, you're not alone.

At Wildflower Therapy, with offices in Philadelphia and Devon, PA, we are experts in helping children, adolescents, and families navigate ARFID recovery with compassion, expertise, and evidence-based treatment. We regularly work with families from Wayne, Villanova, Radnor, Bryn Mawr, Malvern, and surrounding Main Line communities who are looking for highly specialized outpatient support for their child's eating disorder recovery.

What Is ARFID?

Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterized by significantly restricted eating that is not driven by a desire to lose weight or change body shape.

Children and adolescents with ARFID may restrict their eating because of:

• Sensory sensitivities related to taste, texture, smell, temperature, or appearance

• Fear of choking, vomiting, allergic reactions, or gastrointestinal distress

• Low interest in food or eating

• Anxiety surrounding meals or new foods

• Neurodivergence, including ADHD or autism spectrum conditions

Unlike more commonly recognized eating disorders such as anorexia nervosa, children with ARFID are not typically motivated by body image concerns (although the most up to date research we have does suggest that body image concerns can slowly begin to develop in these children, even when the crux of their struggle is not in this arena). ARFID can have profound impacts on physical health, emotional well-being, social functioning, and family life.

Is It Just Picky Eating, or Could It Be ARFID?

One of the questions we hear most often from parents in Wayne, Villanova, and Devon is:

"How do I know if this is normal picky eating or something more serious?"

While many children experience phases of selective eating, ARFID often looks different.

Signs that your child may have ARFID include:

• Eating fewer than 20 foods

• Eliminating foods over time rather than expanding their diet

• Experiencing significant anxiety around meals

• Avoiding birthday parties, sleepovers, camps, or restaurants because of food concerns

• Difficulty maintaining growth or nutrition

• Family meals becoming highly stressful

• Panic, gagging, or distress when presented with new foods

• Avoidance around eating due to fear of adverse consequences, like vomiting or stomach pain.

• Dependence on supplements, nutritional drinks, or a very limited number of "safe foods"

Parents often tell us:

• "We've tried everything."

• "Our pediatrician wasn't worried because growth looked okay."

• "No one seems to understand how severe this is."

• "We spend every meal negotiating."

• “She’s always been picky, but in the last few months she’s actually started to lose weight so now we’re getting concerned.”

If this sounds familiar, you are not alone. ARFID is a very tricky, very amorphous, and highly misunderstood eating disorder. Parents often find themselves struggling with questions for months or years without any guidance. And in fact, SO many parents end up calling us after researching and finding this diagnosis themselves (vs having a pediatrician or another therapist suggest it.)

Why Is ARFID So Common in Neurodivergent Children?

If you’ve been doing a lot of googling, you probably already know this-many, many children with ARFID are also neurodivergent.

At Wildflower Therapy, we frequently work with children and adolescents who have ARFID alongside of:

• ADHD

• Autism spectrum conditions

• Anxiety disorders

• OCD

• Sensory processing differences

• Twice exceptional profilesn

For many neurodivergent children, food isn't simply a preference. Food experiences may involve genuine sensory overwhelm, heightened anxiety responses, interoceptive differences, or fear-based avoidance.

This is why approaches that rely on pressure, punishment, bribery, or "they'll eat when they're hungry" often backfire and increase distress for everyone involved. (They are also frankly dangerous for neurodivergent kiddos, as typical pressure techniques to eat more likely results in extended periods without eating at all, vs “caving” and eating non preferred foods.)

Our approach at Wildflower is gentle yet firm, neurodiversity-affirming, trauma-informed, and individualized to your child's specific experience. The psychotherapy that we tailor to ARFID often involves exposure-based techniques, parent coaching, AND talk therapy about what is going on underneath your child’s relationship with food that is feeding into their actual eating behaviors and tendencies.

My Child Completed CHOP's ARFID Program. What Happens Next?

Many of the families we work with come to us after receiving treatment through the Children's Hospital of Philadelphia (CHOP) Eating Disorder Assessment and Treatment Program. CHOP's behavioral and family-based approaches provide critical support during acute phases of treatment, but many families benefit from continued outpatient therapy afterward.

Common concerns we hear from parents after CHOP include:

• "We made progress, but we're afraid of losing momentum."

• "Our child is eating more, but the anxiety is still intense."

• "We need ongoing support closer to home."

• "We're exhausted and want help maintaining recovery."

• "Our child still struggles socially because of ARFID."

The transition from intensive treatment to outpatient care can feel both hopeful and scary.

At Wildflower Therapy, we understand that discharge from a higher level of care doesn't mean recovery is finished. In fact, this period is often when families need specialized outpatient support the most.

We frequently provide step-down outpatient therapy and have in-person spaces in Devon and Philadelphia for the children and adolescents who may benefit from in-person sessions. We are very experienced in providing guidance for families who have children and adolescents transitioning from:

• CHOP's outpatient, intensive outpatient, or partial hospitalization programs

• Hospital-based feeding programs

• Residential eating disorder treatment programs

• Other specialized ARFID treatment settings

We also strongly believe in collaborative care and regularly coordinate with pediatricians, psychiatrists, dietitians, schools, and prior treatment teams when families desire this approach.

What Does Therapy for ARFID Actually Look Like?

Parents are often relieved to hear that ARFID treatment does not involve shaming, forcing, or blaming.

Instead, treatment may involve:

Parent coaching and family support

Parents play a critical role in helping children recover from ARFID. We help parents learn strategies that reduce conflict while increasing support and confidence.

Anxiety treatment

Many children with ARFID experience significant anxiety surrounding eating, bodily sensations, or new experiences. We utilize evidence-based approaches to help children gradually build tolerance and confidence. We also focus on building very strong, caring relationships in order to be a truly meaningful “third space” adult in your child’s life. We feel so strongly that children and teens working with us should feel how much we care about and truly like them.

Exposure-based interventions

Carefully planned and collaborative food exposures can help children expand flexibility while reducing fear and avoidance.

Sensory support

For children with sensory-based ARFID, treatment focuses on increasing comfort, flexibility, and tolerance without invalidating sensory experiences.

Neurodiversity-affirming therapy

We work with children as they are-not as someone else thinks they should be.

Finding an ARFID Therapist in Wayne, Villanova, Devon, (or the Main Line area in general)

Finding an outpatient therapist who truly understands ARFID can be difficult.

Many therapists treat anxiety generally but have little experience treating eating disorders. Others treat eating disorders but have limited training in ARFID specifically. Other still are trained in anxiety, eating disorders, but are not comfortable working with young children or adolescents.

At Wildflower Therapy, our clinicians do not just “work” with people with eating disorders. We truly specialize in this area, and we all have experience working across every level including higher levels of treatment. We are also highly skilled in anxiety interventions, and have specific training working with kids as young as five, all the way up to adults.

We provide therapy that is:

• Evidence-based

• Health at Every Size®-informed

• Neurodiversity-affirming

• LGBTQIA+ celebratory

• Trauma-informed

• Family-centered

We see children, adolescents, young adults, and families in person at our Devon office, our Philadelphia office, and virtually throughout Pennsylvania.

You Do NOT Have to Figure This Out Alone

If your child struggles with ARFID, selective eating, sensory eating challenges, or anxiety around food, there is hope.

Whether your family lives in Wayne, Villanova, Devon, Radnor, Bryn Mawr, Philadelphia, or elsewhere on the Main Line, our team at Wildflower Therapy would be honored to help support your child's recovery journey.

If your child has recently completed treatment through CHOP's ARFID program and you're looking for specialized outpatient therapy, we're here to help.

Recovery is possible. And neither you nor your child have to do it alone.

To learn more about ARFID treatment at Wildflower Therapy, schedule a free consultation call through our website at wildflowertherapyllc.com.

Looking for Eating Disorder Therapy?

At Wildflower Therapy, our clinicians provide compassionate, evidence-based treatment for children, adolescents, adults, and families struggling with eating disorders (including ARFID, anorexia, bulimia, binge eating disorder, and exercise addiction), body image concerns, and related challenges.

Our therapists also support children, teens, adults, and families who are navigating things like ADHD, anxiety, depression, OCD, and maternal mental health/infertility.

We provide therapy in-person in Philadelphia or Devon (and virtually for anyone in Pennsylvania, New Jersey, Delaware, Florida, South Carolina, Vermont, Virginia, Ohio, and Massechusetts.)

Again, you do NOT have to do this alone. If you’re concerned about your child’s relationship with food, reaching out for a free consultation call the Wildflower director (that’s me! Dr. Colleen Reichmann) is an important next best step!