The Not So Hungry Caterpillar: Supporting Families' Feeding Issues in Early Intervention

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.

1. Understand each family’s priorities. Some parents want to simply see their children eat larger quantities of food, while others worry about variety or more fruits and vegetables. Families’ priorities might also include reducing existing behaviors before implementing other strategies. By meeting a family on their level and assisting them with their immediate needs, families are more likely to try implementing our strategies between visits.
2. Empower parents to tackle goals between visits. Often in early intervention, parents feel like they just mark time between visits. Empowering parents through session participation, guided feedback and practice opportunities allows them to take control of mealtimes. This also gives them the confidence to try new approaches. If the child completes a task only for you, parents can get discouraged and feel that they cause the issues. Coaching parents through techniques and allowing them to practice during sessions creates situations for positive reinforcement.
3. Celebrate small victories. Children receiving early intervention services can experience positive changes every day. Paying increased attention to a new food, talking about it, or taking a lick of a it are all small steps toward a big goal. Demonstrating each achievement to parents provides cause for celebration and helps them stay motivated to help their child reach the goals. Celebrating the milestones their child achieves as they wind their way through the developmental stages can be helpful in allowing the parents to have a better understanding of the progress their child is making.

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

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