Wednesday, February 18, 2015

What I Have Learned About Feeding Therapy in the Last Year

For those of you that do not regularly follow my blog, let me give you a little background on myself. My first job out of grad school was in a school setting. I always knew that I wanted to be a school based therapist because I love the school setting. I spent 4 years there until my daughter came along. Luckily in our field, we have many options for work settings. I decided that private therapy was the best option for our family because it allowed me more time with my daughter while still getting to do what I loved. However, being a therapist in a school setting, I was not exposed to many types of therapy, feeding therapy being one of them. Over the last year I have been working with patients that have feeding disorders. This was not an area that I thought I would ever like to practice in, but guess what, I really enjoy it. I wanted to share some things that I have learned through experience over the last year providing feeding therapy because, let be honest, this is not a subject that is touched on enough in grad school. I feel like the things I have learned over the last year can be very helpful to parents dealing with picky eaters at home, which is what this post is all about!
 Before I get started, I want to make a small disclaimer: I am not by any means an expert or feeding therapy pro. I am still learning and have lots of training to complete. Also, I have been working with children that demonstrate feeding aversions.  All children with feeding concerns should be evaluated by a professional to make sure they are able to safely eat. 
The child pictured in this post is my daughter. Please do not copy or use these photos without permission. Last but not least, Amazon Affiliate links are provided in this post for your convenience. 
#1: Feeding Therapy is More than Just Eating!
When you are working with a child that has a feeding disorder, you can't just jump in and expect them to take food from you because you said so or because you will reward them with a sticker. You have to make the child comfortable with food- even to the extent of just being in the same room as certain foods.
Therapy needs to be fun! Color pictures of food. Make food out of Play-Doh
Try incorporating plastic or wooden food into your sessions. Have your child pretend to feed his favorite teddy bear. Contrary to what we all learned growing up, it is OK to play with your food!! 
#2: Patience and Baby Steps are Key!
I have learned that feeding therapy is a marathon type of therapy. Unfortunately, parents are usually so incredibly stressed and worried about their child when therapy first begins. They want immediate results, but it is so important to stress to them that this is a slow process. Like I said earlier, with many children, you just need to make them feel comfortable being around food first. Start with simply touching the food, then moving it to another bowl, followed by giving a piece of food a kiss. All of this may take weeks before the child is comfortable enough to even take a lick or small bite of the food.
Baby steps. 
#3: Bye Bye Bowls and Happy Bowls!
It's very important for kids to trust you when introducing new foods. Having a "bye bye bowl" on the table is so helpful. Once a food is placed into the "bye bye bowl" the child does not have to touch the food again. This is a great way to get the child to make contact with a new food yet trust that you are not going to make them eat it. Tell him that if he licks the food, he can then put it in the "bye bye bowl." This will lower pressure in a stressful situation for the child.
Now "happy bowls" are another story! I like to present small amounts of different foods to my patients in separate bowls. If the child finishes all of the food in one of the bowls, it is a "happy bowl!" Celebrate this happy bowl like it is New Years Eve and the ball just dropped! Happy bowls have been huge motivators for my kiddos, but this is something that gets worked up to after the child is beginning to accept a variety of foods and you are working on increasing the quantity. 
#4: Give the Child Some Control in Their Meal Choices
I have an awesome FREE app on my iPad called Sounding Board that I normally use as an AAC tool with my non-verbal kids in therapy. I have used this app with my feeding kiddos with great results. Take pictures of food options that are readily available and let him/her choose what he/she wants to eat. This way the child feels like he/she has some control over the situation and is more likely to eat what they chose rather than what you put in front of them. 
#5: Food Chaining is AWESOME!
Have you heard of the food chaining theory? I bought the book, Food Chaining: The Proven 6-Step Plan to Stop Picky Eating, Solve Feeding Problems, and Expand Your Child’s Diet
 after it was recommended to me by another therapist when I was struggling with getting one of my young patients to try any new foods. This book was written by a team of doctors, SLPs, and OTs. It's based on the theory that you find a similar characteristic in the food(s) that the child already eats to introduce new foods. I learned so much from this book and highly recommend it! 
#6: Parent Support is a MUST!
It doesn't matter how much success you have in a therapy session if the parent will not continue what you are doing at home. All therapy is important for parental involvement, but feeding therapy is critical. Many of these children are underweight and malnourished. It is so important for parents to be involved in the therapy process so they can see what you are doing and how to carry over the consistency into their homes. Also, explain to the parents that food should be something that the child sees more frequently than just in the high chair. Taking their child to the grocery store is a great way to let them help choose their own food and get more exposure. Let him/her help with the cooking. Getting the ingredients out of the fridge, mixing the ingredients together in a bowl, and even setting the table. The more fun you can provide in the whole feeding process, the better it will be for both the parent and the child.

2 comments:

  1. Thanks for sharing these great tips, Kristin!! I've always felt like feeding therapy would be so cool to do, though I haven't gotten the opportunity yet.

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    1. Thanks Lauren :) It's definitely a different but I do enjoy it! Very rewarding when you are able to help keep a child off a feeding tube!

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