Everyone knows Eric Carle’s story of the “very hungry caterpillar.” He wakes up, begins to eat everything in his path, without complaining, until he decides he’s ready for a nap, curls up in his cocoon, and then transforms into a beautiful butterfly. This ideal eat/sleep/wake scenario embodies every parent’s wish!
Unfortunately, families receiving services for their child with feeding challenges usually won’t enjoy this simple routine. The family may deal with a lack of finances that limits the variety of foods presented during meals. Perhaps, the child was diagnosed with a feeding disorder. Or perhaps sensory issues prevent a child from enjoying a variety of food textures and tastes.
For speech-language pathologists providing early intervention for feeding issues, a key to reaching goals involves treating the whole child. A lack of nutrition or other feeding difficulties can affect several different areas of development, from fine and gross motor to social skills. Children might also experience focus challenges if they don’t get enough to eat. A child has trouble attending to any task if their belly isn’t full!
As early-intervention speech-language pathologists treating children in the home, we often become families’ first resource. Questions about mealtimes, potty training, negative behaviors and family activities may all be areas of concern for parents. Even SLPs not specifically treating children for feeding disorders can help support parents who stress over mealtimes.
All children need proper nutrition to function throughout the day. Here are three things to keep in mind when offering advice or strategies to parents.
Understanding the family’s priorities during each session, empowering parents through positive feedback and celebrating each milestone allows SLPs to offer support in various areas for families. Development is a process and should be taken one bite at a time.
April Anderson, MA, CCC-SLP - National Speech/Language Therapy Center
This article is originally published on The ASHA Leader Blog, January 17, 2017
The struggles of a parent during mealtime with a picky eater can range from bad to worse. It often begins with the ever-present protest of “No!” then ends with screaming, tantrums and food flying across the room. The question remains: is the food refusal normal of a picky eater or could the signs be more consistent with a feeding disorder?
A pediatric feeding problem is often accompanied by a developmental delay or medical disorder. These can include, but are not limited to, autism spectrum disorders, Down syndrome, gastrointestinal motility disorders, cerebral palsy, respiratory disorders or cystic fibrosis.
Children who were hospitalized for an extended time at birth or who received a tracheotomy or feeding tube may also have difficulty transitioning to an age appropriate feeding pattern. However, children who are considered typically developing can also develop a fear of food. Research shows that 25 percent of children suffer with some degree of a feeding disorder. In children who suffer from a developmental, neurological or genetic disorders, that number rises to 80 percent (Branan & Ramsey, 2010).
A feeding disorder is characterized by any difficulties eating or drinking including chewing, sucking or swallowing. Children who have not developed age appropriate feeding skills and/or have a genetic, developmental or behavioral disorders can have difficulty during mealtime.
Some signs and symptoms of a problem feeder include:
In order to better treat children with feeding problems, it is important to understand those children who do not meet the criteria. Children who are picky eaters present with the following signs and symptoms (Toomey 2010; Arvedson 2008):
Although mealtimes with either issue can be difficult for parents, distinguishing between the two helps SLPs create the best individualized treatment approach.
Once a professional diagnoses a child with a feeding disorder, there are three key concepts to remember:
Treating a child with a feeding disorder is a challenging but rewarding task. The end goal of treatment should always be a safe, happy and healthy eater.
April Anderson, MA, CCC-SLP - National Speech/Language Therapy Center
This article was published on ASHAsphere on January 8, 2015
Does your child love receiving high fives, tickles, hugs, or stickers for doing a great job? Positive reinforcement is a great way to motivate kids and make them feel good for working hard and accomplishing a goal.
Wouldn't it be great if your toddler requested more carrots at dinner? This is where reward charts step in. Using a chart is a easy way to track goals and get kids to develop new healthy eating habits. Chore and behavior charts have long been in existence, so here are some tips to incorporate healthy eating goals into them.
1. Use a chart that the child understands. Young children like to color and add stickers. Older kids may earn points that they can trade in at the end of the week.
2. Reference the chart during the day, and have it somewhere that is visible during times other than dinner. The key to this is to have your child look forward to meals.
3. Start where the child can be successful. Maybe he first needs to work on tolerating new items on his plate, passing the bowl of peas at dinner, or just taking one bite of a new food. Starting slow will allow him to get excited and remain motivated when the tasks become more difficult.
4. Make the rewards worth it. Maybe your child is working for dessert, an extra 10 minutes of TV before bed, or to go to the pool at the end of the week. Identifying larger rewards (especially for older children) will allow you to promote good behavior over an extended time.
5. Have fun! Let your child choose his own chart based on his favorite story book character or animal that week. Get creative and add drawings, pictures, or stickers. Make a larger than life chart on a poster board or chalk board for the whole family to see.
Continue to let your child know how proud you are of them and what a good job they are doing after tackling each goal. They will continue to look forward to high fives and hugs, as well as want to show off their chart to everyone that comes visit.
I find all of my charts at www.freeprintablebehaviorcharts.com. I love that they have so many to choose from and you are able to type goals right into the chart before printing! Attached below are some examples to get you started!
April Anderson MA, CCC-SLP
The Feeding Clinic at National Speech
On many TV shows we see the mom in the kitchen alone cooking dinner for her family. When she is all done she yells "Dinner!" and her family comes running. Typically, she will get the question "Mom, what's for dinner?" However, getting kids interested in the preparing and cooking of dinner can help not only build their language skills but their motivation to try new foods. Here are some tips to get kids involved in the kitchen.
The mealtime possibilities are endless. Remember, dinner is another opportunity to talk about food and where it comes from, as well as spend precious time with your child.
Have a little one at home? Attached are some fun pre-dinner coloring sheets they will love courtesy of Nourishinteractive.com.
A fun weekend craft the whole family can enjoy! This serves as a great protein snack (for our friends without a nut allergy).
What you will need:
This recipe was adapted from: coffeecupsandcrayons.com
Recently I discovered Tiny Tastes, an amazing app ($1.99 on the app store). It’s a very colorful and animated app, and tells the story of a kangaroo named Tiny who ventures out of her house for the first time. During the story, the user helps Tiny meet new friends and explore new places. At the end of the story, Tiny has worked up an appetite and asks the user to share some of their food with them. This is where the fun begins. The app allows you to take a picture of the child’s food or drink, and Tiny will eat the same thing right along with them. The amount of time allotted is set with a timer, and throughout the meal, Tiny’s food slowly disappears. She also makes chewing noises and comments such as, “mmm” and “This is good.” At the end of the meal, the adult can decide if the child ate enough to earn coins to go to the shop to purchase materials for mealtime or for the story.
Why is this a good app for a picky eater?
If you are looking for ways to extend mealtime or are hoping to have your child try new foods, give Tiny Tastes a try! I’d love to hear how you used it in your household!
For more information on this app, visit Tiny's website.
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